Medical, Political, and Economic Considerations for the Use of MAC for Endoscopic Sedation: Big Price, Little Justification?

Digestive Diseases and Sciences
Basavana GoudraGary R Lichtenstein

Abstract

The last few decades of gastrointestinal (GI) endoscopy have seen phenomenal growth. In many aspects, GI endoscopy has led the field of nonsurgical interventional medicine. In many aspects, this growth is facilitated by advancements in sedation-both drugs and techniques. Unfortunately, the topic of GI endoscopy sedation is also mired in many controversies, mainly emanating from the cost of anesthesia providers. While no one debates their role in the majority of advanced endoscopic procedures, the practice of universal propofol sedation in the USA, delivered by anesthesia providers, needs a closer look. In this review, medical, political, and economic considerations of this important topic are discussed in a very frank and honest way. While such ubiquitous propofol use has increased satisfaction of both patients and gastroenterologists, there is little justification. More importantly, going by the evidence, there is even less justification for the mandated anesthesia providers use for such delivery. Unfortunately, the FDA could not be convinced otherwise. The new drug fospropofol met the same fate. Approval of SEDASYS®, the first computer-assisted personalized sedation system, was a step in the right direction, nevertheless an i...Continue Reading

References

Dec 1, 1965·The American Journal of Digestive Diseases·H E Ticktin, N P Trujillo
Jul 14, 2000·The American Journal of Gastroenterology·G KoshyC S Pitchumoni
Jun 28, 2001·Gastrointestinal Endoscopy·J M NgD Nyam
Mar 27, 2002·The Medical Journal of Australia·Anthony C ClarkeGraham L Kaye
Aug 9, 2003·The American Journal of Gastroenterology·Ludwig T HeussChristoph Beglinger
Mar 16, 2004·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Brian J UlmerDouglas K Rex
Dec 1, 2006·Digestion·S D LadasUNKNOWN European Society of Gastrointestinal Endoscopy Survey of National Endoscopy Society Members
Dec 26, 2006·Biochimica Et Biophysica Acta·Brian K Kobilka
Aug 8, 2007·Gastroenterology·Lawrence B CohenUNKNOWN AGA Institute
May 15, 2008·Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie·Michael F ByrneUNKNOWN Clinical Affairs Committee of the Canadian Association of Gastroenterology
Dec 8, 2009·Gastrointestinal Endoscopy·John J VargoPaul Y Kwo
Aug 30, 2011·Gastrointestinal Endoscopy·James F MartinMichael Gustafson
Apr 12, 2012·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Pankaj Kumar GargVivek Agrawal
Apr 24, 2012·World Journal of Gastrointestinal Endoscopy·Vittorio TerruzziFranco Radaelli
Dec 3, 2013·Handbook of Experimental Pharmacology·Kirsten M Raehal, Laura M Bohn
Jan 9, 2014·Digestive Diseases and Sciences·Basavana Gouda GoudraVinay Chandrasekhara
Jun 12, 2014·Journal of Clinical Anesthesia·Basavana Gouda Goudra, Preet Mohinder Singh
Sep 6, 2014·Saudi Journal of Anaesthesia·Basavana Gouda Goudra, Preet Mohinder Singh
Feb 17, 2015·World Journal of Gastrointestinal Endoscopy·Alexandre Oliveira Ferreira, Marília Cravo
Dec 15, 2015·Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association·Basavana GoudraAmit K Manjunath
May 27, 2016·Endoscopy International Open·Nusrat IqbalIrshad Shaikh
Oct 21, 2016·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Vaibhav WadhwaJohn J Vargo
Oct 4, 2016·International Journal of Health Policy and Management·Andrew J E Harding, Colin Pritchard
Nov 20, 2016·Anesthesia and Analgesia·Basavana Goudra, Preet Mohinder Singh
Jul 20, 2018·United European Gastroenterology Journal·Toshihiro Nishizawa, Hidekazu Suzuki
Mar 29, 2019·World Journal of Gastroenterology : WJG·Takuto SuzukiTaketo Yamaguchi
Jan 10, 2020·Digestive Diseases and Sciences·Basavana GoudraPreet Mohinder
May 11, 2020·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Luca ElliUNKNOWN Digestive Endoscopy team of the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico-Milano
Jun 7, 2020·Gut·Bu'Hussain HayeeJames East

❮ Previous
Next ❯

Citations

Oct 11, 2020·Journal of Gastroenterology and Hepatology·M DoulberisT Kuntzen

❮ Previous
Next ❯

Methods Mentioned

BETA
sedation

Software Mentioned

SEDASYS System
SEDASYS
iData

Related Concepts

Related Feeds

Alternative Complement Pathway

The Alternative Complement Pathway is part of the innate immune system, and activation generates membrane attack complexes that kill pathogenic cells. Discover the latest research on the Alternative Complement Pathway.

Related Papers

Digestive Diseases and Sciences
Basavana GoudraPreet Mohinder
Saudi Journal of Anaesthesia
Basavana Goudra, Preet Mohinder Singh
Expert Review of Gastroenterology & Hepatology
Brijen Shah, Lawrence B Cohen
World Journal of Gastroenterology : WJG
John K TriantafillidisApostolos E Papalois
© 2021 Meta ULC. All rights reserved