| Theme | Optimal Sedation in Gastrointestinal Endoscopy : Understanding and Using the New Guidelines Correctly | |
|---|---|---|
| Title | Administration and Drawbacks of Antagonists | |
| Publish Date | 2015/05 | |
| Author | Takuto Hikichi | Department of Endoscopy, Fukushima Medical University Hospital, Fukushima Medical University |
| Author | Katsutoshi Obara | Department of Endoscopy, Fukushima Medical University Hospital, Fukushima Medical University |
| Author | Tadayuki Takagi | Department of Gastroenterology and Rheumatology, School of Medicine, Fukushima Medical University |
| Author | Rei Suzuki | Department of Gastroenterology and Rheumatology, School of Medicine, Fukushima Medical University |
| Author | Ko Watanabe | Department of Endoscopy, Fukushima Medical University Hospital, Fukushima Medical University |
| Author | Jun Nakamura | Department of Gastroenterology and Rheumatology, School of Medicine, Fukushima Medical University |
| [ Summary ] | Sedation is useful in order to perform painless and safe endoscopic procedures；however, it may also be associated with critical respiratory depression. Therefore, when sedation is administered in endoscopic procedures, it is important to allocate capable staff members and secure environments that allow strict monitoring and proper administration of antagonists for sedative drugs. Staff members require full training on the administration of antagonists. Since flumazenil, as an antagonist for benzodiazepines, is quickly metabolized by the liver and has a short half‒life, its administration may result in re‒sedation. Furthermore, flumazenil is not recommended for patients taking benzodiazepines for the treatment of epilepsy because the administration of this drug may increase the risk of an epileptic seizure. Naloxone hydrochloride is also administered as an antagonist for opioids, although its use is limited. The practice simulation of endoscopic procedures under sedation is an important staff requirement for the training in sedation‒related adverse events. | |