BACKGROUND AND STUDY AIMS: Endoscopist-Directed Nurse-Administered @entity1875 Sedation (EDNAPS) has been evaluated in community settings rather than tertiary referral centers. @entity1 AND METHODS: A hospital-wide prospectively collected database of Medical Emergency Team Calls (METCALL), emergency responses triggered by medically unstable @entity1 , was reviewed. Responses that followed EDNAPS were extracted and compared with a prospectively entered database of all endoscopies performed using EDNAPS over the same period. RESULTS: A total of 33,539 endoscopic procedures (16,393 gastroscopies, 17,146 colonoscopies) were performed on 27,989 @entity1 using EDNAPS. Intravenous drugs included @entity1363 (0-5mg), @entity3575 (0-100mcg), and @entity1875 (10-420mg). Of 23 METCALLs (18 gastroscopies and 5 colonoscopies), there were 16 with ASA scores of III or higher. Indications for gastroscopy were gastrointestinal (GI) @entity548 (n=11; 8 variceal, 3 nonvariceal), @entity1282 (n=5), @entity970 removal (n=1), and @entity2210 (n=1). Fifteen of 22 @entity1 , including all of those who had a colonoscopy, made a full recovery and returned to the ward or were discharged home. In the gastroscopy group, seven were intubated and admitted to Intensive Care, of whom six were emergency cases for @entity360 (n=4 variceal, n=2 non variceal) and one in which the indication was @entity970 removal. Two deaths occurred in the intubated group. CONCLUSIONS: In a tertiary referral center, EDNAPS for low-to-moderate risk (ASA  <=2) @entity1 undergoing gastroscopy and colonoscopy is very safe. Gastroscopy is associated with greater anesthetic risk than colonoscopy and those with high ASA scores needing urgent endoscopy for @entity360 are at particular risk of @entity712 .

Morbidity and mortality of endoscopist-directed nurse-administered XXXX sedation (EDNAPS) in a tertiary referral center.

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity360 :: ('MESH:D006471', 'Disease') :: ['gastrointestinal bleeding', 'upper gastrointestinal hemorrhage'] @entity712 :: ('MESH:D006333', 'Disease') :: ['cardiorespiratory decompensation'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhage'] @entity1875 :: ('MESH:D015742', 'Chemical') :: ['propofol', 'Propofol'] @entity1282 :: ('MESH:D003680', 'Disease') :: ['dysphagia'] @entity2210 :: ('MESH:D004415', 'Disease') :: ['dyspepsia'] @entity1363 :: ('MESH:D008874', 'Chemical') :: ['midazolam'] @entity3575 :: ('MESH:D005283', 'Chemical') :: ['fentanyl'] @entity970 :: ('CHEBI:46793', 'Chemical') :: ['PEG']
@entity1875 :: (MESH:D015742,Chemical) :: ['propofol']
