Performance of Endoscopic Submucosal Dissection According to the Sedation Method

"In this arm1, sedation during endoscopic submucosal dissection is controlled by endoscopists.~First, pethidine 50 mg with midazolam 0.05 mg/kg are injected in a bolus fashion.~When the patient seems to be discomfort or the patient's movements were observed, endoscopists should check the Modified Observer Assessment of Alertness/Sedation (MOAAS).~If MOAAS is 5 or 6, propofol 0.25 mg/kg will be injected. Otherwise, pethidine 12.5 mg will be injected."

"In this arm2, sedation during endoscopic submucosal dissection is controlled by anesthesiologists.~First, remifentanil 0.5 ug/kg with propofol 0.5 mg/kg are injected in a bolus fashion.~Then, remifentanil 0.08 ug/kg/min and propofol 2 mg/kg/h are infused continuously.~When the patient seems to be discomfort or the patient's movements were observed, anesthesiologists should check the MOAAS.~If MOAAS is 5 or 6, infusion rate of propofol will be increased by 0.5 mg/kg/h. Otherwise, infusion rate of remifentanil will be increased by 0.02 ug/kg/min."