Review on sedation for gastrointestinal tract endoscopy in children by non-anesthesiologists  

作　　者：Rok Orel Jernej Brecelj Jorge Amil Dias Claudio Romano Fernanda Barros Mike Thomson Yvan Vandenplas 

机构地区：[1]Children’s Hospital,University Medical Centre Ljubljana [2]Medical Faculty,University of Ljubljana [3]Department of Pediatrics, Hospital S.Joo [4]Pediatric Department,University of Messina [5]the Paediatric Section of the Portuguese Society of Anaesthesiology,Department of Anesthesiology,Hospital S.Joo [6]Centre for Paediatric Gastroenterology,International Academy of Paediatric Endoscopy Training,Sheffield Children’s Hospital [7]Department of Pediatrics,UZ Brussel,Vrije Universiteit Brussel,1090 Brussels,Belgium

出　　处：《World Journal of Gastrointestinal Endoscopy》2015年第9期895-911,共17页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：AIM: To present evidence and formulate recommendations for sedation in pediatric gastrointestinal(GI) endoscopy by non-anesthesiologists.METHODS: The databases MEDLINE, Cochrane and EMBASE were searched for the following keywords "endoscopy, GI", "endoscopy, digestive system" AND "sedation", "conscious sedation", "moderate sedation", "deep sedation" and "hypnotics and sedatives" for publications in English restricted to the pediatric age. We searched additional information published between January 2011 and January 2014. Searches for(upper) GI endoscopy sedation in pediatrics and sedation guidelines by non-anesthesiologists for the adult population were performed. RESULTS: From the available studies three sedation protocols are highlighted. Propofol, which seems to offer the best balance between efficacy and safety is rarely used by non-anesthesiologists mainly because of legal restrictions. Ketamine and a combination of a benzodiazepine and an opioid are more frequently used. Data regarding other sedatives, anesthetics and adjuvant medications used for pediatric GI endoscopy are also presented.CONCLUSION: General anesthesia by a multidisciplinary team led by an anesthesiologist is preferred. The creation of sedation teams led by non-anesthesiologists and a careful selection of anesthetic drugs may offer an alternative, but should be in line with national legislation and institutional regulations.AIM To present evidence and formulate recommendationsfor sedation in pediatric gastrointestinal （GI）endoscopy by non-anesthesiologists.METHODS： The databases MEDLINE, Cochrane andEMBASE were searched for the following keywords＂endoscopy, GI＂, ＂endoscopy, digestive system＂ AND＂sedation＂, ＂conscious sedation＂, ＂moderate sedation＂,＂deep sedation＂ and ＂hypnotics and sedatives＂ forpublications in English restricted to the pediatric age.We searched additional information published between January 2011 and January 2014. Searches for （upper） GIendoscopy sedation in pediatrics and sedation guidelinesby non-anesthesiologists for the adult population wereperformed.RESULTS： From the available studies three sedationprotocols are highlighted. Propofol, which seems tooffer the best balance between efficacy and safety israrely used by non-anesthesiologists mainly becauseof legal restrictions. Ketamine and a combination ofa benzodiazepine and an opioid are more frequentlyused. Data regarding other sedatives, anesthetics andadjuvant medications used for pediatric GI endoscopyare also presented.CONCLUSION： General anesthesia by a multidisciplinaryteam led by an anesthesiologist is preferred. The creationof sedation teams led by non-anesthesiologists anda careful selection of anesthetic drugs may offer analternative, but should be in l

关 键 词：Gastro-intestinal ENDOSCOPY GASTROSCOPY Colonoscopy SEDATIVES Pediatric ages ANESTHETICS ANALGESICS 

分 类 号：R726.1[医药卫生—儿科]