{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:08:23Z","timestamp":1778630903415,"version":"3.51.4"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Sedation in gastrointestinal endoscopy is widely recognized for improving patient comfort, procedure quality, and endoscopist satisfaction. Although non-anesthesiologist-administered sedation (NAS) with propofol is well established for low-risk patients (i.e. American Society of Anesthesiologist [ASA] I-II), evidence for its safety in higher-risk populations remains limited. The aim of this study was to evaluate safety of NAS with propofol in ASA III patients undergoing diagnostic gastrointestinal endoscopy.<\/jats:p>\n                  <jats:p>This observational study included ASA III patients who underwent elective gastroscopy or colonoscopy under NAS with propofol, with or without adjunctive midazolam and\/or fentanyl, between 2017 and 2024. Sedation was administered by trained endoscopy personnel according to European Society of Gastrointestinal Endoscopy\/European Society of Gastroenterology and Endoscopy Nurses and Associates guidelines. Anesthesia-related adverse events (ARAEs) were categorized as minor, moderate, or severe based on World Society of Intravenous Anesthesia definitions. Secondary outcomes included identification of potential risk factors for ARAEs.<\/jats:p>\n                  <jats:p>Among 1423 procedures (43.4% gastroscopies, 56.6% colonoscopies), overall incidence of ARAEs was 5.2% (3.9% minor, 0.9% moderate, 0.4% severe), with no tracheal intubations or deaths. Hypotension (3.6%) was the most frequent and all such events were transient and reversible. Severe ARAEs were all bradycardia, successfully treated with atropine administration. The ARAE rate was higher with propofol + midazolam (8.6%) than with propofol + fentanyl (3.7%, P = 0.04). Logistic regression analysis identified lower body mass index as the only independent predictor of ARAEs (P &lt; 0.001).<\/jats:p>\n                  <jats:p>NAS with propofol appears safe and feasible in ASA III patients when performed by trained staff following standardized protocols and monitoring. These findings support expanding NAS with propofol to higher-risk populations, optimizing resources and access to endoscopic care.<\/jats:p>","DOI":"10.1055\/a-2857-9602","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T23:05:58Z","timestamp":1776985558000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Non-anesthesiologist-administered propofol sedation for gastrointestinal endoscopy in ASA III patients: Eight-year experience"],"prefix":"10.1055","volume":"14","author":[{"given":"Giuliano F.","family":"Bonura","sequence":"additional","affiliation":[{"name":"Azienda USL Modena, Italy","place":["Modena"],"department":["Gastroenterology and Digestive Endoscopy Unit"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8793-5890","authenticated-orcid":false,"given":"Pablo","family":"Cortegoso Valdivia","sequence":"additional","affiliation":[{"name":"University Hospital of Parma, Italy","place":["Parma"],"department":["Gastroenterology and Endoscopy Unit"]},{"name":"University of Southern Denmark, Denmark","place":["Odense"],"department":["Department of Clinical Research"]},{"name":"Odense University Hospital, Denmark","place":["Odense"],"department":["Surgical Research Unit"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella","family":"Frassanito","sequence":"additional","affiliation":[{"name":"Azienda USL Modena, Italy","place":["Modena"],"department":["Gastroenterology and Digestive Endoscopy Unit"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noemi","family":"Gualandi","sequence":"additional","affiliation":[{"name":"Azienda USL Modena, Italy","place":["Modena"],"department":["Gastroenterology and Digestive Endoscopy Unit"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Soriani","sequence":"additional","affiliation":[{"name":"Azienda USL Modena, Italy","place":["Modena"],"department":["Gastroenterology and Digestive Endoscopy Unit"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Indulti","sequence":"additional","affiliation":[{"name":"Azienda USL Modena, Italy","place":["Modena"],"department":["Gastroenterology and Digestive Endoscopy Unit"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Zadro","sequence":"additional","affiliation":[{"name":"Azienda USL Modena, Italy","place":["Modena"],"department":["Gastroenterology and Digestive Endoscopy Unit"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna","family":"Parrella","sequence":"additional","affiliation":[{"name":"Azienda USL Modena, Italy","place":["Modena"],"department":["Gastroenterology and Digestive Endoscopy Unit"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tommaso","family":"Gabbani","sequence":"additional","affiliation":[{"name":"Azienda USL Modena, Italy","place":["Modena"],"department":["Gastroenterology and Digestive Endoscopy Unit"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2107-2156","authenticated-orcid":false,"given":"Antonio","family":"Facciorusso","sequence":"additional","affiliation":[{"name":"Universit\u00e0 del Salento, Italy","place":["Lecce"],"department":["Department Experimental Medicine"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Triantafyllou","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens, Greece","place":["Athens"],"department":["Second Department of Gastroenterology, Attikon University General Hospital"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7854-1080","authenticated-orcid":false,"given":"Mauro","family":"Manno","sequence":"additional","affiliation":[{"name":"Azienda USL Modena, 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