CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(12): E1544-E1547
DOI: 10.1055/a-1964-7458
Original article

Implementation of the Aldrete score reduces recovery time after non-anesthesiologist-administered procedural sedation in gastrointestinal endoscopy

Philip Roelandt
1   Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium
2   Translational Research in Gastrointestinal Diseases (TARGID), Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
,
Rico Haesaerts
1   Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium
,
Ingrid Demedts
1   Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium
2   Translational Research in Gastrointestinal Diseases (TARGID), Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
,
Raf Bisschops
1   Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium
2   Translational Research in Gastrointestinal Diseases (TARGID), Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
› Author Affiliations
Supported by: Fonds Wetenschappelijk Onderzoek G072621N
Supported by: Stichting Tegen Kanker 2018-045

Abstract

Background and study aims Procedural sedation and analgesia (PSA) by trained non-anesthesiologist physicians and/or nurses is often performed during endoscopic procedures. Discharge from the recovery area after monitored observation is frequently based on fixed time parameters or subjective clinical assessment. In this study, the effect of implementation of the Aldrete score on recovery time after procedural sedation was analyzed in a real-life setting.

Patients and methods A prospective observational study of patients undergoing procedural sedation and analgesia during gastroscopy, colonoscopy or endoscopic ultrasound was performed. All procedures were randomly included to represent a real-life situation with different endoscopists, recovery nurses, endoscopy systems and indications. After a first observation period, all endoscopy nurses were trained to implement the Aldrete score when discharging patients, followed by a second observation period.

Results During the first observation period, the average time spent in the recovery area was 59 ± 22 minutes after procedural sedation. After implementation of the Aldrete score, the recovery time decreased significantly to 47 ± 25 minutes (P < 0.01) with identical doses of procedural sedation and analgesia. The decrease in time was between 19 % and 35 % for the different endoscopic procedures.

Conclusions Implementation of the Aldrete score after procedural sedation and analgesia significantly reduces the time spent in the recovery area. The score can be used to safely implement a discharge policy that provides more efficient and standardized management for an endoscopy service.



Publication History

Received: 18 July 2022

Accepted after revision: 12 October 2022

Article published online:
15 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Dumonceau JM, Riphaus A, Schreiber F. et al. Non-anesthesiologist administration of propofol for gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates Guideline – Updated June 2015. Endoscopy 2015; 47: 1175-1189
  • 2 Aldrete JA. The post-anesthesia recovery score revisited. J Clin Anesth 1995; 7: 89-91
  • 3 Bisschops R, Saunders R, Dooms C. et al. Implementing capnography to help improve patient safety during procedural sedation: quality improvement in a high-volume gastroenterology department. Eur J Gastroenterol Hepatol 2021; 33: e522-e528
  • 4 Aldrete JA, Kroulik D. A postanesthetic recovery score. Anesth Analg 1970; 49: 924-934
  • 5 Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg 1953; 32: 260-267
  • 6 Aldrete JA. Modifications to the postanesthesia score for use in ambulatory surgery. J Perianesth Nurs 1998; 13: 148-155
  • 7 DE-Quadros LG, Kaiser-Júnior RL, Felix VN. et al. Colonoscopy: randomized comparative study of insufflation with carbon dioxide versus air. Arq Bras Cir Dig 2017; 30: 177-181
  • 8 Marshall SI, Chung F. Discharge criteria and complications after ambulatory surgery. Anesth Analg 1999; 88: 508-517