Room for Quality Improvement in Endoscopist-Directed Sedation: Results from the First Nationwide Survey in Korea

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Authors: Chang Kyun Lee ; Seok Ho Dong ; Eun Sun Kim ; Sung-Hoon Moon ; Hong Jun Park ; Dong-Hoon Yang ; Young Chul Yoo ; Tae Hoon Lee ; Sang Kil Lee ; Jong Jin Hyun ; The Korean Society of Gastrointestinal Endoscopy Task Force on Endoscopic Sedation

MeSH: Adult ; Aged ; Aged, 80 and over ; Colonoscopy/methods ; Colonoscopy/psychology ; Conscious Sedation/methods* ; Conscious Sedation/psychology ; Conscious Sedation/standards ; Endoscopy, Digestive System/methods ; Endoscopy, Digestive System/psychology ; Endoscopy, Gastrointestinal/methods* ; Endoscopy, Gastrointestinal/psychology ; Female ; Gastroenterology/methods ; Humans ; Hypnotics and Sedatives ; Male ; Middle Aged ; Patient Satisfaction ; Practice Patterns, Physicians'/standards ; Practice Patterns, Physicians'/statistics & numerical data* ; Propofol ; Quality Improvement ; Republic of Korea ; Surveys and Questionnaires

Abstract: BACKGROUND/AIMS: This study sought to characterize the current sedation practices of Korean endoscopists in real-world settings.
METHODS: All active members of the Korean Society of Gastrointestinal Endoscopy were invited to complete an anonymous 35-item questionnaire.
RESULTS: The overall response rate was 22.7% (1,332/5,860). Propofol-based sedation was the dominant method used in both elective esophagogastroduodenoscopy (55.6%) and colonoscopy (52.6%). The mean satisfaction score for propofol-based sedation was significantly higher than that for standard sedation in both examinations (all p<0.001). The use of propofol was supervised exclusively by endoscopists (98.6%). Endoscopists practicing in nonacademic settings, gastroenterologists, or endoscopists with.
CONCLUSIONS: Endoscopist-directed propofol administration is the predominant sedation method used in Korea. This survey strongly suggests that there is much room for quality improvement regarding sedation training and patient vigilance in endoscopist-directed sedation.