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World J Gastroenterol. Jul 28, 2013; 19(28): 4633-4634
Published online Jul 28, 2013. doi: 10.3748/wjg.v19.i28.4633
Published online Jul 28, 2013. doi: 10.3748/wjg.v19.i28.4633
Conscious sedation: A dying practice?
Palaniappan Manickam, Division of Gastroenterology, Department of the Internal Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, MI 48037, United States
Ziad Kanaan, Khalid Zakaria, Department of Internal Medicine, Wayne State University, Rochester, MI 48307, United States
Author contributions: All authors contributed equally to this work.
Correspondence to: Palaniappan Manickam, MD, MPH, Division of Gastroenterology, Department of the Internal Medicine, Oakland University William Beaumont School of Medicine, North Squirrel Road, Royal Oak, MI 48037, United States. palaniappan.manickam@beaumont.edu
Telephone: +1-248-5511227 Fax: +1-248-5517581
Received: March 28, 2013
Revised: June 10, 2013
Accepted: June 18, 2013
Published online: July 28, 2013
Revised: June 10, 2013
Accepted: June 18, 2013
Published online: July 28, 2013
Core Tip
Core tip: Even though the most recent “Multisociety sedation curriculum for gastrointestinal endoscopy” guidelines addressed the upper-limit range of Midazolam for proper sedation in prolonged endoscopic procedures, there are no clear-cut guidelines on the upper limit of Fentanyl dosing, especially with the risk of rigid chest syndrome and drug accumulation in skeletal muscle at high doses. Additionally, we also raised the question of whether Propofol or other agents used for deep sedation should be a routine indication for patients with chronic opioid use.