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Vol. 40. Issue 1.
Pages 67-74 (January - March 2012)
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Vol. 40. Issue 1.
Pages 67-74 (January - March 2012)
DOI: 10.1016/S0120-3347(12)70012-6
Open Access
Recomendaciones para la sedación y la analgesia por médicos no anestesiólogos y odontólogos de pacientes mayores de 12 años
Sedation and analgesia recommendations for non-anesthesiologist physicians and dentists in patients over 12 years old
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Pedro Ibarraa,??
Corresponding author
halogenado@gmail.com

Autor para correspondencia: Avda. Calle 127 # 21-60 cons. 218 Bogotá, Colombia, 110121.
, Manuel Galindob, Alberto Molanoc, Claudia Niñob, Adriana Rubianod, Piedad Echeverrye, Jorge Rincónf, Albis Hanig, Fabio Gilh, Luis Sabbaghi, Jaime Donadoj, Isabel Artunduagak, Rocío Carbonellk, Fernando Vieiral, Carlos Gaidosm, Ana María Orozcol, José Trigosn, Carolina Ruizo, Ricardo Baronap, Rafael Sarmientoq, Martha Fonsecak y Juan Polaníak
a Anestesiólogo. Coordinador, Comité de Seguridad, SCARE
b Anestesiólogo. Comité de Seguridad, SCARE
c Anestesiólogo. Sedarte Ltda
d Anestesiólogo. Sedación Ambulatoria, SAS
e Anestesióloga, Coordinadora, Comité de Anestesia Pediátrica, SCARE
f Cirujano maxilofacial, FOC
g Gastroenteróloga. Presidente, ACG
h Gastroenterólogo. Presidente, ACED
i Gastroenterólogo. Expresidente, ACED
j Odontólogo. Presidente, FOC
k Secretaría Distrital de Salud
l Anestesiólogo. MESEDA
m Odontólogo. Presidente, CCO
n Abogado, Comité de Sedación, FOC
o Odontopediatra. Presidente, ACOP
p Abogado, SCARE
q Anestesiólogo. Sociedad Cundinamarquesa de Anestesiología Sociedad Colombiana de Anestesiología y Reanimación (SCARE), Federación Odontológica Colombiana (FOC), Asociación Colombiana de Gastroenterología (ACG), Asociación Colombiana de Endoscopia Digestiva (ACED), Secretaría Distrital de Salud (SDS) de Bogotá, Colegio Colombiano de Odontólogos (CCO), Academia Colombiana de Odontología Pediátrica (ACOP). Bogotá, Colombia
Article information
Resumen

Las complicaciones relacionadas con la sedación son, en su enorme mayoría, prevenibles. El presente documento establece unas recomendaciones para que los no anestesiólogos puedan realizar sedaciones nivel I y II con un buen nivel de seguridad. Sus aspectos más importantes son: administración de la sedación por una persona diferente del operador; recomendaciones en cuanto a la capacitación, la monitorización, el uso de un solo medicamento para la sedación y la disponibilidad de medicamentos y equipos de respaldo; la necesidad de realizar una evaluación previa a la sedación, así como el consentimiento informado y el registro durante el procedimiento; y recomendaciones para considerar un bajo umbral con el fin de solicitar el apoyo de un anestesiólogo.

Palabras clave:
Consenso
Analgesia
Médicos
Odontólogos
Pacientes
Abstract

Most of the complications related to sedation are preventable. This document defines some recommendations for non-anesthesiologists so that they can provide sedation level I and II with adequate safety. The most important recommendations are: that the sedation be provided by someone different from the person who performs the surgical procedure; designation of the training and monitoring of thje person who sedates; the use of only one medication for sedation, and the availability of medications and equipment to manage complications; the mandatory need of an assessment prior to the sedation, as well as informed consent and record of events during the procedure; and the recommendation of having a low threshold to request the support of an anesthesiologist.

Keywords:
Consensus
Analgesia
Physicians
Dentists
Patients
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Referencias
[1.]
L. Landro.
Taming the ‘Wild West’ of Outpatient Surgery - Doctors’ Offices.
Wall Street Journal (Washington)., (2010),
[2.]
S.M. Bhananker, K.L. Posner, F.W. Cheney, et al.
Injury and liability associated with monitored anesthesia care: a closed claims analysis.
Anesthesiology., 104 (2006), pp. 228-234
[3.]
J. Metzner, K.B. Domino.
Risks of anesthesia or sedation outside the operating room: the role of the anesthesia care provider.
Curr Opin Anaesthesiol., 23 (2010), pp. 523-531
[4.]
J. Metzner, K.L. Posner, K.B. Domino.
The risk and safety of anesthesia at remote locations: the US closed claims analysis.
Curr Opin Anaesthesiol., 22 (2009), pp. 502-508
[5.]
B.V. Ambrosiadou, D.G. Goulis.
The DELPHI method as a consensus and knowledge acquisition tool for the evaluation of the DIABETES system for insulin administration.
Med Inform Internet Med., 24 (1999), pp. 257-268
[6.]
Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology. 2002;96:1004–17.
[7.]
M.J. Sagarin, E.D. Barton, Y.M. Chng, et al.
Airway management by US and Canadian emergency medicine residents: a multicenter analysis of more than 6,000 endotracheal intubation attempts.
Ann Emerg Med., 46 (2005), pp. 328-336
[8.]
M. Galindo Arias.
Morbimortalidad por anestesia en Colombia.
Rev Colomb Anestesiol., 31 (2003), pp. 53-61
[9.]
S. Ahmad.
Office based--is my anesthetic care any different?. Assessment and management.
Anesthesiology Clin., 28 (2010), pp. 369-384
[10.]
D.T. Goulson, R.Y. Fragneto.
Anesthesia for gastrointestinal endoscopic procedures.
Anesthesiology Clin., 27 (2009), pp. 71-85
[11.]
R.M. Pino.
The nature of anesthesia and procedural sedation outside of the operating room.
Curr Opin Anaesthesiol., 20 (2007), pp. 347-351
[12.]
World Health Organization (WHO).
Safe Surgery Saves Lives. Surgical Safety Checklist.
WHO, (2009),
[13.]
A. Arriaga, R. Urman, F. Shapiro.
Boston: Institute for Safety in Office-Based Surgery (ISOBS);.
Safety checklist for office-based surgery, (2010),
[14.]
ANZCA with other Societies and Colleges: Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical, Dental or Surgical Procedures, Review Professional Statement 9, 2010. Australia, New Zeland: College of Anaesthetists; 2010.
[15.]
K.R. McQuaid, L. Laine.
A systematic review and meta-analysis of randomized, controlled trials of moderate sedation for routine endoscopic procedures.
Gastrointest Endosc., 67 (2008), pp. 910-923
[16.]
American Dental Association (ADA).
Guidelines for the Use of Sedation and General Anesthesia by Dentists.
ADA, (2007),
[17.]
Center for Medicaid and State Operations/Survey and Certification Group: Revised Hospital Anesthesia Services Interpretive Guidelines-State Operations Manual (SOM) Appendix A. Baltimore: Services Hah., CMS; 2010. p. 16.
[18.]
Singh H, Poluha W, Cheung M, et al. Propofol for sedation during colonoscopy. Cochrane Database Syst Rev. 2008:CD006268.
[19.]
D.K. Rex, V.P. Deenadayalu, E. Eid, et al.
Endoscopist-directed administration of propofol: a worldwide safety experience.
Gastroenterol., 137 (2009), pp. 1229-1237
[20.]
A.M. Thompson, D.J. Wright, W. Murray, et al.
Analysis of 153 deaths after upper gastrointestinal endoscopy: room for improvement?.
Surg Endosc., 18 (2004), pp. 22-25
[21.]
J.J. Vargo, L.B. Cohen, D.K. Rex, et al.
Position statement: nonanesthesiologist administration of propofol for GI endoscopy.
Gastrointest Endosc., 70 (2009), pp. 1053-1059
[22.]
J. Woodcock.
FDA Denial Letter to ACG Petition on Propofol.
Department of Human and Health Services, (2010),
[23.]
J.M. Dumonceau, A. Riphaus, J.R. Aparicio, et al.
European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy.
Endoscopy., 42 (2010), pp. 960-974
Copyright © 2012. Sociedad Colombiana de Anestesiología y Reanimación
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