{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T13:27:06Z","timestamp":1777123626323,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T00:00:00Z","timestamp":1734739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The efficacy and safety of a sedation regimen combining dexmedetomidine and midazolam during endoscopic submucosal dissection for upper gastrointestinal tumors remains unclear. In this study, we aimed to evaluate the efficacy and safety of this sedation regimen, where non\u2010anesthesiologists performed sedation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixty\u2010eight patients who underwent endoscopic submucosal dissection for upper gastrointestinal tumors, sedated by non\u2010anesthesiologists, were retrospectively evaluated. The sedation was performed by non\u2010anesthesiologists as part of on\u2010the\u2010job training (OJT) under anesthesiologists' supervision. Each non\u2010anesthesiologist received OJT at least thrice. Proficiency levels were assessed during the third OJT session. The target sedation depth was a Richmond Agitation\u2010Sedation Scale of \u22122 to \u22124, with 2 L\/min of oxygen delivered via a nasal cannula at sedation initiation. The treatment completion rates, which measured efficacy and safety, were assessed by the frequencies of respiratory depression, hypotension, and bradycardia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 14, 52, and two patients with superficial esophageal cancer, early gastric cancer, and gastric adenoma, respectively. The median treatment time was 68 and 84\u00a0min for superficial esophageal cancer, early gastric cancer, and adenoma, respectively. Endoscopic submucosal dissection was completed in all patients. No severe sedation\u2010related adverse events were reported; however, peripheral arterial oxygen saturation &lt;90%, hypotension, and bradycardia occurred in 1 (1.5%), 30 (44.1%), and 30 patients (44.1%), respectively. All 22 non\u2010anesthesiologists who underwent the proficiency evaluation passed the test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A sedation regimen combining dexmedetomidine and midazolam can be feasibly administered by non\u2010anesthesiologists. Further studies are needed to verify the effectiveness of OJT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/deo2.70045","type":"journal-article","created":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T18:58:46Z","timestamp":1734807526000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Feasibility of non\u2010anesthesiologist\u2010administered sedation with dexmedetomidine and midazolam during endoscopic submucosal dissection of upper gastrointestinal tumors"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6434-2902","authenticated-orcid":false,"given":"Kenji","family":"Ishido","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Kitasato University School of Medicine  Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kitasato University School of Medicine  Kanagawa Japan"},{"name":"Department of Gastroenterology Ebina General Hospital  Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gen","family":"Kitahara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kitasato University School of Medicine  Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuaki","family":"Furue","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kitasato University School of Medicine  Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuya","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kitasato University School of Medicine  Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akinori","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kitasato University School of Medicine  Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromi","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Kitasato University School of Medicine  Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirotsugu","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Kitasato University School of Medicine  Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chika","family":"Kusano","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kitasato University School of Medicine  Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.06.002"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e32832dba50"},{"key":"e_1_2_10_4_1","unstructured":"Japanese Society of Anesthesiologists. Proposal of the Japanese Society of Anesthesiologists for the shortage of anesthesiologist manpower. Accessed: October 2 2024 (In Japanese).https:\/\/anesth.or.jp\/files\/download\/news\/suggestion20050209_1.pdf"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2017.07.018"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13882"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-018-0897-5"},{"key":"e_1_2_10_8_1","unstructured":"American Society of Anesthesiologists. ASA physical status classification system. 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