Review on sedation for gastrointestinal tract endoscopy inchildren by non-anesthesiologists

• 作者: Claudio Romano Fernanda Barros Jernej Brecelj Jorge Amil Dias Mike Thomson Rok Orel Yvan Vandenplas.
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Gastro-intestinal ENDOSCOPY GASTROSCOPY Colonoscopy SEDATIVES Pediatric ages ANESTHETICS ANALGESICS
• 年，卷（期）: 2015,（9）
• 页码范围: 895-911
• 页数: 17页
• 分类号: R

摘要

AIM To present evidence and formulate recommendationsfor sedation in pediatric gastrointestinal （GI）endoscopy by non-anesthesiologists.METHODS： The databases MEDLINE, Cochrane andEMBASE were searched for the following keywords＂endoscopy, GI＂, ＂endoscopy, digestive system＂ AND＂sedation＂, ＂conscious sedation＂, ＂moderate sedation＂,＂deep sedation＂ and ＂hypnotics and sedatives＂ forpublications in English restricted to the pediatric age.We searched additional information published between January 2011 and January 2014. Searches for （upper） GIendoscopy sedation in pediatrics and sedation guidelinesby non-anesthesiologists for the adult population wereperformed.RESULTS： From the available studies three sedationprotocols are highlighted. Propofol, which seems tooffer the best balance between efficacy and safety israrely used by non-anesthesiologists mainly becauseof legal restrictions. Ketamine and a combination ofa benzodiazepine and an opioid are more frequentlyused. Data regarding other sedatives, anesthetics andadjuvant medications used for pediatric GI endoscopyare also presented.CONCLUSION： General anesthesia by a multidisciplinaryteam led by an anesthesiologist is preferred. The creationof sedation teams led by non-anesthesiologists anda careful selection of anesthetic drugs may offer analternative, but should be in l