Issa IA, Lakis R, Issa T. Sedation in endoscopy: Finding the balance between safety and efficacy. World J Gastrointest Endosc 2025; 17(8): 109695 [DOI: 10.4253/wjge.v17.i8.109695]
Corresponding Author of This Article
Iyad A Issa, MD, Consultant, Department of Gastroenterology and Hepatology, Harley Street Medical Center, No. A21 Villa, Marina Village, Abu Dhabi 41475, United Arab Emirates. iyadissa71@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Aug 16, 2025; 17(8): 109695 Published online Aug 16, 2025. doi: 10.4253/wjge.v17.i8.109695
Sedation in endoscopy: Finding the balance between safety and efficacy
Iyad A Issa, Remi Lakis, Taly Issa
Iyad A Issa, Department of Gastroenterology and Hepatology, Harley Street Medical Center, Abu Dhabi 41475, United Arab Emirates
Remi Lakis, Department of Gastroenterology and Hepatology, Al Zahra University Hospital, Beirut 0000, Beyrouth, Lebanon
Taly Issa, Medical School, University of Nicosia, Nicosia 24005, Lefkosía, Cyprus
Author contributions: Issa IA designed the overall concept and outline of the manuscript; Lakis R and Issa T contributed to the discussion and design of the manuscript; Issa IA, Lakis R and Issa T contributed to the writing, and editing the manuscript, illustrations, and review of literature; all authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Iyad A Issa, MD, Consultant, Department of Gastroenterology and Hepatology, Harley Street Medical Center, No. A21 Villa, Marina Village, Abu Dhabi 41475, United Arab Emirates. iyadissa71@gmail.com
Received: May 19, 2025 Revised: June 8, 2025 Accepted: July 17, 2025 Published online: August 16, 2025 Processing time: 88 Days and 19.5 Hours
Abstract
Sedation is the standard of care in gastrointestinal (GI) endoscopy in most institutions. Various protocols are employed to ensure a comfor patient experience and a high procedural success rate. Benzodiazepines combined with opioids are the most commonly used methods. However, these drugs have been associated with numerous adverse effects, including respiratory depression, hypoxia, and hypotension. Cohen et al conducted a study in this issue demonstrating the ability to minimize or eliminate opioid use without compromising procedural success rate or patient comfort. In this editorial, we explore the diverse sedation methods employed in GI procedures, assess the efficacy and safety of the drugs used, and highlight best practices
Core Tip: Optimizing sedation in gastrointestinal endoscopy requires a careful balance of efficacy and safety, tailored to individual patient needs and procedural demands. Recent insights suggest that midazolam as a standalone agent can achieve comparable patient satisfaction and safety profiles to the traditional midazolam-fentanyl combination, potentially reducing the risk of opioid-related complications.
