By Peter B. Cotton
Crucial new name within the complex Digestive Endoscopy seriesAdvanced Digestive Endoscopy: perform & security presents a pragmatic guide on tips on how to practice innovations properly and successfully so as to maximise price, and to lessen dangers. basically established, it covers education, endoscopy and imaging apparatus, an infection regulate, sufferer coaching and tracking, issues and the way to prevent and take care of them. increasing at the content material of Peter Cotton’s best-selling sensible Gastrointestinal Endoscopy, this instructive quantity includes details and instructions on all points of the perform of endoscopy, and is a perfect significant other for either the trainee and the skilled endoscopist.Key positive aspects include:Written by means of the top foreign names in endoscopy textual content has been expertly edited by way of Peter Cotton right into a succinct and instructive structure provided in brief paragraphs established with headings, subheadings and bullet issues Richly illustrated all through with full-color photos
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Qadeer et al. performed a meta-analysis of 12 randomized controlled trials comparing propofol to traditional sedation. Of the 1162 patients, 634 received propofol and 527 received midazolam, meperidine and/or fentanyl . Hypoxemia and hypotension were used as endpoints. 79). 01). This indicates that, for parameters analyzed, propofol mediated sedation is as safe as traditional sedation for EGD, ERCP and EUS and appears to be safer for colonoscopy. A water soluble prodrug of propofol (fospropofol sodium) has been studied in humans .
Outpatient colonoscopies entail longer procedure times but similar turnover times, with two rooms adequate for maximal endoscopist efficiency. 0 to average risk EGDs in a nonteaching assignment, which we schedule every 15 min—but could just as well list for 10, 12, 18, or 20 min, depending upon the desired pace, documentation requirements, and patient care duties between procedures. 0 (30 min each), and ERCP and EUS procedures, which are always teaching assignments, are assigned a value of ∼5 (75– 80 min each), including room turnaround.
The procedures with the highest percentage of deep sedation assessments were EUS (29%) and ERCP (35%). Multivariate analysis showed that only ERCP and EUS were independent risk factors for deep sedation and not Body Mass Index, sedation dose or procedure duration. 33 Purposeful response after repeated/painful stimulation Intervention may be required May be inadequate Usually maintained No repsonse, event with painful stimulation Intervention often required Intervention often required May require intervention General anesthesia Adapted from Gross JB, Bailey PL, Caplan RA et al.
Advanced Digestive Endoscopy: Practice and Safety by Peter B. Cotton