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Do we really need an anesthesiologist for routine colonoscopy in American Society of Anesthesiologist 1 and 2 patients?
- Source :
-
Current opinion in anaesthesiology [Curr Opin Anaesthesiol] 2018 Aug; Vol. 31 (4), pp. 463-468. - Publication Year :
- 2018
-
Abstract
- Purpose of Review: In an era where healthcare costs are being heavily scrutinized, every expenditure is reviewed for medical necessity. Multiple national gastroenterology societies have issued statements regarding whether an anesthesiologist is necessary for routine colonoscopies in American Society of Anesthesiologist (ASA) 1 and 2 patients.<br />Recent Findings: A large percentage of patients are undergoing screening colonoscopy without any sedation at all, which would not require an independent practitioner to administer medications. Advances in technique and technology are making colonoscopies less stimulating. Advantages to administering sedation, including propofol, have been seen even when not administered under the direction of an anesthesiologist and complications seem to be rare. The additional cost of having monitored anesthesia care appears to be a driving factor in whether a patient receives it or not.<br />Summary: A large multiinstitutional randomized control trial would be necessary to rule out potential confounders and to determine whether there is a safety benefit or detriment to having anesthesiologist-directed care in the setting of routine colonoscopies in ASA 1 and 2 patients. Further discussion would be necessary regarding what the monetary value of that effect is if a small difference were to be detected.
- Subjects :
- Anesthesia economics
Anesthesia methods
Colonoscopy economics
Colonoscopy methods
Colonoscopy standards
Colorectal Neoplasms diagnosis
Early Detection of Cancer economics
Early Detection of Cancer methods
Gastroenterology economics
Gastroenterology methods
Gastroenterology standards
Health Expenditures
Humans
Insurance, Health, Reimbursement standards
Mass Screening economics
Mass Screening methods
Mass Screening organization & administration
Patient Safety
Patient Satisfaction
Practice Guidelines as Topic
United States
Anesthesia statistics & numerical data
Anesthesiologists statistics & numerical data
Colonoscopy adverse effects
Early Detection of Cancer adverse effects
Mass Screening adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1473-6500
- Volume :
- 31
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Current opinion in anaesthesiology
- Publication Type :
- Academic Journal
- Accession number :
- 29870424
- Full Text :
- https://doi.org/10.1097/ACO.0000000000000608