Anesthesiology/Sedation

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Question
If receiving IV sedation for a gastroscopy do they also give you spray to numb your throat?
Why do they resist giving general anaesthetic for a gastroscopy?
How sedated are you actually? Are you aware?
Thanks!

Answer
Hello, Max. Thank you for your question today.

They do spray the back of the throat with an anesthetic solution before the endoscopy is done. This is because IV sedation does not suppress the gag reflex. When this reflex is blocked by the local anesthetic the endoscope is much easier to insert and the procedure progresses much more quickly.

We use a technique called TIVA, or Total Intravenous Anesthesia. I use a combination of medications that reduces discomfort, keeps the patient from recalling the procedure and keeps the patient from moving. The drugs I use have a very quick onset but wear off very quickly. That allows me to titrate the medications to the procedure so that the patient does have a long postoperative recovery period. Very few patients report that they recalled anything about the procedure.

General anesthesia is not utilized because these procedure are typically short and are not particularly physiologically stressful. Also, we must use more invasive techniques to ensure that the patient can continue to breath during the procedure. Generally, TIVA is safer for the patient for these type of procedures.

I hope this reply answers your questions. If not, please feel free to contact me again. Again, thanks for your important question.

Anesthesiology

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Charles T Porter Jr MD

Expertise

Questions in all fields of Anesthesiology except Pain Management.

Experience

I have been in the practice of Anesthesiology since 1981.

Organizations
American Society of Anesthesiologists, International Anesthesia Research Society, Texas Society of Anesthesiologists, Texas Medical Association

Education/Credentials
Graduate of the Citadel and the Medical University of South Carolina. Completed Anesthesiology residency at the Naval Medical Center San Diego, California. Board certified in Anesthesiology and a Fellow of the American College of Anesthesiologists.

Awards and Honors
Alpha Omega Alpha National Medical Honor Society 1978, Outstanding Graduate Anesthesiology Resident Naval Medical Center San Diego California

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