Clinical practice guideline for the management of sedation outside of operating room in patients over 12 years
Keywords:
Practice guidelines as topic, Evidence-based practice, Conscious sedation, Deep sedation, Colombia
Abstract
Introduction:
Sedation is a practice frequently used in multiple settings outside the operating room. Currently, it is employed by different interdisciplinary groups. It is imperative to ensure safe, standardized practices and proper training of the personnel involved.
Objectives:
To update available information, create minimum standards of care for performing high-quality sedation procedures based on the best available evidence. These standards lead to safe and effective care practices, reducing unjustified variability.
Materials and methods:
A group of different health professionals with experience in sedation outside the operating room and representatives of scientific and patient societies developed the guideline. Through a non-formal consensus of thematic and methodological experts, the content, scope and objectives, study populations, and questions to be examined were all defined. A systematic review of the literature was performed to formulate the recommendations with graduated levels of evidence in accordance with GRADE methodology.
Results:
A summarized version of the Clinical Practice Guideline with recommendations for the administration of sedation as part of diagnostic or therapeutic procedures outside the operating room in patients over the age of 12.
Conclusions:
The Clinical Practice Guideline presents evidence-based recommendations in order to standardize the procedure, improving the quality of care, and reducing morbidity of patients that require sedation outside of the operating room.
References
1. Youn A, Ko Y, Kim Y. Anesthesia and sedation outside of the operating room. Korean J Anesthesiol. 2015;68:323-31.
2. American Society of Anesthesiologists. Task force on sedation and analgesia by non-anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology. 2002;96:1004-17.
3. Australia and New Zealand College of Anaesthetists. Guidelines on sedation and/or analgesia for diagnostic and interventional medical or surgical procedures; 2014 [citado 28 Mar 2017]. Disponible en: https://goo.gl/IU9Amm.
4. Ehrhardt BS, Staubach KC. A program for education, competency, and quality in procedural sedation. Int Anesthesiol Clin. 2013;51:33-42.
5. Hession PM, Joshi GP. Sedation: not quite that simple. Anesthesiol Clin. 2010;28:281-94.
6. Agency for Clinical Innovation. Minimum Standards for Safe Procedural Sedation Project; 2015 [citado 28 Mar 2017]. Disponible en: http://www.aci.health.nsw.gov.au.
7. Leroy P. Improving procedural sedation and/or analgesia in children: from practice over evidence to practice. Maastricht University; 2012.
8. Vargo JJ, Niklewski PJ, Williams JL, Martin JF, Faigel DO. Patient safety during sedation by anesthesia professionals during routine upper endoscopy and colonoscopy: an analysis of 1.38 million procedures. Gastrointest Endosc. 2017;85:101-8.
9. American Society of Anesthesiologists. Standards & Guidelines, Guidelines for Office-Based Anesthesia; 2015 [citado 28 Mar 2017]. Disponible en: https://goo.gl/cdLvFB.
10. Gillespie B, Chaboyer W, Thalib L, John M, Fairweather N, Slater K. Systematic review and meta-analysis of the effect of the World Health Organization surgical safety checklist on postoperative complications. Anesthesiology. 2014;120:1380-9.
11. Bal BS, Crowell MD, Kohli DR, Menendez J, Rashti F, Kumar AS, et al. What factors are associated with the difficult-to-sedate endoscopy patient? Dig Dis Sci. 2012;57:2527-34.
12. Lee S-Y, Son HJ, Lee JM, Bae MH, Kim JJ, Paik S, et al. Identification of factors that influence conscious sedation in gastrointestinal endoscopy. J Korean Med Sci. 2004;19: 536-40.
13. Brady M, Kinn S, Stuart P, Ness V. Preoperative fasting for adults to prevent perioperative complications. Cochrane Database Syst Rev. 2003;4:CD004423.
14. Manyande A, Cyna A, Yip P, Choo C, Middleton P. Non-pharmacological interventions for assisting the induction of anaesthesia in children (Review). Cochrane Database Syst Rev. 2015;7:CD006447.
15. Goudra BG, Singh PM, Gouda G, Borle A, Gouda D, Dravida A, et al. Safety of Non-Anesthesia Provider-Administered Propofol (NAAP) sedation in advanced gastrointestinal endoscopic procedures: comparative meta-analysis of pooled results. Dig Dis Sci. 2015;60:2612-27.
16. Park CH, Shin S, Lee SK, Lee H, Lee YC, Park JC, et al. Assessing the stability and safety of procedure during endoscopic submucosa dissection according to sedation methods: a randomized trial. PLoS ONE. 2015;10:e0120529.
17. Conway A, Douglas C, Sutherland J. A systematic review of capnography for sedation. Anaesthesia. 2016;71:450-4.
18. Varndell W, Elliott D, Fry M. The validity, reliability, responsiveness and applicability of observation sedation-scoring instruments for use with adult patients in the emergency department: a systematic literature review. Australas Emerg Nurs J. 2015;18:1-23.
19. Park SW, Lee H, Ahn H. Bispectral index versus standard monitoring in sedation for endoscopic procedures: a systematic review and meta-analysis. Dig Dis Sci. 2016;61:814-24.
20. Aboumarzouk O, Agarwal T, Syed N, Chek S, Milewski P, Nelson R. Nitrous oxide for colonoscopy. Cochrane database Syst Rev. 2011. Pubmed Central PMCID: 21833967.
21. Wang D, Chen C, Chen J, Xu Y,Wang L. The use of propofol as a sedative agent in gastrointestinal endoscopy: a meta-analysis. PLoS ONE. 2013;8:e5331.
22. Wakai A, O'Sullivan R, Blackburn C, McCabe A, Reece E, O'Connor G, et al. The use of propofol for procedural sedation in emergency departments. Cochrane Database Syst Rev. 2015;7:CD007399. [
23. Godambe SA, Elliot V, Matheny D, Pershad J. Comparison of propofol/fentanyl versus ketamine/midazolam for brief orthopedic procedural sedation in a pediatric emergency department. Pediatrics. 2003;112:116-23.
24. Taylor D, O'Brien D, Ritchie P, Pasco J, Cameron P. Propofol versus midazolam/fentanyl for reduction of anterior shoulder dislocation. Acad EmergMed. 2005;12:13-9.
25. Miner J, Gray R, Bahr J, Patel R, McGill J. Randomized clinical trial of propofol versus ketamine for procedural sedation in the emergency department. Acad Emerg Med. 2010;17:604-11.
26. Wang D, Wang S, Chen J, Xu Y, Chen C, Long A, et al. Propofol combined with traditional sedative agents versus propofol-alone sedation for gastrointestinal endoscopy: a meta-analysis. Scand J Gastroenterol. 2013;48:101-10.
27. Nishizawa T, Suzuki H, Sagara S, Kanai T, Yahagi N. Dexmedetomidine versus midazolam for gastrointestinal endoscopy: a meta-analysis. Dig Endosc. 2015;27:8-15.
28. Lourenco-Matharu L, Ashley P, Furness S. Sedation of children undergoing dental treatment. Cochrane Database Syst Rev. 2012.
29. Rubiano-Pinzón AM, Burbano-Paredes CC, Hernández-Caicedo ÁC, Rincón-Valenzuela DA, Benavides-Caro CA, Restrepo-Palacio S, et al. Currículo para la administración de sedación fuera del quirófano en pacientes mayores de 12 años. Rev Colomb Anestesiol. 2017;45:239-50.
2. American Society of Anesthesiologists. Task force on sedation and analgesia by non-anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology. 2002;96:1004-17.
3. Australia and New Zealand College of Anaesthetists. Guidelines on sedation and/or analgesia for diagnostic and interventional medical or surgical procedures; 2014 [citado 28 Mar 2017]. Disponible en: https://goo.gl/IU9Amm.
4. Ehrhardt BS, Staubach KC. A program for education, competency, and quality in procedural sedation. Int Anesthesiol Clin. 2013;51:33-42.
5. Hession PM, Joshi GP. Sedation: not quite that simple. Anesthesiol Clin. 2010;28:281-94.
6. Agency for Clinical Innovation. Minimum Standards for Safe Procedural Sedation Project; 2015 [citado 28 Mar 2017]. Disponible en: http://www.aci.health.nsw.gov.au.
7. Leroy P. Improving procedural sedation and/or analgesia in children: from practice over evidence to practice. Maastricht University; 2012.
8. Vargo JJ, Niklewski PJ, Williams JL, Martin JF, Faigel DO. Patient safety during sedation by anesthesia professionals during routine upper endoscopy and colonoscopy: an analysis of 1.38 million procedures. Gastrointest Endosc. 2017;85:101-8.
9. American Society of Anesthesiologists. Standards & Guidelines, Guidelines for Office-Based Anesthesia; 2015 [citado 28 Mar 2017]. Disponible en: https://goo.gl/cdLvFB.
10. Gillespie B, Chaboyer W, Thalib L, John M, Fairweather N, Slater K. Systematic review and meta-analysis of the effect of the World Health Organization surgical safety checklist on postoperative complications. Anesthesiology. 2014;120:1380-9.
11. Bal BS, Crowell MD, Kohli DR, Menendez J, Rashti F, Kumar AS, et al. What factors are associated with the difficult-to-sedate endoscopy patient? Dig Dis Sci. 2012;57:2527-34.
12. Lee S-Y, Son HJ, Lee JM, Bae MH, Kim JJ, Paik S, et al. Identification of factors that influence conscious sedation in gastrointestinal endoscopy. J Korean Med Sci. 2004;19: 536-40.
13. Brady M, Kinn S, Stuart P, Ness V. Preoperative fasting for adults to prevent perioperative complications. Cochrane Database Syst Rev. 2003;4:CD004423.
14. Manyande A, Cyna A, Yip P, Choo C, Middleton P. Non-pharmacological interventions for assisting the induction of anaesthesia in children (Review). Cochrane Database Syst Rev. 2015;7:CD006447.
15. Goudra BG, Singh PM, Gouda G, Borle A, Gouda D, Dravida A, et al. Safety of Non-Anesthesia Provider-Administered Propofol (NAAP) sedation in advanced gastrointestinal endoscopic procedures: comparative meta-analysis of pooled results. Dig Dis Sci. 2015;60:2612-27.
16. Park CH, Shin S, Lee SK, Lee H, Lee YC, Park JC, et al. Assessing the stability and safety of procedure during endoscopic submucosa dissection according to sedation methods: a randomized trial. PLoS ONE. 2015;10:e0120529.
17. Conway A, Douglas C, Sutherland J. A systematic review of capnography for sedation. Anaesthesia. 2016;71:450-4.
18. Varndell W, Elliott D, Fry M. The validity, reliability, responsiveness and applicability of observation sedation-scoring instruments for use with adult patients in the emergency department: a systematic literature review. Australas Emerg Nurs J. 2015;18:1-23.
19. Park SW, Lee H, Ahn H. Bispectral index versus standard monitoring in sedation for endoscopic procedures: a systematic review and meta-analysis. Dig Dis Sci. 2016;61:814-24.
20. Aboumarzouk O, Agarwal T, Syed N, Chek S, Milewski P, Nelson R. Nitrous oxide for colonoscopy. Cochrane database Syst Rev. 2011. Pubmed Central PMCID: 21833967.
21. Wang D, Chen C, Chen J, Xu Y,Wang L. The use of propofol as a sedative agent in gastrointestinal endoscopy: a meta-analysis. PLoS ONE. 2013;8:e5331.
22. Wakai A, O'Sullivan R, Blackburn C, McCabe A, Reece E, O'Connor G, et al. The use of propofol for procedural sedation in emergency departments. Cochrane Database Syst Rev. 2015;7:CD007399. [
23. Godambe SA, Elliot V, Matheny D, Pershad J. Comparison of propofol/fentanyl versus ketamine/midazolam for brief orthopedic procedural sedation in a pediatric emergency department. Pediatrics. 2003;112:116-23.
24. Taylor D, O'Brien D, Ritchie P, Pasco J, Cameron P. Propofol versus midazolam/fentanyl for reduction of anterior shoulder dislocation. Acad EmergMed. 2005;12:13-9.
25. Miner J, Gray R, Bahr J, Patel R, McGill J. Randomized clinical trial of propofol versus ketamine for procedural sedation in the emergency department. Acad Emerg Med. 2010;17:604-11.
26. Wang D, Wang S, Chen J, Xu Y, Chen C, Long A, et al. Propofol combined with traditional sedative agents versus propofol-alone sedation for gastrointestinal endoscopy: a meta-analysis. Scand J Gastroenterol. 2013;48:101-10.
27. Nishizawa T, Suzuki H, Sagara S, Kanai T, Yahagi N. Dexmedetomidine versus midazolam for gastrointestinal endoscopy: a meta-analysis. Dig Endosc. 2015;27:8-15.
28. Lourenco-Matharu L, Ashley P, Furness S. Sedation of children undergoing dental treatment. Cochrane Database Syst Rev. 2012.
29. Rubiano-Pinzón AM, Burbano-Paredes CC, Hernández-Caicedo ÁC, Rincón-Valenzuela DA, Benavides-Caro CA, Restrepo-Palacio S, et al. Currículo para la administración de sedación fuera del quirófano en pacientes mayores de 12 años. Rev Colomb Anestesiol. 2017;45:239-50.
How to Cite
1.
Burbano-Paredes CC, Amaya-Gui J, Rubiano-Pinzón AM, Hernández-Caicedo Ángela C, Grillo-Ardila CF. Clinical practice guideline for the management of sedation outside of operating room in patients over 12 years. Colomb. J. Anesthesiol. [Internet]. 2017 Jul. 1 [cited 2024 Apr. 24];45(3):224–238. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/657
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Published
2017-07-01
How to Cite
1.
Burbano-Paredes CC, Amaya-Gui J, Rubiano-Pinzón AM, Hernández-Caicedo Ángela C, Grillo-Ardila CF. Clinical practice guideline for the management of sedation outside of operating room in patients over 12 years. Colomb. J. Anesthesiol. [Internet]. 2017 Jul. 1 [cited 2024 Apr. 24];45(3):224–238. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/657
Issue
Section
Clinical Practice Guides
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