Endoscopy sedation side effects

Esophagogastroduodenoscopy or endoscopy is a medical procedure which enables the doctor to see the upper part of the gastrointestinal tract, such as esophagus, stomach or duodenum. This procedure uses endoscope (thin and flexible telescope) and places it through the mouth into the esophagus and further down the gastrointestinal tract, where it is needed. On the tip of this instrument there is a tiny camera and the light and the doctor can easily see the inside of your abdominal organs. In certain cases, doctor may also use endoscope to biopsy the lining of these organs.

Endoscopy is considered to be very good test to detect changes in the upper part of the gut, but some early ulcers or cancerous changes may still be missed. Repeated endoscopy is commonly advised for patients with persisting or worsening symptoms, regardless the previous testing results.

Endoscopy Procedure

Endoscopy is a common medical procedure and it does not last for more than 10 minutes in most cases. Doctors usually advise their patients not to eat several (4 to 6 hours) before the test. If the patient uses some medications he or she should consult the doctor whether the therapy should be stopped or not prior to endoscopy.

The whole appointment will probably take about 2 hours of your time and you may need someone to drive you home if you receive sedatives. Most patients do not experience any pain except for slight discomfort while swallowing the endoscope. However, doctors usually use local anesthetics to numb the throat and sedatives to relax the patient and then ask him or her to swallow the endoscope.

Since the instrument possesses the camera, once the doctor turns it on it will send picture to the screen. This enables the doctor to see abnormalities and problems in the esophagus, stomach or duodenum and, if necessary, take a small sample (using the same instrument) from the problematic area. The whole procedure is ended by pulling the endoscope out from your mouth.

The American Society of Anesthesiology has published definitions for different levels of sedation specifically, at the level of “moderate sedation,” the patient maintains ventilatory and cardiovascular function and is able to make purposeful responses to verbal or tactile stimuli, while at “deep sedation,” patients cannot be easily aroused but is still able to respond to noxious or insistent stimuli. Airway support may be required for deep sedation. To allow the procedure to proceed smoothly, sedatives are usually dosed to achieve:

moderate sedation (benzodiazepine and opiate sedation) or
deep sedation (monitored anesthesia care with propofol).
In a minority of cases, full “general anesthesia” (with intubation of the patient and the use of anesthetic agents such as nitrous oxide or ketamine) is required because of patient characteristics or procedural complexity.

✓ Fact confirmed: Sedation for routine gastrointestinal endoscopic procedures: a review on efficacy, safety, efficiency, cost and satisfaction Otto S. Lin; 2017 Oct 23.

Possible Problems after Endoscopy

Endoscopy procedure usually does not take long and patients could be in and out of the doctor’s office for an hour or two. However, some patients, who received sedatives to calm them down, may have to stay a bit longer before hitting home.

Sedative drugs should help them relax and prevent unpleasant feelings about endoscopy. However, these medications may also make you feel drowsy and thus unable to drive or operate some machinery for the next 24 hours after this procedure. For this reason, doctors recommend calling someone to drive and escort you home after endoscopy. Drowsiness is not persistent and complete recovery is expected some 24 hours after the procedure. Some people may experience temporary loss of memory, due to the use of sedatives, causing them to forget all doctors say during and shortly after the procedure.

Endoscopy may also cause some other side effects, especially sore throat and sleepiness (because of sedatives). There is slightly increased chance to experience chest infection or pneumonia. Elderly patients may have a stroke or heart attack during endoscopy.

Patients who happen to experience abdominal pain, high temperature, breathing problems or start to vomit blood after endoscopy should ask for immediate medical assistance to prevent and avoid further medical problems.