Anaesthesia during a colonoscopy
In colonoscopy, an endoscope (tubular instrument with camera) is inserted through the anus into the large intestine so that the doctor can detect any changes in the mucous membrane there. This procedure is usually painless, but somewhat unpleasant. Anesthesia is therefore not absolutely necessary for a colonoscopy.
In consultation with the patient, it is decided whether the patient will undergo the colonoscopy in full consciousness or whether he/she does not wish to undergo it. This depends on the duration of the colonoscopy, on the patient’s personal feeling of pain and fear of the colonoscopy. In most cases, however, the colonoscopy is performed under a light anaesthetic, a so-called sedation.
This involves injecting the patient with a sedative, which allows him or her to sleep so that he or she is not aware of the examination. The difference to general anaesthesia is that sleep is not so deep when sedated. Although the patient is also given an infusion, he does not need to be ventilated during sedation.
However, the heart, circulation and breathing functions are controlled. After the colonoscopy, the patient can sleep in and is not allowed to drive for the next 24 hours. Sedation should always be performed in patients with high blood pressure or heart failure.
It is also recommended for very anxious patients. Colonoscopies are also known as colonoscopy and are nowadays a routine diagnostic and therapeutic treatment. The procedure is performed with the help of a coloscope.
A colonoscope is a flexible tube with a small camera, a strong light and various openings for inserting instruments at the end. Fibre-optic bundles guide light and colour spots along the colonoscope and project the image to be seen on a screen. Before every colonoscopy, the patient must first clean his or her intestine by means of medicinal laxatives.
Furthermore, he must be fasting before the colonoscopy. Shortly before the procedure, a short anaesthetic is injected and the patient is positioned laterally. Then the colonoscope is pushed into the anus and slowly advanced to the transition from small intestine to large intestine.
In order to create optimal visibility conditions for the examiner, it is necessary to introduce air so that the intestine unfolds during the examination. The examiner tries to push the tube all the way to the front with various rotary movements. While pulling it back, he then inspects the intestinal wall, examines it for inflammation, bleeding and tumours and can also take samples using small pliers inserted from the outside, which can then be examined under a microscope.
Often smaller and larger polyps are seen, which are usually removed in the same session to prevent the development of cancer. Tumours are usually biopsied, in rare cases a visual diagnosis may be sufficient in the case of advanced colon carcinoma. Bleeding that is seen can be stopped with suture or drug injections.
Colonoscopy is used therapeutically to clarify long-lasting pain or diarrhoea as well as frequent changes in diarrhoea and constipation and in cases of blood in the stool. As a preventive examination, everyone aged 55 and over should have a colonoscopy, which is paid for by health insurance companies. Despite the minor procedure, bleeding, perforations and inflammation may still occur in rare cases, making further medical action necessary.
