Tips for anesthesia gastrointestinal endoscopy to help you start a pain-free journey

Author: Bi Xi, the Fifth Medical Center of the General Hospital of the Chinese People's Liberation Army

Qi Xiaobao The Fifth Medical Center of PLA General Hospital

Reviewer: Lu Zheng, deputy chief physician, Fifth Medical Center, PLA General Hospital

Gastroenteroscopy is an invisible guardian of gastrointestinal health, which can assist doctors in accurate diagnosis and early intervention. Anesthesia gastroenteroscopy, with its advantages of being painless and safe, makes the examination process more comfortable, especially for sensitive or special groups. However, the lack of understanding of anesthesia gastroenteroscopy makes many patients feel fear before the examination. Today, we will lead you to have a deep understanding of the relevant knowledge of anesthesia gastroenteroscopy, clarify the precautions before and after the examination, and help everyone look at this examination more rationally.

1. What is the difference between conventional gastroenteroscopy and anesthesia gastroenteroscopy?

Conventional gastroenteroscopy is performed when the patient is awake. Anesthesia gastroenteroscopy is performed when the patient is sedated and asleep after being given anesthesia. Anesthesia gastroenteroscopy is also called painless endoscopy.

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2. Who cannot undergo anesthetized gastrointestinal endoscopy?

1. Those who are in critical condition such as shock.

2. Patients with acute upper respiratory tract infection, cough, sputum, massive hematemesis, gastric retention (prone to suffocation), etc.

3. Patients with corrosive esophagitis and gastritis.

4. Patients with moderate or above cardiopulmonary dysfunction, acute myocardial infarction, acute cerebral infarction, cerebral hemorrhage, bronchitis and asthma, severe cor pulmonale, severe hypertension, etc.

5. Patients with rapidly worsening colon inflammation (acute inflammation of the intestine and anus, ischemic enteritis, etc.), acute peritonitis, etc., suspected gastrointestinal perforation, intestinal fistula, or extensive and severe intestinal adhesions.

6. Patients suspected of postoperative peritonitis or extensive intestinal adhesions after gastrointestinal tumor surgery.

7. Those who are extremely weak and cannot tolerate preoperative bowel preparation and examination.

8. Patients with massive ascites.

9. People with severe liver and kidney dysfunction.

10. Pregnant and lactating women.

11. Patients with glaucoma, prostatic hyperplasia and a history of urinary retention.

12. Patients who are allergic to or should avoid using propofol, midazolam, fentanyl, or scopolamine ester local anesthetics.

13. People with severe snoring or obesity should use this product with caution.

14. Use caution if you have bradycardia.

3. What do you need to prepare before anesthesia for gastrointestinal endoscopy?

1. You need to complete an electrocardiogram, chest X-ray, hepatitis B and C tests, blood routine, blood type, coagulation function, AIDS, syphilis and other tests in advance, and bring the test results to the endoscopy center for anesthesiologists to assess the anesthesia risk and determine whether anesthesia can be performed. After signing the informed consent form, make an appointment for reasonable arrangements. On the day of the examination, queue up at the triage counter according to the appointment time.

2. Before the examination, empty your bladder, remove your removable dentures, and give your mobile phone, watch, jewelry and other valuables to your family members for safekeeping. Remove the nail polish on the middle finger of your right hand to facilitate monitoring of blood oxygen saturation.

3. Family members are requested to wait in the designated area so that when the patient cannot express clearly or encounters an emergency, the staff can find the family members at any time to ask or inform the patient of the condition and obtain signatures.

4. Patients undergoing anesthetized gastrointestinal endoscopy must be accompanied by a family member, and can only leave with a family member if they meet the discharge score requirements after the examination.

5. Female patients should avoid colonoscopy during the menstrual period, and endoscopic examination is also prohibited during pregnancy.

4. What should you pay attention to after anesthetized gastrointestinal endoscopy?

1. After anesthesia, you need to fast and drink water for 2 hours. After that, you can eat semi-liquid food, such as porridge, noodles, etc., and resume normal diet the next day. If you feel sore and uncomfortable in the throat or find a small amount of blood in your saliva after the operation, don't panic, and don't vomit or cough deliberately. This is caused by friction damage to the pharyngeal mucosa during the insertion of the endoscope. Generally, it can be recovered in 1 to 2 days. Deliberate vomiting and coughing may cause bleeding to worsen.

2. Abdominal distension and discomfort after anesthesia gastroscopy is caused by the expansion of the stomach cavity during the examination. You should get enough rest, get out of bed and move around with your family members to promote gastrointestinal motility, and relieve abdominal distension by burping and anal gas discharge.

3. Patients who need to have their diseased tissues biopsied should eat semi-liquid food for dinner on the same day and three meals the next day, and avoid raw, hard, hot, and sweet foods to facilitate wound healing.

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4. If you experience severe abdominal pain, vomiting blood, or bloody stools after gastrointestinal endoscopy, you should go to the emergency department of the hospital immediately to avoid delaying the condition.

5. You are not allowed to drive a motor vehicle, engage in high-altitude operations, actuarial work, logical analysis, etc. on the day after the inspection, and should not engage in heavy physical labor.

5. What is the cause of nausea and vomiting after anesthesia gastroenteroscopy? What should I do?

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1. During anesthesia gastrointestinal endoscopy, sufentanil citrate is commonly used as an analgesic. Common adverse reactions of this drug include nausea, vomiting, and dizziness, which are more common in middle-aged and elderly women. The longer the anesthesia gastrointestinal endoscopy, the higher the frequency of postoperative nausea and vomiting.

2. Nursing for nausea and vomiting after anesthesia

(1) Care for patients and reduce their anxiety.

(2) Lie flat on your back without a pillow, with your head tilted to one side.

(3) As the drug is metabolized, the patient will generally recover on his own. In serious cases, the patient should be given the correct antiemetic and sedative drugs as prescribed by the doctor.

(4) Keep the ward environment spacious and bright to reduce adverse stimuli.

(5) Accurately record the patient's intake and output, assess dehydration, and check electrolytes and replenish fluids when necessary.

(6) After surgery, you should eat small meals frequently and mainly eat light food, avoiding spicy and fried foods.