attends to patients' post-procedural care.
Propofol is considered by some to be the ideal sedating agent for
endoscopic procedures due to its rapid onset, short half-life and easy
ability titrate doses to achieve the desired level of sedation. It can be
used to achieve mild, medium and deep sedation, and recovery is typi-
cally much quicker than with the midazolam-fentanyl combination.
Patients who regularly use sedatives and narcotics are often insensi-
tive to standard benzodiazepine sedation and may also benefit from
propofol sedation.
For procedures involving deep sedation with propofol, we monitor
the patient's heart rate and non-invasive blood pressure, and employ
continuous pulse oximetry, continuous ECG and capnography.
Constantly evolving
A team here at the Mayo Clinic regularly reviews indications for seda-
tion levels and improves the triaging of patients to moderate or deep
sedation based on procedure type, medical complexity and history of
difficult sedations. Everything we do, from the time a patient is first con-
tacted to the last touch before discharge, is designed to make sure all
patients receive safe sedation and appropriate care.
OSM
5 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 1 9
Dr. Jacob (jacob.adam@mayo.edu) is a consultant in the department of anes-
thesiology and perioperative medicine and an associate professor of anesthesiolo-
gy at the Mayo Clinic in Rochester, Minn.