Authors : Somchai Amornyotin
Volume : 3
Issue : 7
Year : 2014
Page No : 1133-1144
Gastrointestinal endoscopy has become an essential modality for evaluation and treatment of gastrointestinal tract abnormalities. This procedure is complex and may be unsafe if special concerns are not considered. The goal of procedural sedation in endoscopic procedure is the safe and effective control of pain and anxiety, to provide an appropriate degree of memory loss or decreased awareness and to improve endoscopic performance especially in therapeutic procedures. Regardless of regimen used, the safe administration of sedative and analgesic drugs requires an awareness of the particular needs of the patients. The most commonly used sedation regimen for sedation in gastrointestinal endoscopic procedure is still the combination of benzodiazepines and opioids. In addition, the use of propofol has increased enormously in the past decade. New sedative agents are currently used and studied. Although sedation in this endoscopic procedure is considered safe, the sedation has a potential for complications. Sedation-related complications can more easily occur even in healthy populations. Risk evaluation before the procedure and monitoring during and after the procedure as well as increased awareness of the sedation-related complications must be performed. Furthermore, properly trained staff and emergency equipment should be available. This article reviews pharmacokinetics and pharmacodynamics of sedative and analgesic drugs and discusses the clinical use in gastrointestinal endoscopic procedure.