Εndoscopic Sedation: The Anaesthesiologist’s Perspective

Endoscopic procedures, either diagnostic or therapeutic are stressful and sometimes painful to the patient, regardless of the endoscopist’s skill and the diameter of the scope used. In recent years, an ongoing number of gastroenterologists are considering conscious sedation to be an integral component of the endoscopic examination, since it reduces patient’s anxiety and discomfort and improves patient’s tolerance and acceptance of the procedure. Sedation and analgesia also minimize the risk of physical injury during the procedure and provide the endoscopist with an ideal environment for a thorough examination. On the other hand they delay patient’s recovery and discharge, increase the cost of the procedure, and increase the risk of cardiopulmonary complications, which -although infrequent- are the most common type of complications seen during endoscopy. Despite the fact that gastrointestinal endoscopy is generally consider as a safe procedure, a number of severe complications which occur are sedation-related and, according to the literature, sedation-related mortality is high compared to perioperative mortality due to general anaesthesia.