Global Journal of Medical and Pharmaceutical Sciences

Open Access Peer Review International
Open Access

Perioperative Anesthetic Approaches and Risk Management in Gastrointestinal Endoscopic Procedures

4 Division of Gastrointestinal Anesthesia, Mayo Clinic, Rochester, Minnesota, USA
4 Department of Anesthesiology and Critical Care, University of Bologna, Italy

Abstract

Gastrointestinal (GI) endoscopic procedures have become integral to both diagnostic and therapeutic interventions, with increasing complexity requiring advanced perioperative anesthetic management. This review explores contemporary anesthetic approaches and risk mitigation strategies tailored to the diverse range of GI endoscopic procedures, including esophagogastroduodenoscopy (EGD), colonoscopy, endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic ultrasound (EUS). Special attention is given to airway management, sedation techniques, patient positioning, and the management of procedure-specific risks such as aspiration, hypoxia, and cardiovascular instability. The review also addresses considerations in high-risk populations, including the elderly, patients with obstructive sleep apnea, and those with significant cardiopulmonary comorbidities. Emphasis is placed on multidisciplinary planning, individualized sedation plans, and the use of capnography and other monitoring tools to enhance safety and improve outcomes.

Keywords

References

πŸ“„ Fuentes M, et al. Anesthetic Considerations in GI Endoscopy. Revista MΓ©dica Del Hospital General de MΓ©xico. 2021.
πŸ“„ Pardo, et al. Decision tree for airway risk stratification. Unpublished Clinical Guideline. 2020.
πŸ“„ Pardo, et al. Airway Protection Score Development. Journal of Anesthesiology. 2019.
πŸ“„ Cha JM, Jeun JW, Pack KM, et al. Risk of Sedation in OSA Patients. World J Gastroenterol. 2013;19:4745-4751.
πŸ“„ Peri-Operative Management of the Obese Surgical Patient. Anaesthesia. Wiley Online Library. 2015.
πŸ“„ American Society of Anesthesiologists. Preoperative Management of GLP-1 Agonists. [Accessed 18 June 2024].
πŸ“„ Revised cardiac risk index. American heart association guidelines. 2020.
πŸ“„ Glasgow-Blatchford Bleeding Score. British Journal of Surgery. 2015.
πŸ“„ Enestvedt BK, Eisen GM, Holub J, et al. ASA Classification Utility. Gastrointest Endosc. 2013;77:464-471.
πŸ“„ Sharma VK, Nguyen CC, Crowell MD, et al. Cardiopulmonary Events Post-Endoscopy. Gastrointest Endosc. 2007;66:27-34.
πŸ“„ Calderwood AH, Chapman FJ, Cohen J, et al. Safety Guidelines for GI Endoscopy. Gastrointest Endosc. 2014;79:363-72.
πŸ“„ American Society of Anesthesiology. Physical Status Classification. 2014, Accessed 19 April 2015, Available from: http://www.asahq.org/resources/clinical-information/asa-physical-status-classification-system
πŸ“„ Nafiu OO, Burke C, Cowan A, et al. Venous Access in Obese Children. Paediatr Anaesth. 2010;20:172-176.
πŸ“„ Miles G, Salcedo A, Spear D. Nurse-Led Ultrasound IV Program. J Emerg Nurs. 2012;38:353-356.
πŸ“„ Chinnock B, Thornton S, Hendey GW. Predictors of Ultrasound-Guided Cannulation Success. J Emerg Med. 2007;33:401-405.
πŸ“„ Lapostolle F, Catineau J, Garrigue B, et al. Venous Access Difficulty in Emergencies. Intensive Care Med. 2007;33:1452-1457.
πŸ“„ Electrolyte Imbalance in Bowel Preparation. Gastroenterology Journal. 2018.
πŸ“„ Zuckerman MJ, Shen B, Harrison ME, et al. Informed Consent for GI Endoscopy. Gastrointest Endosc. 2007;66:213-218.
πŸ“„ Xu Q, Tu H, Xiang S, et al. Ultrasound-Guided IV Infusion in Colonoscopy. Ann Palliat Med. 2021;10(1):61-73.
πŸ“„ Γ‡akar E, Yilmaz E, Γ‡akar E, et al. Preoperative Carbohydrate Intake Effects. J Perianesth Nurs. 2017;32(6):589-599.
πŸ“„ Xu et al. Gastric Volume Assessment by POCT Ultrasound. Anesthesiology and Perioperative Science. 2024. Available from: https://doi.org/10.1007/s44254-024-00052-8.
πŸ“„ ASGE Guidelines for Sedation in GI Endoscopy. American Society for Gastrointestinal Endoscopy. 2018.
πŸ“„ Bazerbachi et al. Sedation Strategies in GI Endoscopy. Gastroenterology Report. 2022.
πŸ“„ Goudra B, Saumoy M. Anesthesia for Endoscopic Procedures. Clinical Endoscopy. 2022.
πŸ“„ Sundararaman L, Goudra B. Sedation Challenges in Obese Patients. J Clin Med. 2024;13:4635. Available from: https://doi.org/10.3390/jcm13164635.
πŸ“„ Devine BJ. Gentamicin Therapy. Drug Intelligence & Clinical Pharmacy. 1974;8(11):650-655.
πŸ“„ Janmahasatian S, et al. Quantification of Lean Body Weight. Clinical Pharmacokinetics. 2005;44(10):1051-1065.
πŸ“„ ASGE guidelines for sedation and anesthesia in GI endoscopy, endorsed by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and American Gastroenterological Association.
πŸ“„ Nay MA, Fromont L, Eugene A, et al. High-flow nasal oxygenation or standard oxygenation for gastrointestinal endoscopy with sedation in patients at risk of hypoxaemia: A multicenter randomised controlled trial (ODEPH trial). Br J Anaesth. 2021;127:133-142.

How to Cite

Perioperative Anesthetic Approaches and Risk Management in Gastrointestinal Endoscopic Procedures. (2025). Global Journal of Medical and Pharmaceutical Sciences, 4(07), 1-8. https://doi.org/10.55640/

Most read articles by the same author(s)

<< < 1 2 3 4 5 6 > >> 

Similar Articles

1-10 of 16

You may also start an advanced similarity search for this article.