Emergencies and Treatment of Complications

Sedation for gastrointestinal endoscopy may induce central respiratory depression and/or airway obstruction. Early diagnosis and treatment of these complications is mandatory as the resulting hypoxia may cause irreversible damage, particularly to vital organs, or death. Sedatives and centrally acting analgesics depress respiration in a dose-dependent manner. However, significant untoward events are preventable by titrating the doses for sedation and by monitoring patient oxygenation and respiration. Cardiovascular adverse events may also occur during gastrointestinal endoscopy, and can be major or minor. Hypotension needs treatment as well as severe hypertension. Cardiac dysrhythmias may occur due to stress, pain and/or hypercarbia, which may accompany endoscopies. The anesthesia provider must be able to diagnose, assess the risk and treat all the adverse events during gastrointestinal endoscopy. The resuscitation equipment, including the defibrillator, must be readily accessible.