Gastrointestinal Endoscopy
The role of the anaesthetist
Your anaesthetist will want to know about you, your medical conditions and your previous experiences with anaesthesia. If you have a complex medical history, your anaesthetist may want to see you or talk to you before your admission to hospital.
If you have any concerns regarding anaesthesia for endoscopy, a discussion with your anaesthetist can be arranged before you come to hospital. Your gastroenterologist should be able to give you your anaesthetist’s contact details.
You’re in good hands
Anaesthetists in Australia are highly trained medical specialists. After graduating from medical school and completing an internship, at least five more years are spent undergoing training in anaesthesia, pain management, resuscitation and the management of medical emergencies.
When you need to have an endoscopy, a little preparation can help to ensure that the experience is a positive one.
The aims of this pamphlet are to:
- Provide you with basic information about anaesthesia for endoscopy
- Encourage you to ask questions of your anaesthetist
- Help you approach the planned procedure positively.
What sort of anaesthesia?
Anaesthesia for endoscopy is usually achieved by injecting drugs through a cannula placed in a vein, and maintained with intravenous drugs. The anaesthetist monitors your condition closely and constantly adjusts the level of anaesthesia. While this type of anaesthesia is commonly called’ sedation‘ or ’twilight sleep‘, the level of anaesthesia reached is often general anaesthesia. This is because most patients prefer to have no awareness of the procedure. You should discuss your preference with your anaesthetist.
For upper gastrointestinal endoscopy (commonly called simply ’endoscopy‘), you will be asked to place a ’bite guard‘ in your mouth to prevent excessive pressure being placed on your teeth by the gastroscope. Local anaesthetic spray may be used to numb the back of your throat. You will be given oxygen to breathe, and your blood pressure and oxygen levels will be monitored. Endoscopy is usually brief, commonly taking 10 to 15 minutes.
On the day
You will usually be advised to avoid food and fluids before your operation. If you don’t follow this rule of fasting, the operation may be postponed in the interests of your safety as food or fluid in your stomach could enter your lungs. Your gastroenterologist, anaesthetist or the hospital will advise you how long to fast.
You should take most of your regular medicines as normal (e.g. blood pressure tablets). Blood thinners (aspirin, warfarin and other agents like Plavix, Iscover, Pradaxa, Brilinta and Xarelto) and diabetic medication require special consideration and you should be given specific instructions about what to do with these medications. If you are unsure, please ask to speak to your gastroenterologist or your anaesthetist.
Anaesthesia – the risks and complications
Major complications with anaesthesia for endoscopy are very uncommon when anaesthesia is administered by a specialist anaesthetist. Nevertheless, some patients are at an increased risk of complications because of health problems such as heart or respiratory disease, diabetes or obesity, their age and/or because of the type of surgery which they are undergoing. Minor complications include bruising, pain or injury at the injection site, fatigue, altered mental state, headaches, sore throat or damage to teeth or the mouth. Minor changes in blood pressure or oxygen levels are common. Nausea and vomiting are uncommon. There are also some very rare, but serious complications including severe allergic or sensitivity reactions, heart attack, stroke, seizure, brain damage, kidney or liver failure, eye injury, damage to the larynx (voice box) and vocal cords, and pneumonia. Remember that the risks of these more serious complications, including death, are quite remote but do exist.
