RIP, Sedasys

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Pooh & Annie

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  1. Attending Physician
J & J is calling it quits. I'm not completely clear on the details, but I believe it has to do with CMS being less obstructive to anesthesia billing for routine GI stuff. I suppose they figure no one's gonna buy the machine when insurance will cover an anesthesiologist or CRNA.

Anyone know more?
 
J & J is calling it quits. I'm not completely clear on the details, but I believe it has to do with CMS being less obstructive to anesthesia billing for routine GI stuff. I suppose they figure no one's gonna buy the machine when insurance will cover an anesthesiologist or CRNA.

Anyone know more?
As I have said before, we cannot even get a functional iv pump in the OR on a daily basis. OR beds don't work half the time, etc. How do we think this monstruosity is going to work?
 
As I have said before, we cannot even get a functional iv pump in the OR on a daily basis. OR beds don't work half the time, etc. How do we think this monstruosity is going to work?

Haha. Very good point.
 
I can't believe there are so many novel ideas to try to get rid of us. between dumbing down the specialty to inventing machines to replace us.
 
The GI docs did like the system, and had a pretty significant improvement in DC times. But it's hard to quickly convert that time savings to an easily demonstrable increase in profit. The admin needs to see REAL benefits to validate the 300k price and maintenance costs.

The benefit, for sure, is in the propofol, not the machine. The argument for GI nurse administered propofol for ASA I/IIs isn't going away. If a machine can follow a protocol to "safely" give propofol, why can't a nurse?
 
I searched all over and couldn't find anything. But word came down in our department, and I assure you it's not just gossip.
I get "website not found" on sedasys.com

Google cache had it working in January.
 
. If a machine can follow a protocol to "safely" give propofol, why can't a nurse?

Why a nurse? Why not a tech? Why not the Janitor? Why not

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
 
J & J is calling it quits. I'm not completely clear on the details, but I believe it has to do with CMS being less obstructive to anesthesia billing for routine GI stuff. I suppose they figure no one's gonna buy the machine when insurance will cover an anesthesiologist or CRNA.

Anyone know more?
 
iAfter reading some of the "supporting" studies for the Sadasys, it in no way emulated American's consumers demands for endoscopy. In the study, the Average endoscopy time was 14 min, and average propofol dose was 94 mg. this is much less propofol, and much less time, than my typical colonoscopy.

Having performed thousands of anesthesthetics for upper and lower endos and can tell you that you that the parameters for the Sedasys will never fly in the USA. Americans demand deep sedation . - The Sadadys is a light sedation system - and 95 of Americans will not tolerate this. In my opinion, Sadadys and J and J is a true strike out; chose the wrong drug (propofol if poorly suited for light sedation - more like on on/off vs precedex/versedetc ), wrong procedure (purely elective - not a motivated population- think cataract), wrong population (elderly {70+} much more accepting of medical procedures vs 50 and even much less so 20 somethings with Gerd)


Perhaps the Sadasys should resurrect itself with cataract surgery and Precedex?
 
iAfter reading some of the "supporting" studies for the Sadasys, it in no way emulated American's consumers demands for endoscopy. In the study, the Average endoscopy time was 14 min, and average propofol dose was 94 mg. this is much less propofol, and much less time, than my typical colonoscopy.

Having performed thousands of anesthesthetics for upper and lower endos and can tell you that you that the parameters for the Sedasys will never fly in the USA. Americans demand deep sedation . - The Sadadys is a light sedation system - and 95 of Americans will not tolerate this. In my opinion, Sadadys and J and J is a true strike out; chose the wrong drug (propofol if poorly suited for light sedation - more like on on/off vs precedex/versedetc ), wrong procedure (purely elective - not a motivated population- think cataract), wrong population (elderly {70+} much more accepting of medical procedures vs 50 and even much less so 20 somethings with Gerd)


Perhaps the Sadasys should resurrect itself with cataract surgery and Precedex?
I agree with you to an extent. However, I just did an EGD the other day on a morbidly obese anxious man with no neck and a MP 4 airway with light sedation and he loved it. It took me a little longer to interview him and explain the procedure but once he bought in, it was smooth as silk.

My GI docs were reluctant to start on cases like this as well but came around soon enough once I showed them how well it can go. I believe we as anesthesiologist think our pts only want to be out cold. And I think our pts sort of expect this. But it isn't absolutely necessary all the time. I started doing this a few years back when I had a young guy with some progressive swallowing difficulty that was urgently added onto my schedule. He was very obese and I was concerned that there may be an increased risk of aspiration. My options we GETA or light sedation. The pt was very interested in what we might find so I told him he could watch and he did. The GI doc was able to explain everything to him during the procedure. The pt loved it. Unfortunately we found cancer.
 
I agree with you to an extent. However, I just did an EGD the other day on a morbidly obese anxious man with no neck and a MP 4 airway with light sedation and he loved it. It took me a little longer to interview him and explain the procedure but once he bought in, it was smooth as silk.

My GI docs were reluctant to start on cases like this as well but came around soon enough once I showed them how well it can go. I believe we as anesthesiologist think our pts only want to be out cold. And I think our pts sort of expect this. But it isn't absolutely necessary all the time. I started doing this a few years back when I had a young guy with some progressive swallowing difficulty that was urgently added onto my schedule. He was very obese and I was concerned that there may be an increased risk of aspiration. My options we GETA or light sedation. The pt was very interested in what we might find so I told him he could watch and he did. The GI doc was able to explain everything to him during the procedure. The pt loved it. Unfortunately we found cancer.

What was your cocktail? s&s with viscous lido? benzocaine? just versed and fent? just curious so I can try it
 
The GI docs did like the system, and had a pretty significant improvement in DC times. But it's hard to quickly convert that time savings to an easily demonstrable increase in profit. The admin needs to see REAL benefits to validate the 300k price and maintenance costs.

The benefit, for sure, is in the propofol, not the machine. The argument for GI nurse administered propofol for ASA I/IIs isn't going away. If a machine can follow a protocol to "safely" give propofol, why can't a nurse?
This proves the point if was never about safety. It was always about profits. Duh. Ha ha.

Seriously. If GI docs brought more of their commercial insurance patients to hospitals. Than hospitals may take the financial risk of these newer machines.

It's hard for a hospital to pay that much money and be Guinea pigs when all the GI docs bring their BMI over 50 to the hospital and or their Medicare/Medicaid patients.
 
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