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A Few Facts Regarding Endoscopic Anesthesia

By Ann Cole


Endoscopy is a procedure that entails placing a tube in the gastrointestinal system to determine whether there is disease and whether it can be treated through the same process. Being an uncomfortable procedure, endoscopy is normally done under anaesthesia. Level of sedation depends on how long it will take to carry out the procedure. Endoscopic anesthesia is vital in successful diagnosis and treatment of given conditions of the gastrointestinal system.

Before anaesthesia is administered, detailed history, physical examination and investigations will have to be conducted. History taking requires that a good rapport is created between the patient and the doctor. The doctor will need to any underlying conditions such as diabetes and hypertension. They also need to reveal what drugs they could be on as some drugs are known to interact negatively with anaesthetic drugs.

When putting the client under anaesthesia, close monitoring should be done to ensure that the patient does not develop complications that can otherwise be corrected. Basically, blood pressure, rate of breathing and pulse rate need to be carefully assessed and followed up. This is made possible through special machines that are connected to the body of the client. Electrocardiography is an additional requirement in monitors to continuously assess cardiac function.

Oxygen saturation levels are also monitored using a pulse oximeter usually clipped at the tip of one of the fingers. Ideally, saturation levels should be above ninety six per cent. Oxygen should be given via a face mask to ensure levels remain above the target. Vital signs should also be adjusted accordingly when they become abnormal.

A good anaesthetic drug should also ensure muscle relaxation. Relaxation of muscles ensures that the operation is done without experiencing difficulties related to muscle spasm. Since there is no single drug with all these properties, anaesthetic drugs are usually used in combination. Examples include benzodiazepines, muscle relaxants, analgesics among others.

Reversal is performed once the endoscopy is done. Reversal simply means restoring the original awareness of the patient before anaesthesia. This is usually simpler and smoothly eases the patient back to stability unlike induction which can be quite difficult. Some of the reversal agents include flumazenil for benzodiazepines and naloxone for opioids. These reversal agents are otherwise known as antagonists.

Once the procedure is complete, the client is taken to a post anaesthesia care unit, PACU. This is simply a recovery room for patients to be able to fully wake up from anaesthesia and be aware of the surrounding. It serves to closely monitor the individual in case of any complications that may come up immediately after the procedure. As such, vital signs are once again monitored and oxygen is supplemented.

Anaesthesia for endoscopy is indicated particularly for disease occurring along the gastrointestinal system. Depending on severity of the illness, anaesthesia can range from mild sedation to full blown sedation where the patient may not be aware of what is going on. The good thing about endoscopy is that it can be both diagnostic and therapeutic. Examples of diseases handled using endoscopic anaesthesia include oesophageal varices, peptic ulcer disease, upper and lower gastrointestinal malignancy.




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