What must be observed before the anaesthetic
To prepare for a gastroscopy under anesthesia, an informative conversation must be held in advance and a corresponding information sheet must be signed by the patient and the physician. In this form, each patient is individually informed about possible complications, side effects and the course of the anesthesia itself, followed by a short physical examination. It may also be necessary to have an ECG or other examinations in order to ensure that the anaesthesia is as uncomplicated as possible.
Allergy sufferers should present their allergy passport in advance so that no undesirable allergic reactions to the medication administered can occur (for example, some anaesthetics contain chicken proteins, which can lead to allergic reactions). A dental prosthesis should be removed as a precaution before a gastroscopy. At the time of the gastroscopy, you should come to the clinic on an empty stomach.
This means that no solid food was consumed at least 12 hours before and no liquid food at least 3 hours before. One reason for this is that this allows a better view with the endoscope. In addition, the anaesthesia also causes the sphincter muscle of the stomach to relax and the protective reflexes to fail, which can ultimately lead to inhalation (aspiration) of stomach contents. If possible, smoking should also be avoided a few hours before the gastroscopy, as this increases the probability of complications in the circulation. General information on this topic can also be found in our main article: Anaesthetic induction
Anaesthesia for a gastroscopy
A gastroscopy can be performed either in an awake or sleeping, “narcotised” state. In the first option, an anesthetic spray is sprayed into the throat, which leads to short-term, localized insensitivity to pain.Thus, the gagging sensation can be prevented if the examination tube bumps into the back of the throat. The advantage of this method is that after the examination there are no restrictions or side effects caused by an anaesthetic, vehicles and machines may be operated afterwards.
The anaesthetic effect in the throat lasts only 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 may experience the feeling of the gastroscope in the stomach as unpleasant. A slight pressure due to the inflation of the stomach with air can also be felt.
As a rule, however, a gastroscopy does not cause any pain, so a local anaesthetic is sufficient in many cases. In addition to the anaesthetic spray in the throat, a short-acting anaesthetic can be given before the gastroscopy if desired. This is not a general anesthesia where artificial respiration is necessary.
Instead, only a sedative and sleeping pill is administered (e.g. diazepam). These anaesthetic drugs work very quickly and one falls asleep in the vein immediately after administration. In order to be able to administer such an anaesthetic, a vein dwell catheter (thin rubber tube which is placed in a vein, for example on the forearm, to administer the medication over it) must be placed before the examination.
The anesthesia does not make you aware of the gastroscopy itself, the swallowing of the tube and the examination in the stomach and duodenum are so to speak overslept and not consciously perceived. The risk of complications due to the anesthesia is very low. Side effects due to the short anaesthesia occur, if at all, in people with several previous illnesses or in emergency gastroscopy.
