Sedation and analgesia can be administered by an anesthesiologist or non-anesthesiologist as intermittent boluses or continuous infusion throughout the procedure. Moreover, patient controlled sedation and target controlled infusion are alternative modes of drug delivery. Anesthesiologist versus non-anesthesiologist debate Debate exists on whether the staff administering sedation should be an anesthesiologist, a gastroenterologist or a non-anesthesiologist (70, lit). Although, reports suggesting the safety of sedation administered by non-anesthesiologists exist in the literature, incidence of adverse hemodynamic and airway events were reported as 1.44% and 0.74% respectively (36-41). The reasons behind nurse rather than physician organizations …show more content…
Most authors recommend that sedation with propofol should be performed by a registered nurse only in low risk patients (4). In two studies, Rex et al reported that, trained nurses administered sedation with propofol has low risk (3, 36). As a result, the ASA and the American Association of Nurse Anesthetists issued a joint statement in 2004 that, propofol for sedation/analgesia should be administered only by persons trained in the administration of general anesthesia. This restriction is concordant with specific language in the propofol package insert (123). In 2010 members of the European Society of Gastrointestinal Endoscopy (ESGE), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA) published a guideline on non-anesthesiologist administration of propofol for gastrointestinal endoscopy (95). However, at the ESA General Assembly held in Amsterdam on 15 June 2011, the majority of the active members approved the motion to retract the endorsement, because a majority of the national societies of the ESA felt unable to support this guideline following publication (96). Consequently, the ESA hereby retracted its endorsement of this