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Use of sedation in gastrointestinal endoscopy: a nationwide survey in Spain

Baudet, Juan-Salvadora; Borque, Pilara; Borja, Elisaa; Alarcón-Fernández, Onofreb; Sánchez-del-Río, Antoniob; Campo, Rafaelc; Avilés, Juana

European Journal of Gastroenterology & Hepatology: August 2009 - Volume 21 - Issue 8 - p 882-888
doi: 10.1097/MEG.0b013e328314b7ca
Original Articles: Endoscopy

Introduction Gastrointestinal endoscopy causes discomfort and pain in patients. Sedation reduces anxiety and pain. Its use, however, continues to be a controversial issue and it varies greatly from one country to another. The use of sedation in Spanish gastrointestinal endoscopy (GIE) units is unknown.

Aim To determine the use of sedation in Spanish GIE units.

Materials and methods A 24-question survey on the use of sedation was distributed among 300 Spanish GIE units.

Results Surveys were answered by 197 GIE units (65%), which had performed 588 326 endoscopies over the past 12 months. Sedation was used in more than 20% of gastroscopies performed at 55% of the GIE units, and more than 20% of colonoscopies were sedated at 71% of the units; endoscopic retrograde cholangiopancreatography (ERCP) is almost always performed under sedation. The most common drugs were midazolam for gastroscopy and midazolam and pethidine for colonoscopy and ERCP; propofol is used by anesthetists; pulse oximetry is used at 77% of GIE units; 42% of the GIE units fill in a nursing record; 52% of GIE units have recovery rooms and 91% have a cardiac arrest trolley.

Conclusion The use of sedation in endoscopy varies greatly in Spain. It is seldom used in gastroscopy; it is more frequent in colonoscopy, and in ERCP it is the norm. In most GIE units sedation is controlled by the endoscopist with pulse oximetry. The most commonly used drugs are benzodiazepines, on their own for gastroscopy and combined with opioids for colonoscopy and ERCP.

aGastroenterology Service

bResearch Unit, Hospital Universitario Ntra. Sra, de Candelaria, S/C de Tenerife

cGastroenterology Service, Hospital de Sabadell (Corporació Parc Taulí), Sabadell, Spain

Correspondence to Dr Juan-Salvador Baudet, Gastroenterology Service, Hospital Universitario Ntra. Sra. de Candelaria, Crra. Del Rosario 145, (38010), S/C de Tenerife, Spain

Tel: +34 922 601707; fax: +34 922 600535; e-mail:

Received 8 May 2008 Accepted 8 August 2008

© 2009 Lippincott Williams & Wilkins, Inc.