title: Nurse-administered propofol sedation for gastrointestinal endoscopic procedures: first Nordic results from implementation of a structured training program.
abstract: BACKGROUND
  Proper training to improve safety of NAPS (nurse-administered propofol sedation) is essential.
  
  
  OBJECTIVE
  To communicate our experience with a training program of NAPS.
  
  
  METHODS
  In 2007, a training program was introduced for endoscopists and endoscopy nurses in collaboration with the Department of Anaesthesiology. During a 2.5-year period, eight nurses were trained. Propofol was given as monotherapy. The training program for nurses consisted of a 6-week course including theoretical and practical training whereas the training program for endoscopists consisted of 2.5 h of theory. Patients were selected based on strict criteria including patients in ASA (American Society of Anesthesiologists) group I-III.
  
  
  RESULTS
  2527 patients undergoing 2.656 gastrointestinal endoscopic procedures were included. The patients were ASA group I, II and III in 34.7%, 56% and 9,3%, respectively. Median dose of propofol was 300 mg. No mortality was noted. 119 of 2527 patients developed short lasting hypoxia (4.7%); 61 (2.4%) needed suction; 22 (0.9%) required bag-mask ventilation and 8 (0.3%) procedures had to be discontinued. In 11 patients (0.4%), anesthetic assistance was called due to short lasting desaturation. 34 patients (1.3%) experienced a change in blood pressure greater than 30%.
  
  
  CONCLUSIONS
  NAPS provided by properly trained nurses according to the present protocol is safe and only associated with a minor risk (short lasting hypoxia 4.7%). National or international structured training programs are at present few or non-existing. The present training program has documented its value and is suggested as the basis for the current development of guidelines.
authors: Department of Endoscopy, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
authors: Charlotte
authors: C
authors: Slagelse
authors: Peter
authors: P
authors: Vilmann
authors: Pernille
authors: P
authors: Hornslet
authors: Anne
authors: A
authors: Hammering
authors: Teit
authors: T
authors: Mantoni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002983:Clinical Competence; D054810:Deep Sedation / Q000451:nursing*; D004509:Education, Nursing, Continuing; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000451:nursing*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D007022:Hypotension / Q000139:chemically induced; D000860:Hypoxia / Q000139:chemically induced / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009664:Norway; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol