BMJ 1995;311:452 (12 August)

Letters

Monitoring during endoscopy

Attention to sedation techniques may reduce mortality

EDITOR,--J E Charlton draws attention to the estimated overall death rate of 1 in 2000 from upper gastrointestinal endoscopy, which is usually performed under sedation or local anaesthesia, or both.1 When compared with the overall mortality solely attributable to anaesthesia, which is 1 in 185000,2 this mortality seems unacceptably high.

Recommendations for standards of sedation and for monitoring patients during gastrointestinal endoscopy were published by the British Society of Gastroenterology in 1991,3 and guidelines for sedation by non-anaesthetists were published by a working party of the Royal College of Surgeons in 1993.4 Despite this, practice across Britain seems to vary widely.

We were surprised to find that in some regions the preferred benzodiazepine for sedation during endoscopy is diazepam,5 which has an active principal metabolite (desmethyldiazepam) with a half life of 48-96 hours. Midazolam has been recommended as the drug of choice for . . . [Full text of this article]


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Relevant Article

Monitoring and supplemental oxygen during endoscopy
J E Charlton
BMJ 1995 310: 886-887. [Extract] [Full Text]

This article has been cited by other articles:

  • MURPHY, M S. (1997). Sedation for invasive procedures in paediatrics. Arch. Dis. Child. 77: 281-284 [Full text]  
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