Drugs used for sedation in gastrointestinal endoscopy

Abstract

Background: Sedation, defined as the depressed level of consciousness induced by the administration of drugs, is used widely for gastrointestinal endoscopy to relieve the patient's anxiety and discomfort. In addition, a successful procedure can be anticipated with the control of unintended movements. Therefore, sedation has become an essential element of gastrointestinal endoscopy.Current Concepts: Sedation is classified into the following four stages according to the level of consciousness: minimal sedation or anxiolysis, moderate sedation or conscious sedation, deep sedation, and general anesthesia. The degree of response to sedation varies from person to person, depending on the age, underlying diseases, alcohol or medication intake, anxiety level, sensitivity to pain, and pharmacogenetic characteristics. In particular, certain situations require special attention not only during preoperative evaluation but also during the procedure and recovery, such as old age, obesity, pregnancy, lactation, and liver cirrhosis. Therefore, the same procedure may require different levels of sedation in different patients, and some patients may even experience changing levels of sedation during a single procedure.Discussion and Conclusion: Although most patients undergoing gastrointestinal endoscopy under sedation recover without any problem, various types of adverse events related to sedation may occur occasionally. In rare cases, serious complications may occur that threaten the patient's life. Therefore, basic principles governing the facilities and equipment as well as performance of sedation itself should be followed to prevent unfavorable accidents. Moreover, every medical personnel should be familiar with the pharmacological properties of the drugs used for sedation and trained for emergencies.