The seemingly constant debate over the best way to sedate patients for GI procedures is complicated, demanding discussions about healthcare economics, case efficiencies and safe patient care. Two developing sedation options were highlighted in Outpatient Surgery Magazine’s June 2008 issue: the Sedasys System, a computer-assisted sedation device, and Aquavan, a propofol variant that promises minimal sedation for diagnostic procedures without the need for anesthesia providers' supervision. Since then, new developments could affect the future application of both.
In July the FDA denied Aquavan for approval, but did leave the door open for its eventual approval. "We are confident that our continued discussions with the FDA will lead to the timely approval of this important new therapy," says Mary Lynne Hedley, PhD, executive vice president of Eisai Corporation of North America, the drug’s manufacturer.
According to research presented earlier this month at the American College of Gastroenterologists’ annual meeting in Orlando, Fla., patients sedated with the Sedasys System (fentanyl with propofol infusion) returned to regular psychomotor skills 30 minutes faster than the standard of care group (sedated with fentanyl or meperidine with midazolam). Potential benefits of this increased recovery time could include reliability of scheduling, reduced nursing costs and a reduction in patient backlog, according to Ethicon, the system’s manufacturer.
In the end, healthcare professionals shouldn’t lose sight of what matters most: the patients. As Jeff Mandel, MD, clinical associate professor of anesthesiology and critical care at the University of Pennsylvania School of Medicine in Philadelphia, says, "Right now, specialty groups are focused on a very narrow aspect of care, based on their own economic interests. All involved parties can prevent an awful lot of colon cancer deaths by focusing on getting screening compliance to three times what it is now."
—Daniel Cook
