Specialist Updates 
Gastroenterology

Endoscopic procedures: Should nurses administer propofol?

Endoscopists from an Australian hospital say guidelines should be changed to allow them to direct nurses to perform sedation
Clare Pain
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17 August 2020
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Sedation using propofol in low-risk patients having endoscopic procedures can be carried out safely by the endoscopist directing a registered nurse to administer the hypnotic, according to doctors from a Queensland hospital.

They say endoscopist-directed nurse-administered propofol sedation (EDNAPS) is supported as being safe and effective by overseas research but is not included in current Australian and New Zealand College of Anaesthetists (ANZCA) sedation guidelines.

While the ANZCA guidelines allow endoscopists to direct sedation using benzodiazepine/opioid combinations, the presence of a second trained medical practitioner is required when propofol is used. 

The gastroenterologists provide results from a prospective cohort study carried out at Cairns Hospital, Queensland, between 2013 and 2019, where low-risk endoscopic procedures have been carried out by EDNAPS since 2000.

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