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Chapter 14
ABSTRACT
Background:
In the Netherlands, sedation practitioners under indirect supervision of an
anaesthesiologist perform a significant proportion of moderate-to-deep sedations. To
evaluate safety of this practice, a national registry of sedation related adverse events was
assembled.
Methods:
This prospective observational data registry included all consecutive cases of
adults undergoing procedural analgo-sedation in 24 Dutch hospitals from the 1st February
2015 to 1st March 2016. Data was collected with an adopted adverse event-reporting tool
from the International Sedation Task Force of the World Society of Intravenous Anaesthesia.
Results:
11.869 patients undergoing moderate-to-deep sedation for a wide range of
procedures are included in the registry. Patients had a median (IQR)) age of 64 years (IQR
51-72) and were classified as ASA 1 in 19.1%; ASA 2 in 57.6%; ASA 3 in 21.6%, and ASA 4
in 1.2% of the cases. 1393 patients (11.7%) experienced at least one adverse event. The
majority of these patients (92%) received a - mostly simple - intervention (e.g. chin lift) to
treat the adverse event. Sixteen patients (0.13%) required an unplanned hospital admission,
2 patients (0.017%) had a poor outcome, both related to the procedure and not to the
sedation.
Conclusion:
Moderate to deep sedation performed by trained sedation practitioners results
in a low serious complication rate. On-going evaluation of care processes is required, to
ensure further performance improvement.