title: Recommended sedation and intraprocedural monitoring for gastric endoscopic submucosal dissection.
abstract: Endoscopic submucosal dissection is associated with a longer treatment time and a higher risk of patient discomfort than conventional procedures. Adequate, safe sedation is therefore essential. Sedation can cause adverse effects such as hypoxemia and hypotension, requiring continuous intraoperative and postoperative monitoring of blood pressure, use of the electrocardiogram, and arterial blood oxygen saturation by pulse oximetry. A physician and a nurse solely responsible for sedating and monitoring the patient should be present during treatment.A combination of benzodiazepines and analgesics are generally used for sedation, but new sedatives such as propofol and dexmedetomidine hydrochloride are expected to be useful agents. Endoscopists should become more familiar with sedatives, analgesics, and emergency procedures in the future.
authors: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan. tohrus@kitasato-u.ac.jp
authors: Tohru
authors: T
authors: Sasaki
authors: Satoshi
authors: S
authors: Tanabe
authors: Kenji
authors: K
authors: Ishido
authors: Mizutomo
authors: M
authors: Azuma
authors: Chikatoshi
authors: C
authors: Katada
authors: Katsuhiko
authors: K
authors: Higuchi
authors: Wasaburo
authors: W
authors: Koizumi
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects; D016292:Procedural Sedation / Q000379:methods*; D004210:Dissection / Q000379:methods*; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D019983:Guideline Adherence; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D008874:Midazolam / Q000008:administration & dosage / Q000009:adverse effects; D008991:Monitoring, Physiologic / Q000379:methods*; D010348:Patient Care Team; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D001569:Benzodiazepines; D008874:Midazolam; D015742:Propofol