Sedation and pain relief options
1All endoscopic procedures can be associated with some discomfort but there are a number of options to minimise this. Your patient information leaflet explains these options in more detail and there is information below.
If you have any questions or want to discuss your options; please contact the Unit in advance and ask to speak to a nurse or on the day of the procedure, you can discuss them with the nurses or the endoscopist.
Throat spray if you having Gastroscopy
This is a spray that numbs the throat and therefore minimises the discomfort in the throat during gastroscopy.
For the procedure you are completely awake and feel bloated due to the air. Whilst this can be uncomfortable, it is not painful. A diagnostic gastroscopy usually takes less than 10 minutes, and the spray wears off after approximately 30 minutes.
The benefit of having throat spray is that you are able to go home more quickly, you do not require a friend or family to accompany you and you can drive a car or operate machinery straight away after. For this reason, many people choose throat spray for diagnostic gastroscopy.
Gas and air (Nitrous Oxide or Entonox)
If you are having a colonoscopy or flexible sigmoidoscopy, you will be offered gas and air which is commonly used to relieve labour pain. You inhale the gas using a hand-held mouthpiece. This provides very rapid pain relief but also wears off quickly. You are entirely awake during the procedure and can go home rapidly after. No other precautions are required so many people find this a more convenient approach.
This will only be offered if you have not had eye or ear surgery in the last 3 months or any loss of consciousness/ head injury, pneumothorax, air embolism, a recent diving, emphysema, or gross abdominal distention.
Sedation
With sedation you receive an injection (via a cannula inserted in the arm or hand) of one or a combination of drugs to relax and reduce discomfort. Commonly we use a drug called Midazolam (a sedative or relaxing drug). Sometimes this may be combined with a strong painkiller either Fentanyl or Pethidine.
The doctor or nurse providing the sedation will discuss with you what is best on the day. These medications will make you lightly drowsy and relaxed, but not make you go to sleep like a general anaesthetic. You will still hear what is said to you and therefore, will be able to carry out simple instructions during the procedure. Some people do not remember anything about the procedure once the effects have worn off.
Sedation may provide a more comfortable procedure but has the disadvantage of requiring a more prolonged recovery in hospital. If you are having sedation, you must arrange for a responsible adult to collect you and stay with you overnight. If you have not been able to make these arrangements, you will not be able to have the procedure with sedation.
You should not drive, return to work, operate machinery, or drink alcohol for 24 hours after the procedure, nor should you make any important decisions. The reason for this is that the sedation may, even though you may feel perfectly normal, still be in the body and may impair your judgement.
In addition, certain patient groups may be more at risk from the effects of sedation such as patients with sleep apnoea or breathing problems including asthma or COPD. If you have any of these, they will have to be taken into consideration when the sedation drugs are being chosen and administered and it may be necessary to use lower doses or not at all. This will be discussed with you by the referring doctor and the0 endoscopist on the day.
Last Modified: 9:21am 25/07/2024