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European Society of Anaesthesiology and European Board of Anaesthesiology guidelines for procedural sedation and analgesia in adults

Hinkelbein, Jochen; Lamperti, Massimo; Akeson, Jonas LU ; Santos, Joao; Costa, Joao; De Robertis, Edoardo; Longrois, Dan; Novak-Jankovic, Vesna; Petrini, Flavia and Struys, Michel M.R.F., et al. (2018) In European Journal of Anaesthesiology 35(1). p.6-24
Abstract

Procedural sedation and analgesia (PSA) has become a widespread practice given the increasing demand to relieve anxiety, discomfort and pain during invasive diagnostic and therapeutic procedures. The role of, and credentialing required by, anaesthesiologists and practitioners performing PSA has been debated for years in different guidelines. For this reason, the European Society of Anaesthesiology (ESA) and the European Board of Anaesthesiology have created a taskforce of experts that has been assigned to create an evidence-based guideline and, whenever the evidence was weak, a consensus amongst experts on: The evaluation of adult patients undergoing PSA, the role and competences required for the clinicians to safely perform PSA, the... (More)

Procedural sedation and analgesia (PSA) has become a widespread practice given the increasing demand to relieve anxiety, discomfort and pain during invasive diagnostic and therapeutic procedures. The role of, and credentialing required by, anaesthesiologists and practitioners performing PSA has been debated for years in different guidelines. For this reason, the European Society of Anaesthesiology (ESA) and the European Board of Anaesthesiology have created a taskforce of experts that has been assigned to create an evidence-based guideline and, whenever the evidence was weak, a consensus amongst experts on: The evaluation of adult patients undergoing PSA, the role and competences required for the clinicians to safely perform PSA, the commonly used drugs for PSA, the adverse events that PSA can lead to, the minimum monitoring requirements and post-procedure discharge criteria. A search of the literature from 2003 to 2016 was performed by a professional librarian and the retrieved articles were analysed to allow a critical appraisal according to the Grading of Recommendations Assessment, Development and Evaluation method. The Taskforce selected 2248 articles. Where there was insufficiently clear and concordant evidence on a topic, the Rand Appropriateness Method with three rounds of Delphi voting was used to obtain the highest level of consensus among the taskforce experts. These guidelines contain recommendations on PSA in the adult population. It does not address sedation performed in the ICU or in children and it does not aim to provide a legal statement on how PSA should be performed and by whom. The National Societies of Anaesthesiology and Ministries of Health should use this evidence-based document to help decision-making on how PSA should be performed in their countries. The final draft of the document was available to ESA members via the website for 4 weeks with the facility for them to upload their comments. Comments and suggestions of individual members and national Societies were considered and the guidelines were amended accordingly. The ESA guidelines Committee and ESA board finally approved and ratified it before publication.

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European Journal of Anaesthesiology
volume
35
issue
1
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19 pages
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European Society of Anaesthesiology
external identifiers
  • scopus:85039721045
ISSN
0265-0215
DOI
10.1097/EJA.0000000000000683
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English
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yes
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17ccd2e8-45d1-443b-8420-b443ae5d8137
date added to LUP
2018-01-22 09:56:46
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2018-01-23 03:00:14
@article{17ccd2e8-45d1-443b-8420-b443ae5d8137,
  abstract     = {<p>Procedural sedation and analgesia (PSA) has become a widespread practice given the increasing demand to relieve anxiety, discomfort and pain during invasive diagnostic and therapeutic procedures. The role of, and credentialing required by, anaesthesiologists and practitioners performing PSA has been debated for years in different guidelines. For this reason, the European Society of Anaesthesiology (ESA) and the European Board of Anaesthesiology have created a taskforce of experts that has been assigned to create an evidence-based guideline and, whenever the evidence was weak, a consensus amongst experts on: The evaluation of adult patients undergoing PSA, the role and competences required for the clinicians to safely perform PSA, the commonly used drugs for PSA, the adverse events that PSA can lead to, the minimum monitoring requirements and post-procedure discharge criteria. A search of the literature from 2003 to 2016 was performed by a professional librarian and the retrieved articles were analysed to allow a critical appraisal according to the Grading of Recommendations Assessment, Development and Evaluation method. The Taskforce selected 2248 articles. Where there was insufficiently clear and concordant evidence on a topic, the Rand Appropriateness Method with three rounds of Delphi voting was used to obtain the highest level of consensus among the taskforce experts. These guidelines contain recommendations on PSA in the adult population. It does not address sedation performed in the ICU or in children and it does not aim to provide a legal statement on how PSA should be performed and by whom. The National Societies of Anaesthesiology and Ministries of Health should use this evidence-based document to help decision-making on how PSA should be performed in their countries. The final draft of the document was available to ESA members via the website for 4 weeks with the facility for them to upload their comments. Comments and suggestions of individual members and national Societies were considered and the guidelines were amended accordingly. The ESA guidelines Committee and ESA board finally approved and ratified it before publication.</p>},
  author       = {Hinkelbein, Jochen and Lamperti, Massimo and Akeson, Jonas and Santos, Joao and Costa, Joao and De Robertis, Edoardo and Longrois, Dan and Novak-Jankovic, Vesna and Petrini, Flavia and Struys, Michel M.R.F. and Veyckemans, Francis and Fuchs-Buder, Thomas and Fitzgerald, Robert},
  issn         = {0265-0215},
  language     = {eng},
  number       = {1},
  pages        = {6--24},
  publisher    = {European Society of Anaesthesiology},
  series       = {European Journal of Anaesthesiology},
  title        = {European Society of Anaesthesiology and European Board of Anaesthesiology guidelines for procedural sedation and analgesia in adults},
  url          = {http://dx.doi.org/10.1097/EJA.0000000000000683},
  volume       = {35},
  year         = {2018},
}