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Sedierung in der gastrointestinalen Endoskopie

Sedation in gastro-intestinal endoscopy

  • CME Weiterbildung · Zertifizierte Fortbildung
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Der Gastroenterologe Aims and scope

Zusammenfassung

Die erste deutsche S3-Leitlinie zur Sedierung in der gastrointestinalen Endoskopie [1] gibt einen strukturierten Überblick darüber, welche Anforderungen an strukturelle und persönliche Qualifikation bereits bestehen, welche Personalressourcen notwendig sind, nach welchen Standards adäquat über die Sedierung aufzuklären ist und wie die Risikostratifizierung der Patienten erfolgt. Neu ist hierbei die durch ein juristisches Fachgutachten von Prof. Dr. Dr. Alexander Ehlers und Partner (s. Homepage der DGVS) und verschiedene ärztliche Fachgruppen befürwortete Delegation einer Sedierung mit Propofol durch nichtärztliches Assistenzpersonal (sog. „nurse administered propofol sedation“, kurz NAPS) innerhalb klar definierter Grenzen. Weltweit einmalig ist, dass diese und auch die anderen Empfehlungen unter Einbindung sämtlicher auf diesem Gebiet relevanter Berufsgruppen, also Gastroenterologen, Anästhesisten, Chirurgen, endoskopisches Assistenzpersonal, Juristen, aber auch Patientenselbsthilfegruppen, etabliert und verabschiedet wurden. Der folgende Beitrag fasst die aktuellen Empfehlungen der Leitlinie zusammen. Auch auswärtige Leitlinien und neuere wissenschaftliche Ergebnisse wurden berücksichtigt.

Abstract

The first German S3 guidelines on sedation in gastro-intestinal endoscopy give a structured overview on which demands on structural and personnel qualifications already exist, which personnel resources are necessary, which standards can be used to adequately clarify sedation and how risk stratification of patients should be carried out. Newly included is the delegation of sedation with propofol to non-medical assistant personnel, so-called nurse-administered propofol sedation (NAPS) within clearly defined limits, advocated by a legal evaluation by Prof. Dr. Dr. Alexander Ehlers and Partner (see homepage of the DGVS) and various medical expert groups. A worldwide premiere is that this and the other recommendations have been established and ratified by all relevant professional groups in this area, i.e. gastro-enterologists, anesthetists, surgeons, endoscope assistant personnel, the legal profession and even patient self-help groups. The following article summarizes the current recommendations of the guidelines and takes guidelines from other countries and new scientific results into consideration.

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Interessenkonflikt

Die Autoren weisen auf folgende Beziehungen hin: Referentenhonorare von Fresenius Kabi, Falk Foundation, AstraZeneca. Unterstützung bei klinischen Studien: Fresenius Kabi, Oridion.

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Authors and Affiliations

  1. Medizinische Universitätsklinik, Knappschaftskrankenhaus, In der Schornau 23-25, 44892, Bochum, Deutschland

    A. Riphaus

  2. Fachbereich Gastroenterologie, Deutsche Klinik für Diagnostik, Aukammallee 33, 65193, Wiesbaden, Deutschland

    T. Wehrmann

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  1. A. Riphaus
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  2. T. Wehrmann
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Correspondence to A. Riphaus or T. Wehrmann.

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Riphaus, A., Wehrmann, T. Sedierung in der gastrointestinalen Endoskopie. Gastroenterologe 5, 143–155 (2010). https://doi.org/10.1007/s11377-009-0388-x

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