Conscious Sedation for Endoscopic Procedure: A Systematic Review

Zahid   Hussain Khan; Fadhaa  Shnan Al-fadhili

doi:10.18502/aacc.v7i2.6302

Zahid Hussain Khan Department of Anesthesiology and Intensive Care, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Fadhaa Shnan Al-fadhili Department of Anesthesiology and Intensive Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran..

DOI: https://doi.org/10.18502/aacc.v7i2.6302

Keywords: Conscious sedation; Endoscopic procedure; Patient's outcome

Abstract

Background: Sedation has a beneficial impact on patient’s tolerance to the endoscopic procedure. Conscious sedation is the anesthetic techniques of choice for endoscopic procedure. Conscious sedation for endoscopic procedure could be with one drug or a combination of drugs. There have been broad variations in sedation procedure between different countries, and even between different units within the same country. All drugs which depress the central nervous system have the ability to produce respiratory or cardiovascular complications. Endoscopy has a recorded mortality of 1 in 2000 and a morbidity rate of 1 in 200. These sedation techniques have their effects on patients.

The main goal of this study is to describe the effects of conscious sedation on patients' outcome for endoscopic procedure.

Methods: The design for this study was a review of literature in the medical databases of PubMed, Scopus, Embase, Cochrane and hand search journals from conferences in English. All studies that evaluated the use of CS for endoscopic procedure were included.

Results: The results showed that the pain level of the patient (visual analogue scale) was substantially positive when conscious sedation was used. Conscious sedation, however is a lightly sedated patient who is conscious, amnesic, co-operative on demand and free from fear and anxiety. It is often used during endoscopic procedures to minimize discomfort and relax the patients. The intraoperative hypotension has also been extreme in some medications relative to others.

Conclusion: The study revealed that CS is reliable and well tolerated anesthetic technique for endoscopic procedures, and is a better option for elective endoscopic procedures

CS benefits for endoscopisit and patient outcome is superior to GA such as; short recovery times, less analgesia requirement, comfortable for patient which in turn, leads to faster induction, faster endoscopy, faster discharge, and faster turnaround time. Patients are usually willing to go home after a couple of hours. Rapid recovery is a benefit not only for patients, but also for hospital and day surgery departments. This increases the overall performance of the endoscopy unit.