Some hospitals and gastroenterologists were looking for a way to improve the sedation of patients receiving screening colonoscopies and upper endoscopies while cutting out the costs associated with having an anesthesiologist present for the procedures.
Midazolam and fentanyl, common sedatives used by gastroenterologists, can lead to inadequate sedation of patients, who may take hours to recover. Propofol has fewer side effects but normally has to be administered by an anesthesiologist, which boosts costs.
Ethicon, a Johnson & Johnson subsidiary, developed a computer-assisted sedation system called Sedasys. Despite the concerns of anesthesiologists, the system was approved by the Food and Drug Administration in 2013 to deliver propofol for miminal-to-moderate sedation for colonoscopies and upper endoscopies without an anesthesiologist in the room. As a condition of approval, Ethicon agreed to require an anesthesiologist be on-call during procedures and to sell the system for use only by providers credentialed for the use of propofol for moderate sedation.
Last September, Virginia Mason Medical Center in Seattle became the first hospital to start using the Sedasys system. Since then, Rhode Island Hospital in Providence; ProMedica Toledo (Ohio) Hospital; Grace Medical Center in Lubbock, Texas; and Loma Linda (Calif.) University Medical Center have started using the system.