Effectiveness and safety of sedation in gastrointestinal endoscopy:An opinion review
作者机构：Division of Gastroenterology and HepatologyDepartment of MedicineNihon University School of MedicineChiyoda-kuTokyo 101-8309Japan
出 版 物：《World Journal of Meta-Analysis》 (世界荟萃分析杂志)
年 卷 期：2020年第8卷第2期
页 面：48-53页
主 题：Gastrointestinal endoscopy Conscious sedation Propofol Midazolam Remimazolam Benzodiazepine
摘 要：Although endoscopy is a less invasive procedure than surgery,patients can experience pain without sedation.Patients expect reduced pain during endoscopies from effective and safe sedatives.Midazolam and propofol are used for endoscopic sedation in many countries and regions.Midazolam is a widely available benzodiazepine,and many clinical trials have shown it to be an effective sedative.However,patients who are sedated with midazolam require rest in the recovery room due to its relatively long half-life,and an antagonist such as flumazenil may need to be administered in cases of deep or prolonged sedation.Propofol is a short-acting sedative with a short half-life and a quick recovery time.Therefore,the use of propofol has been increasing.However,propofol has a narrow margin of safety and often induces adverse effects such as respiratory depression.Also,propofol has no specific antagonist,and should be administered by an anesthesiologist or an endoscopist familiar with anesthesia.Remimazolam,which is a novel ultra-short-acting benzodiazepine,has recently gained attention.Remimazolam has a short half-life and an antagonist.Both effective and safe sedation is desired in accordance with the increasing need for sedative endoscopies.Therefore,in this review each sedative is summarized.
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