Anaesthesia for endoscopy

Endoscopy procedures, which include gastroscopy and colonoscopy, are frequently performed as day-stay cases.

Gastroscopy is a procedure where a flexible tube with a camera at its tip is inserted via the mouth passing through the oesophagus into the stomach and first part of the small bowel. It is used to investigate and treat symptoms such as difficulty swallowing, heartburn (gastroesophageal reflux disease), and oesophageal and stomach tumours.

Colonoscopy is a procedure where a long flexible tube with a camera at its tip is inserted via the rectum to allow a doctor to see the large bowel. It is used to investigate conditions affecting the large intestine.

Many conditions do not have symptoms at the early stages and endoscopic treatment usually involves removing polyps or foreign objects.

In most cases, endoscopy patients are given deep “procedural sedation”, which allows the specialist to perform the procedure and aims to ensure patient safety and comfort.

An anaesthetist may use a variety of medications and techniques to achieve procedural sedation and/or pain relief. The most common medications used that are injected into a vein are benzodiazepines (which act on the brain and the nervous system) such as midazolam for sedation, and opioids (which decrease the patient’s perception of pain), such as fentanyl, for pain relief.

During deep sedation, where patients lose consciousness and respond only to painful touch, patients may have difficulty with breathing normally and their heart function may be affected. The anaesthetist is trained to avoid these situations