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Guidelines on Safety and Sedation During Endoscopic Procedures

September 2003

This report was originally published in 1991 and has been updated by Dr Robin Teague on behalf of the Endoscopy Section Committee of the British Society of Gastroenterology

Introduction

There has been considerable progress in sedation practice during endoscopic procedures since the last guidelines were published over 10 years ago. Audits by Daneshmend 1991, Quine 1995 and Bowles 2001 revealed that the culture has changed substantially from that of the late 1980's and early 90's. However, there is no room for complacency, and at the time of writing there is no evidence to suggest that the 30 day mortality of 1:2000 reported by Quine (1995) has improved significantly. This may be partly explained by the almost total lack of structured training in safe sedation across the profession. A recent report has again highlighted the problem and suggested that each hospital nominate two Consultants, one Anaesthetist and one a user of Sedation (usually a Gastroenterologist) to collaborate in the local implementation of guidelines and the provision of a specialist service for patients with particular problems.

The guidelines below have been mainly drawn from the Recommendations for Standards of Sedation and Patient Monitoring during Gastrointestinal Endoscopy, published by the Endoscopy Section Committee Working Party . The report of the Working Party on guidelines for Sedation by Non-anaesthetists, published by The Royal College of Surgeons of England, June 1993, and Implementing and ensuring safe sedation practice for healthcare procedures in adults, the report of an intercollegiate working party chaired by the Royal College of Anaesthetists 2002. Where possible the original wording of the documents has been retained and the documents updated

The following BSG publication may also be of interest: