Academy of Medicine, Singapore clinical guideline on the use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting

Introduction: In Singapore, non-anaesthesiologists generally administer sedation during gastrointestinal endoscopy. The drugs used for in hospital endoscopy centres now include propofol addition to benzodiazepines and opiates. requirements peri-procedural monitoring discharge protocols have also evolved. There is a need develop an evidence-based clinical guideline on the safe effective use of by setting. Methods: Academy Medicine, Singapore appointed expert workgroup comprising 18 gastroenterologists, general surgeons anaesthesiologists guidelines formulated questions related different aspects endoscopic sedation, conducted relevant literature search, adopted Grading Recommendations, Assessment, Development Evaluation (GRADE) methodology developed recommendations consensus using modified Delphi process. Results: made 16 encompassing 7 areas: (1) purpose benefits disadvantages endoscopy; (2) pre-procedural assessment, preparation consent taking sedation; (3) Efficacy safety (4) role anaesthesiologist-administered (5) performance (6) post-sedation care after (7) training non-anaesthesiologists. Conclusion: These serve guide practice Keywords: Benzodiazepines, opiates, propofol,