Comparison of differing sedation practice for upper endoscopic ultrasound using expert observational analysis of the procedural sedation

Journal of Patient Safety
John Michael TrummelGeorge T Blike

Abstract

To compare the quality between 2 commonly used sedation practices for upper endoscopic ultrasound (EUS) by using expert observational analysis of the sedation practice. After institutional review board approval, 50 adults undergoing EUS had videotape observation of the procedural sedation: 25 received benzodiazepine/opiate administered by the endoscopy team as per the standard protocol at our institution, and 25 received propofol administered by a dedicated anesthesiologist. Quantitative analysis of the video was performed using the Dartmouth Operative Conditions Scale (DOCS). The DOCS is a tool previously developed to quantify the adequacy of procedural sedation through an objective measurement of the patient state during the sedation process. In this study, the DOCS was used in a novel way to compare the quality of sedation provided by different sedation protocols. Data were collected on patient demographics, patient and provider satisfaction, efficiency, side effects, and safety measures. Videotape analysis using the DOCS revealed that 52% (13/25) of the standard group exhibited an uncontrolled patient state (significant undersedation and/or oversedation) on 1 or more occasion during their EUS procedure compared with 28% (7/...Continue Reading

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Mar 17, 2011·International Journal of Colorectal Disease·Fen WangWu-Liang Tang
Sep 25, 2012·World Journal of Gastroenterology : WJG·Christian JenssenSiegbert Faiss
Jul 30, 2010·Digestive Diseases and Sciences·Lawrence B Cohen
Dec 19, 2015·Anesthesia and Analgesia·Mark R WilliamsRobert H Dworkin

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