0
Letters |

Anesthesia Care for Low-Risk Patients Undergoing Gastrointestinal Endoscopies

Azriel Perel, MD
JAMA. 2012;307(24):2585-2587. doi:10.1001/jama.2012.6537.
Text Size: A A A
Published online

Extract

To the Editor: Authors from the RAND Corporation recently reported that utilization of anesthesia services during gastroenterology procedures increased substantially and that much of the associated expenditure can be considered potentially discretionary because sedation of low-risk patients by nonanesthesiologists is safe.1 The authors partly attribute this seemingly unjustified growth of anesthesia services to the adoption of propofol.1 Due to its short-acting properties, propofol has become a popular drug for procedural sedation. However, propofol administration may be associated with serious adverse effects, which include hypotension, bradycardia, airway obstruction, hypoventilation, hypoxemia, and apnea. In addition, propofol has a narrow therapeutic range, which may lead to an unintentional slip into a state of general anesthesia, especially in elderly patients. When such adverse effects occur, they require active respiratory and cardiovascular rescue measures because there are no specific antagonists that reverse the action of propofol. Because of these well-known risks, the manufacturers of the drug restricted its use to persons trained in the administration of general anesthesia only.

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

June 27, 2012
Pascal Scemama, MD, MBA; Brian Lee, MD; Emily Guimaraes, MD
JAMA. 2012;307(24):2585-2587. doi:10.1001/jama.2012.6539.
June 27, 2012
Douglas K. Rex, MD
JAMA. 2012;307(24):2585-2587. doi:10.1001/jama.2012.6535.
June 27, 2012
James Nielsen, MBBS, FANZCA
JAMA. 2012;307(24):2585-2587. doi:10.1001/jama.2012.6533.
June 27, 2012
Hangsheng Liu, PhD; Soeren Mattke, MD, DSc
JAMA. 2012;307(24):2585-2587. doi:10.1001/jama.2012.6541.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Jobs
brightcove.createExperiences();