Tuesday, 20 February 2018

A Review Of Endoscopic Anesthesia

By Walter Fisher


Sedation is normally performed to patients for safe therapeutic or diagnostic procedures, and such procedures require highly trained physicians and highly suitable facilities. To add on that, the patients should be monitored during the sedation, and the physicians are required to use safe sedative techniques, and the application of the drugs should also be made efficiently. The patients are also assisted in recovering well after the procedure. Endoscopic anesthesia should thus be performed by physicians who are experienced to avoid further complications that can cost the life of a patient.

Sedation normally tends to be different in different states and the main causes are normally ambulatory. The procedure is short hence the agents are short lasting as well. More so, they have adverse effects that are very minimal so long as doctors adhere to the safety profiles. Therefore, it is wise to follow the set protocol to avoid risking lives.

The physicians have to determine a pre-analgesic evaluation and use sedative doses that will be most convenient and accurate. The procedure may vary in various states, but the results tend to be always the same provided physicians monitor the patients. Also, drug application should be performed well so avoid obvious mistakes. Only the qualified physicians who are also very experienced are allowed to undertake such procedures due to the safety of the patients.

Analgesia is usually a very critical tool for procedures such as gastrointestinal endoscopy. Normally, the analgesics are used to make the patient more comfortable and to improve the performance of these procedures. The physicians thus decide whether the patient needs to be put under depending on the type of GIE, the time the procedure is likely to take, challenges that may be encountered, the physical status of the subject and preferences of a physician.

Although these procedures vary in various states, the ASA has come up with a standard SOP to act as the main benchmark for all doctors worldwide. This protocol explains terms such as minimal analgesia, moderate analgesia, deep and general analgesia to help physicians understand the conditions in details.

This protocol helps the physicians must be able to rescue patients from analgesia that has become deeper than what was targeted. Thus, it is important that the personnel performing the procedure be highly qualified and the patient to be monitored after the administration of the sedatives. Failure to follow the standard may lead to serious complications.

A pre-anesthesia assessment should be done, and the subjects should have an updated examination history that is relevant. The areas that are monitored during the sedation are the patterns of respiration, mucosa or skin color, the consciousness of the patient and whether the facial expression of patients indicates that they are in a comfortable level.

Analgesic compounds like ketamine dissociate very fast and are mostly used in children. It is administered through intravenous, intramuscular, rectal or oral routes. Midazolam is normally short-acting and highly water soluble. Other sedatives like pethidine, fentanyl, and propofol also have similar effects thus they can be used as well. The physicians should be able to know which analgesic is appropriate for each person.




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