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John J. Vargo, M.D., MPH, FACG
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:
In addition, certain medical conditions are important for the
doctor to know about. They include:
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.
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