Expertise: Health Tips
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IV
Sedation During Endoscopy
Every available means to ensure the safety of patients
during endoscopic procedures is compulsory. The thorough
preparation of the unit to handle endoscopic procedures and
potential adverse outcomes is mandatory. Appropriate patient
preparation, skilled assistants, and monitoring of the
patient's well-being before, during and after the procedure
ensures that endoscopic examinations can be carried out
safely.
The maintenance of airway and cardiorespiratory equilibrium
during sedated endoscopic examination requires a dedicated
medical personnel adapt at advanced airway and resuscitation
skills. This is the sedationist/anaesthetist. The
sedationist is responsible for allowing the procedure to
occur in a safe manner.
A pre procedural assessment is conducted prior to the
administration. This aided by the medical checklist that
patients are requested to complete. Endoscopic sedation is
defined by the individualised titration of sedative hypnotic
drugs and analgesic agents. The relative risks involved can
then be estimated from patient and procedural factors and
monitoring during endoscopic procedures is dependent upon a
thorough understanding and assessment of the risk to the
patient.
Familiarity of the pharmacological property of the agents
used and also of the procedure allows for optimal use of
sedative agents to ensure deep sedation without rendering
apnoea.
Fasting rule of four hours is used to reduce the risk of
aspiration of stomach content during the procedure.
Recovery is in two stages. The first is complete when the
patient is awake and the blood pressure is stable. This may
require additional intravenous fluid therapy. During the
second stage the patient regains all their usual bodily
function however may still be drowsy and often will have
variable amnesia lasting 2- 4hours.
Adherence to the post procedure instruction of not driving
is therefore of significant importance.
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