SedationAnalgesia Administration Practice Varies according to Endoscopy Facility (Hospital- or Office-Based)‎ Setting: Results from a Nationwide Survey in Greece

Abstract EN

Objectives.

To examine the impact of endoscopy setting (hospital-based vs.

office-based) on sedation/analgesia administration and to provide nationwide data on monitoring practices among Greek gastroenterologists in real-world settings.

Material and Methods.

A web-based survey regarding sedation/analgesia rates and monitoring practices during endoscopy either in a hospital-based or in an office-based setting was disseminated to the members of the Hellenic Society of Gastroenterology and Professional Association of Gastroenterologists.

Participants were asked to complete a questionnaire, which consisted of 35 items, stratified into 4 sections: demographics, preprocedure (informed consent, initial patient evaluation), intraprocedure (monitoring practices, sedative agents’ administration rate), and postprocedure practices (recovery).

Results.

211 individuals responded (response rate: 40.3%).

Propofol use was significantly higher in the private hospital compared to the public hospital and the office-based setting for esophagogastroduodenoscopy (EGD) (85.8% vs.

19.5% vs.

10.5%, p<0.0001) and colonoscopy (88.2% vs.

20.1% vs.

9.4%, p<0.0001).

This effect was not detected for midazolam, pethidine, and fentanyl use.

Endoscopists themselves administered the medications in most cases.

However, a significant contribution of anesthesiology sedation/analgesia provision was detected in private hospitals (14.7% vs.

2.8% vs.

2.4%, p<0.001) compared to the other settings.

Only 35.2% of the private offices have a separate recovery room, compared to 80.4% and 58.7% of the private hospital- and public hospital-based facilities, respectively, while the nursing personnel monitored patients’ recovery in most of the cases.

Participants were familiar with airway management techniques (83.9% with bag valve mask and 23.2% with endotracheal intubation), while 49.7% and 21.8% had received Basic Life Support (BLS) and Advanced Life Support (ALS) training, respectively.

Conclusion.

The private hospital-based setting is associated with higher propofol sedation administration both for EGD and for colonoscopy.

Greek endoscopists are adequately trained in airway management techniques.