We have the schema encoded in our own XML format, and our tool for applying such an XML doesn't do destructive operations. We also have no logic in stored procs

We have the schema encoded in our own XML format, and our tool for applying such an XML doesn't do destructive operations. We also have no logic in stored procs. So schema changes are very safe and doesn't need much additional review. We commit schema file alongside the rest of the code, and it gets applied as part of the CI run to our dev and QA/test DBs. So not a direct answer I suppose, but it really cuts down on what you need to do manually against the DB.