CURRENT STATUS AND PERSPECTIVE OF SEDATION IN GASTROINTESTINAL ENDOSCOPY

Abstract

Sedation plays an integral role in various clinical settings, including screening endoscopy and advanced gastrointestinal endoscopic procedures. However, sedative agents that have long been used in Japan are not approved for insurance coverage. Current Japanese guidelines for sedation in gastrointestinal endoscopy are largely based on evidence derived from studies conducted in other countries. In Japan, sedation is commonly administered by endoscopists rather than anesthesiologists during routine clinical practice. Ideal sedation regimens offer rapid induction and recovery while ensuring high levels of safety and satisfaction for patients and physicians. Because deeply sedating agents may adversely affect cardiopulmonary function, minimizing drug dosage through combination therapy with analgesics or adjunctive agents is preferable. Future trends in sedation are expected to shift toward ultra-short-acting medications with reduced cardiopulmonary suppression, while also considering health care economics.