Chapter 29 ANAESTHESIA FOR ENDOSCOPY
• Patients do not need a deep level of anaesthesia, only moderate sedation—drug-induced depression of consciousness.
• A review of medications and results of investigations is necessary, in particular the presence of hepatic or renal impairment, which affects drug clearances and half-lives.
• All patients need reliable intravenous access, oxygen, pulse oximetry, accessible Ambu bag, emergency drugs, reversal drugs for benzodiazepines and narcotics and access to an electrocardiogram (ECG) and defibrillator.
INTRODUCTION
In order to undertake upper or lower gastrointestinal endoscopy patients must be anaesthetised in some way. They do not need a deep level of anaesthesia, only moderate sedation—drug induced depression of consciousness. The purpose of this chapter is to give an outline of patient assessment (see Chapter 28 for more information), monitoring and drugs used in order to sedate patients undergoing procedures.
PATIENT ASSESSMENT
• Appropriate medical assessment of patient, especially cardiovascular and respiratory history (questionnaires are often helpful).
• Ask about previous sedation, anaesthetics, allergies, fasting and damaged or loose teeth (this is of particular interest for upper endoscopy).
