1.Academy of Medicine, Singapore clinical guideline on the use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting.
Tiing Leong ANG ; Edwin SEET ; Yaw Chong GOH ; Wee Khoon NG ; Calvin Jianyi KOH ; Hock Foong LUI ; James Weiquan LI ; Aung Myint OO ; Kieron Boon Leng LIM ; Kok Sun HO ; Min Hoe CHEW ; Wai Leong QUAN ; Damien Meng Yew TAN ; Kheng Hong NG ; Hak Su GOH ; Wai Kit CHEONG ; Philip TSENG ; Khoon Lin LING
Annals of the Academy of Medicine, Singapore 2022;51(1):24-39
INTRODUCTION:
In Singapore, non-anaesthesiologists generally administer sedation during gastrointestinal endoscopy. The drugs used for sedation in hospital endoscopy centres now include propofol in addition to benzodiazepines and opiates. The requirements for peri-procedural monitoring and discharge protocols have also evolved. There is a need to develop an evidence-based clinical guideline on the safe and effective use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting.
METHODS:
The Academy of Medicine, Singapore appointed an expert workgroup comprising 18 gastroenterologists, general surgeons and anaesthesiologists to develop guidelines on the use of sedation during gastrointestinal endoscopy. The workgroup formulated clinical questions related to different aspects of endoscopic sedation, conducted a relevant literature search, adopted Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology and developed recommendations by consensus using a modified Delphi process.
RESULTS:
The workgroup made 16 recommendations encompassing 7 areas: (1) purpose of sedation, benefits and disadvantages of sedation during gastrointestinal endoscopy; (2) pre-procedural assessment, preparation and consent taking for sedation; (3) Efficacy and safety of drugs used in sedation; (4) the role of anaesthesiologist administered sedation during gastrointestinal endoscopy; (5) performance of sedation; (6) post-sedation care and discharge after sedation; and (7) training in sedation for gastrointestinal endoscopy for non-anaesthesiologists.
CONCLUSION
These recommendations serve to guide clinical practice during sedation for gastrointestinal endoscopy by non-anaesthesiologists in the hospital setting.
Conscious Sedation
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Endoscopy, Gastrointestinal
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Hospitals
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Humans
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Hypnotics and Sedatives
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Singapore
2.Chapter of Gastroenterologists professional guidance for management of patients with liver disease in Singapore during the COVID-19 pandemic.
Jason Pik Eu CHANG ; Yu Jun WONG ; Wei Lyn YANG ; Kieron Boon Leng LIM ; Poh Seng TAN ; Gim Hin HO ; Benjamin Cherng Hann YIP ; James Weiquan LI ; Chern Hao CHONG ; David Eng Hui ONG ; Tju Siang CHUA ; Charles Kien Fong VU ; Kok Ann GWEE ; Tiing Leong ANG ; Chee Kiat TAN
Singapore medical journal 2020;61(12):619-623
In this paper, we aim to provide professional guidance to clinicians who are managing patients with chronic liver disease during the current coronavirus disease 2019 (COVID-19) pandemic in Singapore. We reviewed and summarised the available relevant published data on liver disease in COVID-19 and the advisory statements that were issued by major professional bodies, such as the American Association for the Study of Liver Diseases and European Association for the Study of the Liver, contextualising the recommendations to our local situation.
COVID-19/epidemiology*
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Carcinoma, Hepatocellular/therapy*
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Chronic Disease
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Hepatitis B, Chronic/therapy*
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Hepatitis C, Chronic/therapy*
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Humans
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Liver Cirrhosis/therapy*
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Liver Diseases/therapy*
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Liver Neoplasms/therapy*
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Liver Transplantation
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Singapore/epidemiology*