Procedural sedation and analgosedation in adults during diagnostic esophagogastroduodenoscopy and colonoscopy. Guidelines of the All-Russian public organization “Federation of Anesthesiologists and Reanimatologists”

According to the Order of the Ministry of Health of the Russian Federation dated 04.27.2021 No 404n, as part of the medical screening of the adult population, it is mandatory to perform esophagogastroduodenoscopy at the first stage of medical examination at the age of 45 and colonoscopy for persons aged 40 years in the scope of the second stage of medical screening. The value of esophagogastroduodenoscopy and colonoscopy depends on the quality of the examination of the mucous membrane and the timely examination. There are many factors that prevent the achievement of the criteria for the quality of the study, including the lack or insufficient depth of procedural sedation and/or analgesia. The article presents guidelines for procedural sedation and/or analgesia in adult patients with esophagogastroduodenoscopy and colonoscopy. The recommendations are based on regulatory legal acts, guidelines, and the results of clinical trials and metanalyses. The evidence of the need for esophagogastroduodenoscopy and colonoscopy under conditions of procedural sedation and/or analgesia is substantiated. The recommendations describe algorithms for assessing the risk of lung aspiration and cardiopulmonary complications before performing endoscopic examinations. Based on the results of clinical studies, a technique of stepwise administration of propofol has been developed. Extended periprocedural monitoring of vital functions is proposed. The criteria for recovery and discharge of patient’s home are described. The developed recommendations are aimed at providing effective and safe procedural sedation and/or analgesia in adult patients with diagnostic esophagogastroduodenoscopy and colonoscopy.