Abstracts from Around the World

The administration of propofol by nonanesthesiologists for gastrointestinal endoscopic procedures remains highly controversial. This statement, issued jointly by our 4 societies, is based upon a systematic literature review from an experienced, 4 member committee. To date, over 460,000 published cases of nonanesthesiologist administered propofol (NAAP) have been reported. Of these, there have been 3 deaths, all of which occurred during or after upper endoscopy. No mortalities have been reported in those undergoing colonoscopy or in those classified as American Society of Anesthesiology (ASA) Class I or II. When examining economic models, cost effectiveness appears to be improved for gastroenterologist administered propofol for advanced procedures (eg, endoscopic retrograde cholangiopancreatography [ERCP] or endoscopic ultrasonography [EUS]). Anesthesiologist administered sedation for healthy low risk patients was not proven to be beneficial. The overall safety profile of NAAP is equivalent to standard sedation for routine procedures and may be equivalent for advanced procedures, although more data are needed. Training guidelines were offered for those physicians who wish to provide propofol and were comprised of 4 components: didactic training, airway workshop, simulation training, and preceptorship.