Sedation for GI Procedures

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Sedation Overview

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

  Before your procedure, you will get medicine through a vein your arm (called an IV). The medicine will help you relax and feel sleepy. There are different types of sedation:

  1. Conscious sedation (moderate sedation): You will feel sleepy and you may not remember things. You will still be able to follow simple instructions.
  2. Deep sedation: You will be more asleep. You will need closer checks on your breathing and blood pressure.
  3. General anesthesia: You will be fully asleep and unaware of anything during the procedure. A tube is placed in your throat to help you to breathe. When the procedure is over, the medication will be stopped. You will wake up and the breathing tube will be removed.

  Most GI procedures use moderate sedation or deep sedation. General anesthesia may be needed for longer or more complicated procedures, or if you have medical problems that make sedation risky. Your sedation may be managed by your GI doctor and a trained sedation nurse or by a specialist called an anesthesia provider. Deep sedation and general anesthesia are usually given by an anesthesia provider. Sometimes, sedation by an anesthesia provider may cost extra on your insurance.</p

  Without sedation: Some people choose to have their procedure without sedation. If you choose this, you will be awake during the procedure. You might feel cramping or discomfort from gas used during the exam. If you prefer this, talk to your healthcare team when you arrive.

  Important preparation:

  • Do not eat or drink before your procedure.
  • You will receive instructions to follow. Read them carefully and stick to them.
  • Usually, you cannot eat solid food for 8 hours before your procedure and you cannot drink clear liquids (like water) for 2 hours before the procedure.
  • If you take certain medications, your doctor might ask you to drink only clear liquids for 24 hours before the procedure.

  Why is this important? If there is food or liquid in your stomach during sedation, it could cause a serious infection in your lungs called “aspiration.”

• Is sedation safe?

  Sedation is safe for most people. Problems are very rare - they happen less than 1% of the time. The most common problem is a drop in breathing or heart rate while you are sleepy. You will receive oxygen through a small tube in your nose to keep your oxygen levels normal.

  • Planning your sedation: Your medical team will check for any drug allergies, medications (including over-the-counter medications), and your medical history before your procedure. This helps your doctor choose the type and amount of sedation that is right for you.
  • During your procedure: Your medical team will closely watch your heart rate, breathing, blood pressure, and oxygen levels before, during, and after your procedure. If there is a problem, they may give you a medication to stop the sedation and wake you up.
  • After the procedure: Most people do not remember what happened during or right after the procedure. You might feel sick to your stomach afterward, but medicine can help. You will be monitored in a recovery area and most people are ready to go home about an hour after the procedure. You should feel back to normal soon.

  Print the checklist below and share any questions or concerns with your healthcare team before your procedure.

  Tell your doctor about any medications you take, including:

  Medicine that “thins the blood” such as Coumadin, Lovenox, Heparin, and Plavix, Brilinta, Aspirin, Rivaroxaban, Apixaban, Edoxaban, and Dabigatran.	yes | no
  Medicine for diabetes (high blood sugar), including pills or insulin.	yes | no
  Pain medicine, including narcotics.	yes | no
  Seizure medicine.	yes | no
  Sleeping pills.	yes | no
  Medicine for anxiety or nerves	yes | no
  Breathing medications, including inhalers.	yes | no
  Medications for weight loss: GLP-1 agonists such as Ozempic, Wegovy, Victoza, Trulicity, Mounjaro.	yes | no

  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, including stroke	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 your sedation?	yes | no
  For a previous endoscopy , did you require an anesthesiologist to give you sedation?	yes | no

  Tell your doctor if you have any allergies, especially to medications. Write down the names of any medicines you are allergic to and share this list with your healthcare team.

  Ask questions. If you have any worries or things you are unsure about, ask your healthcare team. Write down your questions.