Enhanced Recovery Pathway for Endoscopy

Evaluation of an Enhanced Recovery Pathway for Endoscopy Patients Receiving Moderate Sedation

The purpose of this study is to compare an Enhanced Recovery Pathway to the current pre-operative/recovery practices of the endoscopy department on patient post-procedure outcomes.

Every 4th to 5th patient that checks in to the endoscopy department for their procedure will be screened for eligibility requirements. If eligible for the study, the patient will be informed about the study and potential risks. All patients giving written informed consent will be enrolled into the enhanced recovery protocol (ERP) [nursing managed ERP: goal-directed fluid management (Lactated Ringer's Solution at 5mL/kg/hr), PONV prophylaxis for an apfel score of 2 or greater (ondansetron 4 mg IV), early mobilization up to chair (within 5-30 minutes of admission to the recovery room), and early PO intake within 15-30 minutes of admission to the recovery room post-procedure] for their procedure.

Inclusion Criteria:

• Outpatient colonoscopy under moderate sedation
• Colonoscopy Indications: Screening

Exclusion Criteria:

• More than one sedation procedure scheduled same day
• Allergy to ondansetron
• Past PONV requiring scopolamine patches
• Diagnoses: ESRD, heart failure, cirrhosis, long QT syndrome
• Patients requiring fluid restrictions, such as dialysis patients
• Post-procedure NPO requirements, such as procedure-related NPO status (stent placement, pneumatic dilation, etc.) or second procedure in another location
• High Fall Risk Patients
• Adults unable to consent
• Pregnant patients