Archive Gastroenterology 2019

Make the Right Choice for Safe Sedation

It's best to base the consciousness level on the patient and the procedure.

Adam Jacob

Adam Jacob, MD


Pamela Bevelhymer, RN, BSN, CNOR
PLEASING PUSH Patients report higher satisfaction following endoscopic procedures after sedation with propofol than with other sedation medications such as midazolam and fentanyl.

Administering anesthesia in our GI procedure rooms typically comes down to deciding between moderate sedation with midazolam and fentanyl or deep sedation with propofol. The optimal choice is made on a case-by-case basis, depending on each patient's health status and the procedure we're about to perform.

The decision-making process begins with a baseline health assessment that checks patients for comorbid conditions — cardiac and pulmonary issues, diabetes and kidney problems — that could increase sedation risks. Patients also undergo a heart, lung and airway exam performed by an anesthesiologist. Although routine health screenings raise many red flags, we also have protocols in place to double-check a patient's condition. If we discover a concerning medical condition at the last minute, we determine if the procedure can proceed or if we should delay it in order to first medically address the issue.

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