Sedation for Endoscopy

Overview

  • What is sedation? Why do I need it for my endoscopy?

    Sedation is a state of sleepiness that occurs when you receive medication to help you rest during a procedure, and is commonly given before an endoscopic procedure. When an endoscopy is performed, some air is instilled into the stomach or intestines, which could cause mild discomfort. Sedation is used to help relieve or avoid the sensation of discomfort. Different terms are used depending upon the specific medication being administered. The term “conscious sedation” also referred to as moderate sedation, is used to refer to the most common combination of medications being administered, and is very adequate for the sedation needs of most patients having an endoscopy. A lesser percentage of patients may require, or may request what is called deep sedation, most commonly with a medication called propofol. This medication also is frequently used to administer general anesthesia for surgery. Propofol requires different patient monitoring during the procedure and, depending upon circumstances, may require anesthesia personnel, and so involve additional patient cost. Most of the time, the medicine is given through a vein.

    Some patients have their endoscopic procedures done without sedation. If you are considering having endoscopy without sedation, discusss this with the staff or doctor on the day of the exam.

  • Is sedation safe?

    Sedation is very safe for most people having an endoscopy. Complications associated with sedation are rare occuring in less than one in every 10,000 people. The most common complications involve a temporary decrease in the rate of breathing or heart rate. By far, the most common problem is a temporary decrease in the blood oxygen level that occurs when breathing slows or subjects are not taking deep breaths. This can be corrected by giving extra oxygen through a small nasal tube. If complications related to sedation occur, medicines can be given by vein that reverse the effects of the sedation medications.

    Your doctor is trained in the use of sedation medications. Your blood pressure, pulse (number of times your heart beats every minute), and oxygen levels are checked regularly during an endoscopic procedure and while in the recovery area. This monitoring of your vital functions helps the staff and your doctor know how you are doing during and after medications are given and recognize any problems.

    The physician or person administering the medication will need to know your history of drug allergies, all of your medications and doses (including over the counter therapies) and your medical history. Having this information handy when you come in for the endoscopy will help your doctor in planning what type and dose of sedation is right for you.

    Below is information that is important for you and your doctor to plan your endoscopy. Please feel free to print this checklist to give it to your doctor before the endoscopy:

    Please tell your doctor if you are taking medicine for any of the following conditions:

    • Medicine that “thins the blood” such as Coumadin, Lovenox, Heparin, and Plavix
    yes | no
    • Any type of medicine that is used for diabetes (high sugar levels in the blood). This includes pills or insulin.
    yes | no
    • Pain medicine
    yes | no
    • Seizure medicine
    yes | no
    • Sleeping pills
    yes | no
    • Medicine for anxiety or nerves
    yes | no

    In addition, certain medical conditions are important for the doctor to know about. They include:

    • Kidney disease
    yes | no
    • Heart disease
    yes | no
    • Lung disease
    yes | no
    • Nervous system disease
    yes | no
    • Liver disease
    yes | no
    • High Blood Pressure
    yes | no
    • Stomach emptying problems
    yes | no
    • Have you or your family members had problems with anesthesia for operations (surgery) or endoscopic procedures in the past?
    yes | no
    • Are you allergic to any medicines?
    yes | no
    • If you had an endoscopy before, were you satisfied with the sedation that you received?
    yes | no
    • If you have had an endoscopy before, did you require an anesthesiologist to administer your sedation medication?
    yes | no

    Please list the medicines that you are allergic to:

     

     

     

     

     

  • When will I be able to drive or go to work?

    Since the medicine can last longer than the endoscopy, it is required that you have a friend or family member take you home. As a rule of thumb, since the sedation medicine can affect your reaction time and your ability to make decisions for a few hours, you cannot drive and it is recommended that you do not go to work or make important decisions until the day after your endoscopy.

Author(s) and Publication Date(s)

John J. Vargo, II, MD, MPH, FACG, Cleveland Clinic, Cleveland, OH – Published July 2005. Updated November 2008.

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