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June 27, 2012

Anesthesia Care for Low-Risk Patients Undergoing Gastrointestinal Endoscopies

JAMA. 2012;307(24):2585-2587. doi:10.1001/jama.2012.6539

To the Editor: The study by Dr Liu and colleagues1 suggests that money could be saved if the use of anesthesiologists for low-risk patients undergoing colonoscopy were eliminated. There has been intense ongoing debate about both the value and safety of propofol and anesthesia care in gastrointestinal endoscopy.2 One challenge in this debate is the difficulty in disentangling the sedation drug regimen (benzodiazepine/opioid vs propofol) from protocols, personnel, monitoring, and depth of sedation. The authors are correct that the value of anesthesia care for routine endoscopy has yet to be demonstrated in the literature. However, its wide utilization appears to be driven by gastroenterologists and patients' perception of its value and is an area of active investigation.