Sedation practices of Greek gastroenterologists: developments in the last decade

Aims Sedation in endoscopy is rapidly evolving worldwide. There are significant differences between countries regarding the use of sedation, the drug agents involved, and the person responsible for administering sedation. Furthermore, in each country, these practices are evolving for a variety of practical, medical, and legal reasons. Our study aimed to analyse the practices of Greek gastroenterologists regarding sedation in endoscopy.

Methods The study was conducted over three periods: 2015, 2018 and 2023. An online questionnaire on endoscopic sedation practices was sent to all registered Greek gastroenterologists via e-mail.

Results Response rates were 38.3% (195/509), 47.1% (258/548) and 48.7% (252/517), respectively. 25.1%, 16.7% and 20.6% of physicians did not regularly use sedation in gastrointestinal endoscopy. Most gastroenterologists (70% in all three periods) almost did not collaborate with an anesthesiologist in almost all cases. Midazolam was used by nearly 90% of physicians utilising sedation, in all three periods. Propofol was used by 30.8%, 27% and 45% of physicians employing sedation, respectively, with a significant increase in use in the last period (p<0.001). Gastroenterologists working in the private sector were more likely to use propofol (p<0.001 in all periods) and more likely to be aided by an anaesthesiologist (p<0.001 in all periods). Physicians using propofol were significantly more satisfied with sedation (p<0.001 in all periods), and most physicians chose propofol if they were to undergo endoscopy themselves, with a further increase in this preference in the last period (p=0.027). In the latter period, the majority of gastroenterologists reported being trained in resuscitation (83.7%) and that a formal training curriculum in sedation and resuscitation during residency should be instituted (96.4%).

Conclusions The use of sedation in gastrointestinal endoscopy is widespread among Greek gastroenterologists. Although midazolam is the most used agent, propofol is preferred by most physicians, with a significant increase in its use over the last decade. Greek gastroenterologists demonstrate a substantial level of training in resuscitation techniques and overwhelmingly consider the development of an educational framework on sedation and resuscitation to be essential.

Publication History

Article published online:
27 March 2025