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Anesthesia and airway management for gastrointestinal endoscopic procedures outside the operating room

Kuzhively, Julie; Pandit, Jaideep J.

Current Opinion in Anesthesiology: August 2019 - Volume 32 - Issue 4 - p 517–522
doi: 10.1097/ACO.0000000000000745

Purpose of review To review the anesthestic and airway management for gastrointestinal procedures outside of the operating room.

Recent findings The number of gastrointestinal endoscopic procedures performed is steadily increasing worldwide. As complexity, duration and invasiveness of procedures increase, there is ever greater requirement for deeper sedation or general anesthesia. A close relationship between anesthetic practitioners and endoscopists is required to ensure safe and successful outcomes. The American Society of Gastrointestinal endoscopy and the British Society of Gastroenterology have recently released guidelines for sedation and general anesthesia in gastrointestinal endoscopy, highlighting the need for careful monitoring for all cases, and anesthetic expertise in complex cases. The recent advances in high-flow nasal oxygenation in sedation may provide alternative options for oxygenation during gastrointestinal sedation, especially in deep sedation and this may reduce the need for general anesthesia.

Summary The advances in gastrointestinal endoscopic intervention have increased the requirement for deep sedation and anesthetic involvement outside of the operating room. Careful titration of anesthetic intervention and close monitoring are required to ensure patient safety.

Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK

Correspondence to Jaideep J. Pandit, St John's College, Oxford OX1 3JP, UK. Tel: +44 1865 221590; e-mail:

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