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This leaflet only describes the sedation part of your care. Please refer to the specific leaflets listed at the end of this leaflet for more information about your endoscopy procedure.
At the Royal Sussex County Hospital in Brighton we run a specialised Enhanced Sedation service in Endoscopy delivered by Consultant Anaesthetists and the Endoscopy Team. Under this deeper sedation, you will be more comfortable during the procedure. This is not a general anaesthetic and you may be at times aware of what is going on but it shouldn’t be distressing. You may remember parts of your procedure afterwards. You are monitored closely and the anaesthetist is at your side to adjust the level of sedation and give painkillers as needed.
There are certain medical conditions which may mean we cannot offer this deeper sedation. If this applies to you, we will make the appropriate arrangements for you.
Enhanced sedation is when a sedative (sedation medicine) is injected into your bloodstream through a drip to relax you.
Anaesthetists are trained in giving the right amount of sedative and managing any side effects. For enhanced sedation in endoscopy, we aim for ‘moderate’ (also called conscious sedation) to ‘deep’ sedation.
With moderate sedation you feel drowsy, comfortable, sleepy and relaxed, but you remain conscious throughout the procedure and able to follow simple instructions. With a general anaesthetic you are
completely unresponsive and unconscious during the procedure. Deep sedation is between the two.
The endoscopy unit will give you instructions on when to stop eating and drinking. You may need bowel preparation for some endoscopy procedures.
You will need to stop eating at least six hours before your treatment, but you may drink clear fluids up to four hours before gastroscopy (OGD) and ERCP and 2 hours for a colonoscopy or flexible sigmoidoscopy. Clear fluids include water, diluted juice (no bits) and black tea or coffee (no milk or cream).
If you have diabetes, you should ask for specific instructions about when you should take your medication and stop eating food.
Before your procedure you will speak to a pre-assessment nurse in person or over the phone who will ask you questions about your health to assess your suitability for enhanced sedation and can answer any questions you have.
You will be seen by the anaesthetist and endoscopist who can answer any questions you have. Your anaesthetist will meet you on the day of your procedure to review your medical history, discuss any risks and answer questions you may have.
When you go to the procedure room we will attach some monitoring equipment to you and prepare you for your procedure. You will be given oxygen to breathe from a plastic tube sitting just inside your nose, or through a clear face mask. You may be offered a local anaesthetic spray to your throat to make you more comfortable.
A small cannula (plastic tube) will be inserted in to one of the veins in your arm and the sedative will be injected through this. The endoscopy starts after you are sedated.
Your anaesthetist will be able to give you more information about any of these risks and the precautions taken to avoid them.
In modern anaesthesia, serious problems are uncommon. Risk cannot be removed completely, but modern drugs, equipment and training have made sedation and anaesthesia much safer.
Anaesthetists take a lot of care to avoid all the risks outlined in this leaflet Information about your endoscopy.
Please refer to the following BSUH leaflets:
Link to the patient information leaflets listed above.
If you have any other questions about your endoscopy or if you have vision, mobility or access issues ask a nurse at the Endoscopy unit or call us on 01273 696955 Ext. 4570.
If you have any other questions about your Enhanced Sedation you can ask your anaesthetists on the day or call the Department of Anaesthesia on 01273 696955 Ext. 4307.
This publication includes text taken from The Royal College of Anaesthetists’ (RCoA) leaflet Sedation Explained, 2018. You can find it and more information about sedation at the RCoA website
but the RCoA has not reviewed this as a whole.
The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.
Publication Date: January 2021
Review Date: October 2023