Korean J Gastroenterol.  2022 Apr;79(4):141-155. 10.4166/kjg.2021.157.

2021 Korean Society of Gastrointestinal Endoscopy Clinical Practice Guidelines for Endoscopic Sedation

• Park HJ
• Kim BW
• Lee JK
• Park Y
• Park JM
• Bae JY
• Seo SY
• Lee JM
• Lee JH
• Chon HK
• Chung JW
• Choi HH
• Kim MH
• Park DA
• Jung JH
• Cho JY
• Endoscopic Sedation Committee of Korean Society of Gastrointestinal Endoscopy

• KMID: 2529364
• DOI: http://doi.org/10.4166/kjg.2021.157

Abstract

Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.

Keyword

Endoscopy; Guideline; Sedation

Figure

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  Fig. 1 PRISMA flow chart for selecting reference clinical practice guidelines. KoMCI, Korea Medical Citation Index; NICE, National Institute of Health and Care Excellence; WHO, World Health Organization.

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  Fig. 2 Mallampati classification of airways. The patient is assessed while sitting up with the mouth opened wide and tongue protruded as much as possible.

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