Key result
In a scoping review of 17 articles, deep sedation managed by trained nurses showed comparable efficacy and safety to sedation administered by certified registered nurse anesthetists.
Why the study?
Although nurse-administered propofol sedation is efficacious and safe in low-risk patients, practices remain severely limited and shared training programs or protocols are difficult to find.
What are the requirements, types of training, and operating methods for nurse-administered propofol sedation in digestive endoscopy?
Systematic Review (n=17)
What are the requirements, types of training, and operating methods for nurse-administered propofol sedation in digestive endoscopy?
Nurse-administered propofol sedation for digestive endoscopy appears safe and effective, but unified international guidelines for training methods are needed.
Lack of shared protocols limits nonanesthesiologist propofol use; leaves open need for standardized training programs.
Although efficacy and safety of nonanesthesiologist administration of propofol and nurse-administered propofol sedation practices have been amply demonstrated in patients at low American Society of Anesthesiologists physical status risk, they are still severely limited. To date, it is quite difficult to find a protocol or a shared training program. The aim of the study was to verify requirements, types of training, and operating methods described in the literature for the administration of propofol by a nurse. A scoping review of the literature was conducted in accordance with the PRISMA-ScR guidelines and in line with Arksey and O'Malley's framework, within four main databases of biomedical interest: MEDLINE, CINAHL, Scopus, and Web of Science. We selected studies published during the last 20 years, including only nurses not trained in anesthesia. Seventeen articles were eligible. Despite the differences between the training and administration methods, efficacy and safety of deep sedation managed by trained nurses were comparable, just like when sedation was administered by certified registered nurse anesthetists. Training programs have been investigated in detail by only a small number of studies, although its efficacy and safety have been widely demonstrated. It is important, then, to collect evidence that allows developing of unified international guidelines for training methods to offer safe and cost-effective quality sedation.
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Minciullo et al. (2023) conducted a systematic review in Digestive endoscopy procedures requiring sedation (n=17). Nurse-administered propofol sedation vs. Certified registered nurse anesthetists was evaluated on Efficacy and safety of deep sedation. In a scoping review of 17 articles, deep sedation managed by trained nurses showed comparable efficacy and safety to sedation administered by certified registered nurse anesthetists.
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