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Practical considerations in the management of sedation for colonoscopy

Tetzlaff, John E.

Current Opinion in Anaesthesiology: August 2016 - Volume 29 - Issue 4 - p 512–518
doi: 10.1097/ACO.0000000000000352
ANESTHESIA OUTSIDE THE OPERATING ROOM: Edited by Natalie F. Holt
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Purpose of review The purpose of this review is to discuss the unique elements of providing anesthesia services for colonoscopy including the practical issues within an endoscopy suite, nothing by mouth status for colonoscopy, chronic medication instructions, appropriate anesthesia equipment, informed consent, pharmacology of agents for sedation, anesthetic techniques, and issues related to postprocedural care.

Recent findings The national trend is toward increasing number and complexity of colonoscopy procedures using anesthesia services. Providing anesthesia services in a dedicated endoscopy suite has unique elements related to open scheduling and the rapid turnover environment. Agents for sedation and general anesthesia for colonoscopy are chosen for rapid onset, amnestic properties, and raid emergence/recovery.

Summary Sedation for colonoscopy is a rapidly expanding subspecialty with special needs created by the increasing medical complexity of the patients, the demands of the endoscopy procedures, the challenges of the endoscopy suite, and the rapid turnover of the outpatient environment.

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Staff, Department of General Anesthesia, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, USA

Correspondence to John E. Tetzlaff, MD, Professor of Anesthesiology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Staff, Department of General Anesthesia, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA. Tel: +1 216 444 3739; fax: +1 216 444 2294; e-mail: tetzlaj@ccf.org

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