American College of Gastroenterology
Advancing Gastroenterology, Improving Patient Care

Sedation for Endoscopy


Overview

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

    Sedation is a state of sleepiness that happens when you receive medication before a procedure to help you rest and relax.

    Sedation relieves or avoids discomfort. For example, the gas used to inflate your stomach and intestines may cause a stretching feeling.

    The depth of your sleepiness depends on the type and dose of medications given through a vein. There are two main types of sedation used for gastrointestinal procedures-conscious sedation and deep sedation.

    The term “conscious sedation,” also known as moderate sedation, is a type of sedation . You will be drowsy and forgetful but can still follow simple instructions while asleep.

    Some patients may require or request “deep sedation” that puts you more deeply asleep. A medication called propofol is typically used. At very high doses, it can achieve “general anesthesia” as used in surgeries.

    Deep sedation requires closer patient monitoring during endoscopy. In many places, its use requires anesthesia personnel and may involve additional patient costs through insurance.

    You may also consider not having sedation for your endoscopy. You would be awake during your procedure and able to observe the procedure as it occurs but may feel some discomfort. If interested, you should discuss it with staff or your doctor before the endoscopy and on the day of endoscopy.

    Sedation also requires you to not eat or drink for some time before the procedure. Usually no liquids for at least 2 hours before you start your procedure and no solid foods for at least 8 hours before your procedure starts. Eating or drinking too soon to your procedure can result in delays to your procedure. Go over the instructions from your doctor.

  • Is sedation safe?

    Sedation is safe for most people. Complications are very rare and happen less than 1% of the time.

    The most common kind of complication is a brief, temporary drop in your breathing or heart rate while you are sleepy. Oxygen through a thin tube in your nose keeps levels high.

    During your endoscopy and in the recovery area after the procedure, the medical team regularly checks heart rate, breathing rate, blood pressure, and oxygen for any problems that come up. If necessary, medicines can be given to reverse sedation.

    After sedation, you likely will not remember what happened during and shortly after the procedure due to the effects of the medication on short term memory . You may have some nausea after sedation that can be treated. Most people feel back to normal within 1 hour and are usually discharged after a short observation period.

    The medical team giving sedation will need to know your drug allergies, your medications and doses (including over the counter medications) and medical conditions you have. This information you share will help your doctor plan the type and dose of sedation that is right for you.

    You can print the checklist below to give to your doctor before your endoscopy to help. You can also discuss with the doctor before your scheduled procedure if you have any questions or concerns.

    Please tell your doctor if you are take:

    • 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

    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, 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

    Please list the medicines that you are allergic to:

     

     

     

     

     

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

    The effects of sedating medications can last for hours. They can be hard to completely notice even after you are awake. For example, your reaction time and deep thinking may be slower for a few hours. Thus, you are required to have a friend or relative take you home and are advised not to go to work or make important decisions until the day after your endoscopy.