Anesthesia for Advanced Endoscopic Procedures

Abstract

The gastrointestinal endoscopy paradigm is rapidly changing, and technological advancements are largely responsible. In tandem, anesthesia providers are adapting to the changing needs and demands. The challenges are unique. Complications arising from the procedures are both routine, such as aspiration and hypoxia, and procedure specific, such as bleeding, pneumothorax, pneumopericardium, and pneumoperitoneum. It is crucial for the anesthesia provider to have a good understanding of the techniques employed by the endoscopist. A higher index of suspicion is also essential to diagnose and appropriately manage many of the complications. In this review, an effort is made to discuss both procedural aspects and anesthesia challenges. We hope that both endoscopists and anesthesia providers will benefit from this review.

Keywords: Anesthesia; Endobariatrics; Endoscopy; Myotomy.

Fig. 1.

Mapleson C breathing system in use in a obese patient undergoing esophageal dilation with propofol deep sedation.

Fig. 2.

Head tilt–chin lift and jaw-thrust maneuvers in use to restore upper airway patency.