REAL RESULTS FROM VIRTUAL SEDATION: APPLICATION TO COLONSCOPY

Abstract

The aim of sedation during endoscopic procedures is to maintain the patient's comfort and sleepiness while avoiding very deep sedation, which could lead to respiratory depression and the loss of the cough and gag reflexes. In our institution, propofol is frequently used to profoundly sedate patients undergoing endoscopic procedures including colonoscopies and gastroscopies. A narrow therapeutic window exists for propofol, characterized by quick transitions from mild sleepiness to deep global anesthesia. The pharmacological response to propofol varies greatly from person to person. For example, obese patients with a STOP-BANG anesthesia risk score of 5 or higher may be particularly susceptible to the effects of propofol, since this medication may relax the soft tissues of the upper airways and lead to rapid oxygen desaturation and hypoxia, particularly in obese patients with a significantly lower functional residual capacity. Virtual sedation may be an excellent technique to limit the usage of hypnotics and anxiolytic treatment and their negative effects, as well as to prevent anxiety and unpleasant feelings during medical procedures. Currently, virtual sedation is promoted as a functional medical tool of particular utility in patient categories characterized by unexpected reactions such as pediatric patients