Estudio observacional retrospectivo sobre la seguridad de la sedación para colonoscopias en pacientes ASA I y II realizada por enfermería y tutelada por anestesiología

Abstract

IntroductionOut of operating room sedation with propofol by non-anaesthesiologists (Non Anaesthesiologist Administration of Propofol) is a growing practice. This is due to the increase in minimally invasive diagnostic and therapeutic procedures requiring sedation, and the difficulty of anaesthesiology services to respond adequately to this demand. ObjectiveThe main objective of this study is to assess the safety of a programme of nurse sedationist-administered target controlled infusion of propofol in colonoscopies supervised by anaesthesiologists. Material and methodsOver a period of 6 months, all ASA I and II patients who required colonoscopy and met the inclusion criteria were included in the study. A total of 381 colonoscopies were performed. Episodes of desaturation, hypo- or hypertension, bradycardia or tachyarrhythmia and the need for anaesthesiology assistance during sedation were analysed. After the procedure, patient satisfaction was assessed on a scale of 1 to 5, and pain was assessed on a numerical verbal scale of 1 to 5. ResultsA small percentage (5%) of patients presented oxygen saturation of less than 90%, without requiring mask ventilation; 7.35% presented hypotension, 3.94% presented bradycardia, and the supervising anaesthesiologist was called in 22% of cases. Patient satisfaction at the end of the procedure was 4.27 out of 5. ConclusionSedation during colonoscopy in ASA I and II patients following an agreed protocol can be safely administered by nurse sedationists under the supervision of an anaesthesiologist.