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In this issue an impressive group of contributors at the forefront of sedation research has been assembled to provide endoscopists and dedicated nursing personnel alike a comprehensive review of important topics in the field sedation and analgesia. A discussion on the pharmacology and agents used to provide moderate and deep sedation provides the basic framework that is a crucial element in determining the driving force behind the developments in sedation and analgesia. An evidence-based approach on the use of unsedated endoscopy is also provided. Other topics included the use of propofol, patient-controlled sedation and analgesia, extended physiologic monitoring, risk management, and quality assurance as they apply to the spectrum of sedation in the endoscopy suite. Sedation and analgesia in the pediatric patient is also addressed.
Sedation Related to Gastrointestinal Endoscopy.
Endoscopy has had a major impact in the development of modern gastroenterology. By using different data it provided a better understanding of pathogenic mechanisms, described new entities and changed diagnostic and therapeutic strategies. Meanwhile, taking advantage of many technical advances, endoscopy has had a developed spectacularly. Video-endoscopes, magnification, confocal and narrow-band imaging endoscopes, endoscopic ultrasounds and enteroscopes emerged. Moreover, endoscopy has surpassed its function as an examination tool and it became a rapid and efficient therapeutic tool of low invasiveness. InTech Open Access Publisher selected several known names from all continents and countries with different levels of development. Multiple specific points of view, with respect to different origins of the authors were presented together with various topics regarding diagnostic or therapeutic endoscopy. This book represents a valuable tool for formation and continuous medical education in endoscopy considering the performances or technical possibilities in different parts of the world.
Sedation for gastrointestinal endoscopy is routinely employed to relieve patients' anxiety and fear of the examination. In recent years, propofol has become a suitable alternative to the previously widely used benzodiazepine. However, as sedation is estimated to be responsible for about 50% of all gastrointestinal endoscopy complications, proper training how to administer sedation and monitor sedated patients is important. This publication contains a selection of short expert reviews presented at an international meeting held in Athens in September 2009, funded by OMED, the Hellenic Society of Gastroenterology, the ESGE and UEGF, and endorsed by the ASGE. An international faculty discussed recent advances in the field, focusing on indications as well the nature and safety of sedatives and analgesics, their administration, the required monitoring and issues related to training in their use. Furthermore, medico-legal issues related to the use of propofol by gastroenterologists were discussed. Containing up-to-date information on sedation for gastrointestinal endoscopy, the publication at hand is a most useful tool for the clinician working in the field.
It's been 4 years since an issue was last devoted to endoscopic sedation, and this issue presents what has been learned and improved upon in that time. An impressive group of contributors at the forefront of sedation research has been assembled to provide endoscopists and dedicated nursing personnel alike a comprehensive review of important topics in the field sedation and analgesia. A discussion on the pharmacology and agents used to provide moderate and deep sedation provides the basic framework that is a crucial element in determining the driving force behind the developments in sedation and analgesia. Other topics included the use of propofol, patient-controlled sedation and analgesia, extended physiologic monitoring, risk management, and quality assurance as they apply to the spectrum of sedation in the endoscopy suite. Sedation and analgesia in the pediatric patient is also addressed.
The reference text for all those practicing diagnostic and therapeutic pediatric endoscopy – trainees, trainers, specialist endoscopists, gastroenterologists and hepatologists alike. Practical Pediatric Gastrointestinal Endoscopy, 3rd Edition provides a comprehensive and up-to-date exploration for the performance of endoscopy in infants, children and young adults. Written in the form of a complete "how to" manual and filled with step-by-step instructions, this book seeks to bring newcomers to the field of pediatric gastrointestinal endoscopy quickly up to speed. The book is also highly useful for experienced specialist endoscopists and gastroenterologists to brush up on best practice in standard techniques and explore advanced topics in the field. Practical Pediatric Gastrointestinal Endoscopy highlights the substantial and important differences between performing an endoscopy on a mature adult and performing one in a pediatric patient. The differences discussed include: GI pathology Subtleties of diagnostic technique specific to children Application of therapeutic endoscopy to specifically pediatric scenarios Anesthesia and sedation Training and skill maintenance Sophisticated endoscopic techniques adapted from adult endoscopy to children and those techniques specifically orientated to problems and diseases mainly encountered in childhood. This guide is becoming an essential companion for those of us providing diagnostic and therapeutic endoscopy for children in the world today and opens the door to future possibilities in this ever-evolving field.
This volume presents the technical and cultural state of the art of two of the riskiest, most complex and operator-dependent digestive operative techniques: endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography (EUS). The authors compare old and new techniques, shedding light on the most recent and innovative scientific findings, including those in the field of anatomic pathology and molecular biology considered relevant for the analysis of tissue samples collected during EUS. In view of the technical difficulties specific to these techniques, the book also offers access to online-videos and numerous images, making it a valuable resource both for physicians approaching these techniques for the first time as well as for those already using them. Organized into 7 sections, it describes in detail all techniques related to ERCP/EUS, together with any specific technical equipment required. It also presents a new paradigm based on the latest results in the areas of prevention, diagnosis and management of the most common complications. Clinical outcomes presented in international literature, as well as algorithms – both based on scientific evidence and expert findings – are illustrated and compared to alternative treatments.