Anesthesia in Endoscopic Procedures

During the last decade there has been an increase of gastrointestinal endoscopic procedures. Endoscopy (gastroscopy, colonoscopy, ERCP and related techniques) means the procedure where a flexible tube with a camera pass into the stomach and first part of the small bowel during gastroscopy and the large bowel during colonoscopy. The equip of anesthesiologists may be asked to provide anesthesia for procedure that require sedation, monitor anesthesia care (MAC) or general anesthesia. MAC is a type of anesthesia service during which a patient is typically still aware, but very relaxed. During endoscopy the patients are in a minimal, moderate or deep procedural sedation which allows the specialist to perform the procedure and aims patients safety and comfort. The common medicines used for sedation are benzodiazepines as midazolam which act on the brain and SNQ and opioids as fentanyl which decrease the patients perception of pain, dexmetedetomidine, low dose ketamine or propofol. Propofol is ideally suited for endoscopy sedation because it is a short acting anesthetic induction drug but always is required greater level of monitoring.