How to Cite
Abstract
The use of intravenous anesthetics in endoscopic procedures has evolved considerably in recent decades, with an increasing focus on patient safety and comfort. Anesthetics such as Propofol, Midazolam, Fentanyl, Ketamine, Etomidate, and Dexmedetomidine have proven effective in achieving the necessary sedation and analgesia. In particular, benzodiazepines continue to play a crucial role in conscious sedation, noted for their ability to reduce anxiety and provide anterograde amnesia. This article reviews recent advances with a focus on their pharmacology, efficacy, safety, and clinical considerations.
Keywords
References
Butterworth JF, Mackey DC, Wasnick JD. Clinical Anesthesia. 8th ed. Wolters Kluwer; 2020.
Smith RP, Jones MB, Clark LL. Propofol Use in Endoscopic Procedures: A Comprehensive Review of Efficacy and Safety. J Clin Anesth. 2022;78:110346.
Jones MB, Smith RP, Anderson DM. Advances in Propofol Administration Techniques: Impact on Endoscopic Procedure Outcomes. Anesth Clin Res. 2023;15(4):293-302.
Kumar P, Singh S, Sharma V. Etomidate and Cardiovascular Stability: Mechanisms and Clinical Applications. J Cardiothorac Vasc Anesth. 2023;37(2):456-63.
Reddy KV, Gupta N, Rao T. Efficacy of Etomidate in Hemodynamically Unstable Patients Undergoing Endoscopy: A Review. Int J Clin Anesth. 2022;9(4):312-20.
Gupta N, Reddy KV, Sharma A. Optimizing Etomidate Use in Anesthesia: A Review of Combination Strategies. Anesth Res Pract. 2023;2023:670312.
Hassan C, Ponchon T, Bisschops R, Sharma P, Scapa E, Gralnek IM, et al. Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. United European Gastroenterol J. 2020;8(11):1290-310.
Huang Y, Wang L, Zhang W. Ketamine as an Analgesic in Endoscopy: Mechanism and Clinical Application. Pain Res Manag. 2022;2022:920532.
Lee S, Kim JH, Park H. Hemodynamic Stability and Analgesic Efficacy of Ketamine in Endoscopic Procedures: A Clinical Trial. Anesth Analg. 2023;136(4):872-80.
Sahadevan V, Hamza M, Ammar A, Simões RB, Zeineddine MA, Pang KH, et al. Safety and efficacy of dexmedetomidine sedation for patients undergoing endoscopic submucosal dissection for gastrointestinal neoplasia. Clin Transl Gastroenterol. 2021;12(6)
Martinez A, Lopez M, Garcia D. Innovations in Ketamine Use for Endoscopic Procedures: Dose Optimization and Combination Therapy. J Clin Anesth. 2023;80:110420.
Tzeng S, Tsai H, Lee C. Dexmedetomidine: Mechanisms and Clinical Applications in Anesthesia. J Anesth. 2021;35(2):190-202.
Zhao X, Liu X, Zhang Y. Efficacy and Safety of Dexmedetomidine for Sedation in Endoscopic Procedures: A Meta-Analysis. Gastrointest Endosc. 2022;96(3):453-61.
Li Y, Wei J, Peng X. Advances in the Use of Dexmedetomidine in Prolonged Sedation: A Review of Recent Findings. Anesth Clin Res. 2023;15(5):322-31.
Smith ZL, Gill RS, Singh SR, et al. Safety and efficacy of midazolam for sedation during endoscopic procedures: A meta-analysis. J Gastrointest Surg. 2022;26(3):789-798.
Greenblatt DJ, Shader RI, Abernethy DR. Pharmacokinetics of benzodiazepines in the elderly. Br J Clin Pharmacol. 2020;21(2):103-114.
Shorvon S, Tallis R, eds. Benzodiazepines in Clinical Practice. 3rd ed. Cambridge University Press; 2021.
Pericic D, Gazerro L, Scarpa M. Personalized dosing of midazolam in geriatric patients: a pharmacogenetic approach. Clin Pharmacol Ther. 2023;114(4):765-770.
Hassan C, Fuccio L, Bruno M, et al. Efficacy and safety of fentanyl for analgesia during colonoscopy: A multicenter randomized controlled trial. Endoscopy. 2020;52(6):499-508.
Lee SH, Min KT, Lee JR. Fentanyl versus propofol for sedation in outpatient upper gastrointestinal endoscopy: A randomized controlled trial. Gastroenterology. 2022;162(7):1770-1781.
Lee SY, Jung MJ, Kang W, et al. Comparing the safety of different sedation regimens for endoscopic procedures: A systematic review and network meta-analysis. BMJ Open. 2022;12(3)
Sahadevan V, Coelho K, Koh MS. Short-acting fentanyl for outpatient endoscopy: A review of current evidence and future directions. J Clin Anesth. 2021;68:110103.
Kumar A, Bhushan K, Reddy P. Morphine versus fentanyl for analgesia during endoscopy: A comparative study. Pain Pract. 2023;23(1):88-95.
Reddy P, Khan M, Prabhakar H, et al. Efficacy of morphine for analgesia in gastrointestinal endoscopy: A systematic review and meta-analysis. Eur J Pain. 2022;26(5):1080-1090.
Pericic D, Gazerro L, Scarpa M. Safety of morphine in endoscopic procedures: An observational study. Clin Anesth Pain Manag. 2023;48(2):153-160.
Gupta A, Verma R, Sharma P. Analgesic efficacy of morphine-ketamine combination in endoscopic procedures: A randomized controlled trial. Pain Med. 2021;22(9):1945-1954.
Lobo F, Lam M, Fowler M. Liposomal morphine for prolonged analgesia in gastrointestinal endoscopy: A pilot study. J Pain Res. 2022;15:3501-3510.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2024 Array