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RISK MANAGEMENT FOR SEDATION IN ENDOSCOPIC SUBMUCOSAL DISSECTION

Endoscopic submucosal dissection takes a longer time to complete, and special attention is needed for patient risk management. Narcotics and benzodiazepines to produce conscious sedation is familiar to the endoscopist. General anesthesia should be indicated for difficult cases. To provide early warning for respiratory compromise, pulse oximetry, capnometer, and continuous visual assessment by trained stuff are needed. On lateral position, axillar vessels and nerve may be damaged, decompression pad is useful. Complications of ESD are not limited to bleeding or perforation, sedation‐related complications are also possible. Education and training for medical personnel is essential to prevent adverse events.