Midway sedation list for endoscopy

This project saw the introduction of a fixed anaesthetist led propofol list for patients requiring an endoscopy who cannot tolerate conscious sedation. This highly successful work has now been adopted as an ongoing service by Betsi Cadwaladr University Health Board at one site, with consideration being given to adopting it at a further two sites.

Endoscopies are mostly performed in day-case endoscopy units under conscious sedation. Conscious sedation provides a high level of patient and physician satisfaction with low adverse effects and associated higher procedural completion rates.

However, some patients do not tolerate endoscopic procedures under conscious sedation and subsequently undergo endoscopy under general anaesthesia in a surgical operating theatre. These patients often have longer waiting times which can have implications for diagnostic times and onward treatment.

Unlike endoscopy under general anaesthesia, sedation via propofol means the procedure can be performed within the endoscopy unit, and can result in shorter recovery times for patients.

Implementing this service added to, and complemented, the service already offered to patients with suspected cancer, providing patient choice in treatment options, empowering them early on in their treatment journey and led to an 80% reduction in the general anaesthesia list.