{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T17:18:55Z","timestamp":1788369535556,"version":"build-2803163510"},"reference-count":30,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["thelancet.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["eClinicalMedicine"],"published-print":{"date-parts":[[2025,7]]},"DOI":"10.1016\/j.eclinm.2025.103307","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T19:42:01Z","timestamp":1750102921000},"page":"103307","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":21,"special_numbering":"C","title":["Pharmacological agents for procedural sedation and analgesia in patients undergoing gastrointestinal endoscopy: a systematic review and network meta-analysis"],"prefix":"10.1016","volume":"85","author":[{"given":"Jiaxin","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowen","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.eclinm.2025.103307_bib1","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1136\/gutjnl-2020-320690","article-title":"Endoscopy and central reading in inflammatory bowel disease clinical trials: achievements, challenges and future developments","volume":"70","author":"Gottlieb","year":"2021","journal-title":"Gut"},{"key":"10.1016\/j.eclinm.2025.103307_bib2","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1001\/jama.2023.25841","article-title":"Lower gastrointestinal hemorrhage","volume":"331","author":"Imran","year":"2024","journal-title":"JAMA"},{"key":"10.1016\/j.eclinm.2025.103307_bib3","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1055\/s-0030-1255612","article-title":"Patient satisfaction with on-demand sedation for outpatient colonoscopy","volume":"42","author":"Seip","year":"2010","journal-title":"Endoscopy"},{"key":"10.1016\/j.eclinm.2025.103307_bib4","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s12876-020-01561-z","article-title":"Sedation practices for routine gastrointestinal endoscopy: a systematic review of recommendations","volume":"21","author":"Dossa","year":"2021","journal-title":"BMC Gastroenterol"},{"key":"10.1016\/j.eclinm.2025.103307_bib5","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.bja.2021.01.028","article-title":"National survey on sedation for gastrointestinal endoscopy in 2758 Chinese hospitals","volume":"127","author":"Zhou","year":"2021","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.eclinm.2025.103307_bib6","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1136\/gutjnl-2023-330396","article-title":"British society of gastroenterology guidelines on sedation in gastrointestinal endoscopy","volume":"73","author":"Sidhu","year":"2024","journal-title":"Gut"},{"key":"10.1016\/j.eclinm.2025.103307_bib7","doi-asserted-by":"crossref","first-page":"456","DOI":"10.5217\/ir.2017.15.4.456","article-title":"Sedation for routine gastrointestinal endoscopic procedures: a review on efficacy, safety, efficiency, cost and satisfaction","volume":"15","author":"Lin","year":"2017","journal-title":"Intest Res"},{"key":"10.1016\/j.eclinm.2025.103307_bib8","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.cgh.2023.10.034","article-title":"AGA clinical practice update on high-quality upper endoscopy: expert review","volume":"22","author":"Nagula","year":"2024","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1016\/j.eclinm.2025.103307_bib9","doi-asserted-by":"crossref","first-page":"710","DOI":"10.14309\/ajg.0000000000000969","article-title":"Nurse-administered propofol continuous infusion sedation: a new paradigm for gastrointestinal procedural sedation","volume":"116","author":"Lin","year":"2021","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.eclinm.2025.103307_bib10","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1016\/j.bja.2024.02.005","article-title":"Remimazolam versus propofol for sedation in gastrointestinal endoscopic procedures: a systematic review and meta-analysis","volume":"132","author":"Barbosa","year":"2024","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.eclinm.2025.103307_bib11","doi-asserted-by":"crossref","DOI":"10.1016\/j.jclinane.2024.111586","article-title":"Comparing oxygen therapies for hypoxemia prevention during gastrointestinal endoscopy under procedural sedation: a systematic review and network meta-analysis","volume":"98","author":"Wang","year":"2024","journal-title":"J Clin Anesth"},{"key":"10.1016\/j.eclinm.2025.103307_bib12","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.bja.2021.10.044","article-title":"Hypotension during propofol sedation for colonoscopy: a retrospective exploratory analysis and meta-analysis","volume":"128","author":"Sneyd","year":"2022","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.eclinm.2025.103307_bib13","doi-asserted-by":"crossref","first-page":"777","DOI":"10.7326\/M14-2385","article-title":"The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations","volume":"162","author":"Hutton","year":"2015","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.eclinm.2025.103307_bib14","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"10.1016\/j.eclinm.2025.103307_bib15","series-title":"Cochrane handbook for systematic reviews of interventions","author":"Higgins","year":"2024"},{"key":"10.1016\/j.eclinm.2025.103307_bib16","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0076654","article-title":"Graphical tools for network meta-analysis in STATA","volume":"8","author":"Chaimani","year":"2013","journal-title":"PLoS One"},{"key":"10.1016\/j.eclinm.2025.103307_bib17","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.d4002","article-title":"Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials","volume":"343","author":"Sterne","year":"2011","journal-title":"BMJ"},{"key":"10.1016\/j.eclinm.2025.103307_bib18","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1111\/anae.15295","article-title":"Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: an abridged Cochrane network meta-analysis","volume":"76","author":"Weibel","year":"2021","journal-title":"Anaesthesia"},{"key":"10.1016\/j.eclinm.2025.103307_bib19","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1111\/anae.14582","article-title":"Analgesic impact of intra-operative opioids vs. opioid-free anaesthesia: a systematic review and meta-analysis","volume":"74","author":"Frauenknecht","year":"2019","journal-title":"Anaesthesia"},{"key":"10.1016\/j.eclinm.2025.103307_bib20","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1097\/00003643-200010000-00007","article-title":"Does etomidate increase postoperative nausea? A double-blind controlled comparison of etomidate in lipid emulsion with propofol for balanced anaesthesia","volume":"17","author":"St Pierre","year":"2000","journal-title":"Eur J Anaesthesiol"},{"key":"10.1016\/j.eclinm.2025.103307_bib21","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1097\/ALN.0b013e3181ff72b5","article-title":"Clinical and molecular pharmacology of etomidate","volume":"114","author":"Forman","year":"2011","journal-title":"Anesthesiology"},{"key":"10.1016\/j.eclinm.2025.103307_bib22","doi-asserted-by":"crossref","first-page":"5989","DOI":"10.1021\/acs.molpharmaceut.4c00325","article-title":"The application and pharmaceutical development of etomidate: challenges and strategies","volume":"21","author":"Zhang","year":"2024","journal-title":"Mol Pharm"},{"key":"10.1016\/j.eclinm.2025.103307_bib23","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1097\/00000542-199901000-00017","article-title":"Reducing myoclonus after etomidate","volume":"90","author":"Doenicke","year":"1999","journal-title":"Anesthesiology"},{"key":"10.1016\/j.eclinm.2025.103307_bib24","article-title":"Comparison of the effectiveness of various drug interventions to prevent etomidate-induced myoclonus: a Bayesian network meta-analysis","volume":"9","author":"Zhang","year":"2022","journal-title":"Front Med"},{"key":"10.1016\/j.eclinm.2025.103307_bib25","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1213\/ANE.0000000000006292","article-title":"Etomidate-induced myoclonus in Sprague-Dawley rats involves neocortical glutamate accumulation and N -methyl- d -aspartate receptor activity","volume":"137","author":"Feng","year":"2023","journal-title":"Anesth Analg"},{"key":"10.1016\/j.eclinm.2025.103307_bib26","doi-asserted-by":"crossref","first-page":"e517","DOI":"10.1097\/MJT.0000000000000404","article-title":"Efficacy and safety of opioids for the prevention of etomidate-induced myoclonus: a meta-analysis","volume":"25","author":"Wang","year":"2018","journal-title":"Am J Ther"},{"key":"10.1016\/j.eclinm.2025.103307_bib27","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2024.1507616","article-title":"Comparative efficacy and safety of 20 intravenous pharmaceutical intervention for prevention of etomidate-induced myoclonus: a systematic review and Bayesian network meta-analysis","volume":"15","author":"Chen","year":"2025","journal-title":"Front Pharmacol"},{"key":"10.1016\/j.eclinm.2025.103307_bib28","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1186\/s12871-023-02167-0","article-title":"Efficacy and safety of esketamine for sedation among patients undergoing gastrointestinal endoscopy: a systematic review and meta-analysis","volume":"23","author":"Lian","year":"2023","journal-title":"BMC Anesthesiol"},{"key":"10.1016\/j.eclinm.2025.103307_bib29","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2023.1279657","article-title":"Overcoming the myths of esketamine administration: different and not difficult","volume":"14","author":"Buchmayer","year":"2023","journal-title":"Front Psychiatry"},{"key":"10.1016\/j.eclinm.2025.103307_bib30","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2024.1364546","article-title":"Efficacy and safety of low-dose esketamine for painless gastrointestinal endoscopy in adults: a systematic evaluation and meta-analysis","volume":"15","author":"Deng","year":"2024","journal-title":"Front Pharmacol"}],"container-title":["eClinicalMedicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589537025002391?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589537025002391?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T13:41:12Z","timestamp":1768830072000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2589537025002391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":30,"alternative-id":["S2589537025002391"],"URL":"https:\/\/doi.org\/10.1016\/j.eclinm.2025.103307","relation":{},"ISSN":["2589-5370"],"issn-type":[{"value":"2589-5370","type":"print"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Pharmacological agents for procedural sedation and analgesia in patients undergoing gastrointestinal endoscopy: a systematic review and network meta-analysis","name":"articletitle","label":"Article Title"},{"value":"eClinicalMedicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.eclinm.2025.103307","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Author(s). Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"103307"}}