[Solved]: rephrase Propofol & satisfaction The quality of…

rephrase Propofol & satisfaction The quality of examinations is improved by the incorporation of sedation and analgesia into endoscopic procedures influencing patients’ willingness to undergo an endoscopic examination or repeated examinations. The practice of sedation for endoscopy varies widely between and within regions. Due to propofol characteristics which combines a rapid onset of action with a short-term effect moreover allowing shorter recovery time and greater patient and examiner satisfaction have surely contributed to the position of this drug, considering it the ideal sedative agent for outpatient and relatively short endoscopic procedures. Sedation during endoscopic procedures has been a topic of debate for the past decade, including how and who should administer it. There is evidence of widespread propofol use for GI endoscopy in several European nations replacing benzodiazepine-based sedation mostly given by endoscopists on their own, without an anesthesiologist’s help. Based on the efficacy and safety of propofol; in diagnostic and therapeutic endoscopy in patients with certain comorbidities such as liver cirrhosis Singapore has appraised that Propofol sedation is efficacious and has advantages over benzodiazepines and other sedatives for GI endoscopy (1). A stable level of sedation was achieved with propofol in heavy drinkers who were hard to sedate with benzodiazepines because of disinhibition. In Canada Propofol was administered largely as an adjunct to fentanyl and midazolam, alone or in combination, if the level of sedation–analgesia was insufficient. Sedative agents were administered by IV bolus by a registered nurse trained in endoscopy, under the direction and supervision of the endoscopist moreover propofol being reserved primarily for patients with poor tolerance of endoscopic procedures, approximately one-half of the gastroenterologists not currently using propofol would like to start (8)/ (37). Propofol is the first choice in endoscopy for the European Society of Gastrointestinal Endoscopy (2). In Italy and Portugal, the preferred agent is propofol and is exclusively administered by an anesthesiologist. Sedation in GIE units is prevalent in Spain, and propofol is usually administered by an anesthesiologist (15). Propofol sedation mainly delivered by nurses or physicians who are non-anesthesiologists is now the routine standard of care in German endoscopy (36). In Greece (12) propofol is used in selected cases; administration was directed by an anesthesiologist, The introduction of a strict training curriculum for endoscopic sedation can effectively eliminate the barriers preventing gastroenterologists from administering propofol (18). In southern India it was found that only a quarter of the centers used propofol without the presence of an anesthesiologist in the endoscopy unit (22). Propofol is currently being used for sedation in approximately one quarter of all endoscopies in the United States gastroenterologists using propofol sedation are administering the drug themselves without an anesthesiologist or CRNA (25). Because of better patient satisfaction and endoscopist’s satisfaction with-out an increase in AEs; propofol based sedation was the most preferred method in most endoscopy units in South Korea in 2019. The majority of these countries permit non-anesthesiologists to perform sedations in GIE However in China The most commonly used sedative was propofol the most commonly used combination of sedatives was propofol plus an opioid, all gastrointestinal endoscopies with sedation were only performed by anesthesiologists (13). Propofol is the drug of choice for endoscopy sedation administered by specialist anesthetists in Australia (14), The Australian guideline recommends that all sedation is directed by medical practitioners; that only anesthesiologists and other suitably qualified medical practitioners administer propofol and deep sedation/general anesthesia (28). Propofol sedation, whether administered by anesthesia professional or an endoscopist, results in faster onset of sedation, reduced recovery time, and quicker discharge when compared with standard sedation using a benzodiazepine and ⁄or opioid. (38) However, propofol has the risk of a rapid change from conscious to deep sedation or even general anesthesia with consecutive cardiopulmonary depression therefore monitoring is important to diagnose and prevent the complications (20) by the use of oxygen supplementation and monitoring of oxygen saturation more frequently (19).