Anesthesia as part of a gastroscopy
A gastroscopy or gastroscopy is used to diagnose the esophagus (Esophagus), stomach (Guest) and duodenum (Duodenum) carried out.
A plastic tube with a light source and a small camera (optics), the so-called gastroscope, is pushed through the mouth and the esophagus into the stomach. The optics enable illnesses or injuries to be made visible on a screen and, if necessary, micro devices can be pushed through openings in the gastroscope during the gastroscopy, with which certain findings can also be treated.
- Liquids are sucked off or fed
- Tissue samples taken
- Bleeding in the upper digestive tract stopped
- superficial tissue changes can be removed directly.
A gastroscopy is usually a brief examination lasting around ten minutes and is considered to be low-risk. It is mainly used when there is suspicion of inflammation of the stomach lining (gastritis), an ulcer, a tumor, varicose veins in the esophagus (Esophageal varices) or a bacterial infection of the stomach with Helicobacter pylori.
In order to perform a gastroscopy, the flexible gastroscope must first be pushed through the mouth and the esophagus into the stomach. In the waking state, the tube can be actively "swallowed", which, however, often causes a gag reflex. It is possible to numb the throat with a spray beforehand in order to suppress the gag reflex and any pain.
People with a particularly pronounced gag reflex, fearful or excited people can be given a sedative or a light anesthetic can be initiated for the gastroscopy.
However, due to the short duration of a gastroscopy, this is usually not necessary.
However, if the patient so wishes, anesthesia can still be used. In this case, the anesthetic procedure consists on the one hand of the administration of an anxiety-relieving tablet before the gastroscopy and the administration of an anesthetic.
In contrast to the local anesthesia that is otherwise used, general anesthesia completely eliminates both pain perception and consciousness of the patient, as the medication administered acts in the central nervous system (especially the brain).
This creates optimal conditions for the examining doctor to perform the gastroscopy.
For more information on general anesthesia, see our main article. You can find it here: Main article general anesthesia
What to consider before anesthesia
To prepare for a gastroscopy under anesthesia must in any case beforehand Educational talk and a corresponding information sheet from patient and doctor signed become.
In this, each patient is individually about possible complications, Side effects and the Procedure of anesthesia Enlightened in itself, followed by a brief physical exam. It may also be Take an EKG or other examinations are necessary to ensure anesthesia that is as uncomplicated as possible.
Allergy sufferers should own Allergy pass Present this in advance so that there are no undesirable allergic reactions to the medication administered (for example, some anesthetics contain egg white, which can lead to allergic reactions).
A Denture should be done before the gastroscopy removed as a precaution become.
At the gastroscopy appointment you should sober appear. This means that no solid food was consumed at least 12 hours beforehand and no liquid food was consumed at least 3 hours beforehand.
On the one hand, this is due to the fact that such a better view with the endoscope is made possible.
Furthermore, the anesthetic also has a Relaxation of the stomach sphincter and a loss of protective reflexes, which ultimately leads to inhalation (aspiration) can come from stomach contents.
If possible, it should also take a few hours No longer smoked before gastroscopy as this increases the likelihood of Complications of the Circulatory elevated.
You can also find general information on this topic in our main article: Induction of anesthesia
Anesthesia during a gastroscopy
A gastroscopy can be done either in the awake or in the sleeping, "anesthetized" state be performed.
In the first variant, a Anesthetic spray sprayed down the throatwhat a short-term local insensitivity to pain leads. Thus the Prevents gagging if the examination tube hits the back of the throat.
The advantage of this method is that you can look after the examination no restrictions or side effects from an anesthetic Has, Vehicles and machines may then be operated. The numbing effect in the throat only lasts for a very short time after the gastroscopy and basically disappears again without causing any side effects.
However, one is awake during the examination and can do that Finding the feeling of the gastroscope in the stomach uncomfortable. Also a slight pressure from inflating the stomach with air can be felt. It usually causes a gastroscopy, however no pain, which is why a local anesthetic is sufficient in many cases.
In addition to the anesthetic spray in the throat, you can do a short-acting anesthesia receive. It is about not a general anestheticthat require artificial ventilation. Instead it will just a sedative and sleeping pill administered (e.g. Diazepam).
These anesthetic drugs work very quickly and you fall asleep immediately after administration into the vein. In order to be able to give such an anesthetic, a Vein indwelling catheters (a thin rubber tube that is placed in a vein, for example on the forearm, in order to administer the medication over it). With the anesthesia you don't notice anything of the gastroscopy, the swallowing of the tube and the examination in the stomach and duodenum are, so to speak, overslept and not consciously noticed.
The The risk of complications from the anesthetic is very low. Side effects from the brief anesthesia occur, if at all, in people with several previous illnesses or in emergency gastroscopy.
Procedure of anesthesia
In the morning before the gastroscopy, a tablet is given, which is a relaxing and anti-anxiety (anxiolytic) effect exercises on the patient.
These are mostly Dormicum. This medication is often sufficient to make a gastroscopy comfortable enough for the patient.
However, was chosen for one general anesthetic decided, further steps are necessary. To initiate general anesthesia, a venous catheter is first placed and oxygen is given through a mask, which is held in front of the nose and mouth of the person to be examined. Then ensures that you fall asleep Anesthetic gas or a drug (usually Propofol), which by means of a syringe intravenous is administered.
During the gastroscopy, the patient's condition is based on his Vital signs (breathing, Heart rhythm, Blood pressure) constantly monitored.
When the examination is over, the anesthetic is finally done diverted. Until the patient is fully conscious again, he will still be about 1 to 2 hours in the recovery room supervised.
To step nausea or pain, these can be treated here.
Drive or operating machines is after an anesthetic for the next few hours not allowed.
Duration of anesthesia and examination
Just like the gastroscopy itself, the anesthesia lasts during this examination not very long; preparing for the gastroscopy generally takes significantly more time than the gastroscopy itself.
For the duration of the examination, one can use about a quarter of an hour go out. From the beginning of the preparations until you wake up, in about one to two hours.
Please also read our page A gastroscopy procedure.
Gastroscopy in children - with anesthesia?
As with adults, is enough larger children and adolescents the Administration of a sedative before a gastroscopy. For this is a Venous access required.
At small children a gastroscopy should, however performed under anesthesia become. The examination is painless, but this cannot be explained to a toddler in advance and the examination may have a negative experience.
In this case, anesthesia makes sense to avoid emotional trauma. However, this can be done no general recommendation because the risks and benefits should always be weighed up on an individual basis.
Risks and Complications
In general, as well as with a gastroscopy in particular, anesthesia is a very safe procedure nowadays and hardly dangerous.
The most common complications occur as a result of the administration of narcotics and pain relievers in the form of cardiovascular problems. However, the anesthetist can counteract this very well by administering medication.
Furthermore, the sedation can lead to slowed breathing or even to respiratory arrest. However, this is not uncommon and can be easily compensated for by the administration of oxygen or short-term ventilation.
Allergic reactions to medication also occur very rarely. This manifests itself in a variety of ways. On the one hand, it can lead to harmless reddening of the skin and rashes, but also to dangerous anaphylactic shock.
On the whole, however, complications during anesthesia can be almost completely avoided with constant monitoring by the anesthetist.
Read more on the topic: Risks of anesthesia
Side effects of anesthesia during gastroscopy
The most common side effect of anesthesia is the occurrence of Nausea after the gastroscopy; in the technical language is used by PONV (English: postoperative nausea and vomiting) spoken.
This, albeit harmless, becomes very unpleasant side effect especially from anesthesiacauses gases and is particularly common in women and non-smokers. However, by giving her nausea medication (Antiemetics) can be effectively counteracted during or after the examination.
Another side effect is that postoperative deliriumwhich especially the elderly concerns. This is a Disturbance of consciousness and orientation right after waking up from anesthesia. Furthermore, it can persist for several days or weeks Memory and concentration disorders come.
Overall, however, there are side effects due to the anesthesia during a gastroscopy very rare, since in this investigation the Very short anesthesia time is and so only one low drug dose is needed.
Generally after a gastroscopy often an uncomfortable, numb feeling in the throat area specified. Sometimes it comes to one temporary hoarseness. These complaints tend to be, however short-lived, permanent damage is extremely rare.
It is recommended to do this long after a gastroscopy no food or drinks to take in until the complaints subsided otherwise there is a risk of choking or "inhaling" food (aspirated).
During the examination, air is fed into the stomach area via the gastroscope temporary feeling of pressure or increased belching to lead.
If the gastroscopy using Narcotics or anesthetics is done, that's it Driving a vehicle until the next morning not appropriate. It should also be used after an anesthetic Do not operate machines, perform dangerous activities or make important decisions become.
If symptoms such as severe pain, vomiting blood, dizziness or the like occur after a gastroscopy, should consulted a doctor immediately become.