NEW
The medical endoscopy room has been equipped with an anesthesia-respiratory apparatus. After the equipment was installed, services such as FGS and FCS under anesthesia became available in the clinic. Procedures under “general anesthesia” are prescribed to patients with a pronounced gag reflex, a low pain threshold, and also in cases where the patient needs two examinations at once: FGS and colonoscopy (examination of the intestines). It is in such cases that anesthesia is used, which allows the procedure to be carried out painlessly for the patient in one day.
Fibrogastroduodenoscopy (FGDS) , or the common colloquial expression “swallow the probe,” has long been recognized as one of the most informative procedures in terms of diagnosing the upper gastrointestinal tract. But at the same time, it is considered quite unpleasant, which frightens patients long before it is performed. In order to save people in need of an examination from the negative aspects that accompany the procedure, in some cases it is recommended to do FGDS under sedation. This option for solving the problem has both pros and cons, which the doctor must first take into account.
Traditional approach
Gastroscopy is a traditional way to assess the condition of the gastrointestinal tract. The method allows you to analyze all changes in the esophagus and stomach, identify inflammatory processes, tumors, detect precancerous conditions at an early stage, and also take samples of the affected areas for biopsy. The procedure is carried out under local anesthesia: before this, the patient is tested for allergies, which are possible to the selected anesthetic.
The effect of the medication ends a few hours after administration, when you can return to everyday activities. Some medications aimed at mild sedation put the patient into a state of lethargy, so doctors recommend stopping driving for at least a day.
General anesthesia is prescribed extremely rarely. In this condition, it is difficult for the doctor to assess the patient’s condition and understand whether the medical actions are correct. It is always more difficult for a patient to survive his new state after such anesthesia than if he were a full participant in the manipulation. Therefore, doctors, as a last resort, if local anesthesia is not possible, prefer to put the person into a state of light sedation or drowsiness instead of deep sleep.
Examination of the stomach in a state of medicated sleep
To relieve patients from physical discomfort and anxiety associated with the procedure, drugs have recently been created that put them into a state of medicated sleep. This technique is called FGDS under sedation - during it all sensations are dulled, sensitivity throughout the body is reduced, and the subject is in a state of drowsiness. When performing a procedure with sedation, both the doctor and the patient benefit in many ways - the diagnostician gets the opportunity to examine the entire surface of the organs without being distracted by the reaction of the patient.
With such anesthesia, muscle relaxation and loss of awareness (complete or partial) occur, which allows you to move the endoscope quickly without causing discomfort to the subject.
Medicinal sleep lasts about 40 minutes, which allows for a complete examination. If a patient’s diagnostic measures include, for example, a colonoscopy (examination of the colon mucosa), then both procedures are performed during this time. Thanks to this, the patient does not need to take the anesthesia drug twice and waste time on a second visit to the clinic.
Differences between gastroscopy under local anesthesia and light sedation
If local anesthesia is chosen for anesthesia, the patient is given an anesthetic solution, and the mouth and throat are treated with an anesthetic spray. The person remains fully conscious and understands everything that is happening. However, at the same time, he slightly feels the impact of the endoscope in the esophagus and may experience unpleasant feelings.
Light sedation is the pain management option preferred in many developed countries. The technique occupies an intermediate place between general and local anesthesia. The patient is injected with anesthetics to relax, calm and immerse himself in a feeling of drowsiness. On the one hand, he feels much less than with local exposure, but on the other hand, he still remains an active participant in the process, which greatly simplifies medical manipulations.
The choice of pain relief option is up to the doctor, but the most extreme option - sleep - is chosen extremely rarely, and not at the request of the patient, but solely for medical reasons.
Diagnostic principle
The essence of FGDS, or as it is also often called FGS (fibrogastroscopy) and gastroscopy, is to insert a special apparatus through the oropharynx and esophagus - a fiberscope (endoscope) into the cavity of the stomach and duodenum. A fiberscope looks like a long narrow tube made of flexible material and a built-in optical part at the end, allowing for examination of organs.
This feature of the procedure entails a certain amount of unpleasant and sometimes even painful sensations. This may include the urge to vomit, sometimes leading to it, pain in the throat and esophagus when the endoscope is advanced. People with a low pain threshold and an increased gag reflex usually imagine themselves with horror as a patient undergoing such a procedure.
Until recently, FGS was performed without the use of anesthesia or other drugs that reduce sensitivity. The only thing used was lidocaine, which causes numbness and loss of sensation in the mouth and throat. For most patients this was sufficient. Currently, three types of anesthesia drugs are used, which have different properties and provide different opportunities for medical personnel and for the patient being examined.
Local anesthesia
As already mentioned above, for this type of anesthesia, drugs based on lidocaine and its analogues are used. The advantages of this method are the patient’s clear consciousness and the possibility of his reaction to sharp pain in the stomach or duodenum, for example, if damaged by an endoscope. Lidocaine and its derivatives do not lead to complications and are well tolerated by patients, with the exception of individual intolerance.
The drug reduces the gag reflex, which slightly calms the person undergoing the examination. After the procedure, the effect of the anesthetic used wears off within approximately 20 minutes, and this allows the patient to immediately go about his business, including driving a car. This method is suitable for gastroscopic examination, and in parallel with any surgical or therapeutic measures, the following types of anesthesia are more often used.
Doctor's comment
Have you been scheduled for a stomach examination, but have you heard a lot about the sensations that arise during the examination? Did you know that you can now do gastroscopy in your sleep? In our clinic, patients who are prescribed this study are completely free from any discomfort. Immediately before the procedure, you will be injected with a drug, after which you will fall into a light medicated sleep. Immediately after the endoscopy, you wake up, without the unpleasant moments associated with anesthesia. After the examination, you can go home immediately. Therefore, if you are worried about abdominal pain, nausea, heartburn and other unpleasant sensations, make an appointment. Moreover, it is better to do this without delaying it for long: if pathological changes are detected at an early stage, the disease can be easily treated. After the procedure, you receive a conclusion along with recommendations regarding diet or further treatment.
Endoscopist Ekaterina Tishchenko
Benefits of gastroscopy during sleep
- Complete painlessness and absence of discomfort during the examination. The patient can leave the clinic immediately after the examination.
- During the study, an analysis is performed for the bacteria Helicobacter pylori - a common cause of erosive and ulcerative lesions of the stomach; the development of a tumor is possible.
- During the examination, you can do a biopsy - take material for further histological examination.
- Gastroscopy in a dream allows in some cases to avoid surgical intervention, because During the procedure, it is possible to carry out a number of therapeutic manipulations: removal of polyps, stopping bleeding, widening constrictions, etc.
Without fear and reproach
Medication-induced sleep today is used not only for gastroscopy. Sedatives may be used, for example, when examining the bladder (cystoscopy) or examining the walls of the uterus using a special optical system (hysteroscopy). True, these are quite rare cases: usually the discomfort during such procedures is eliminated with the help of local anesthesia. But, if a person is very worried or afraid, he may be offered to be examined in his sleep.
Quite often they resort to sedatives during magnetic resonance imaging, especially if they are examining a child. An MRI can take anywhere from 30 to 60 minutes, and you will need to lie still the entire time. For children, this task is almost impossible, so they are put into medicated sleep. This technique is often used in adults suffering from claustrophobia. In the closed space of the tomograph, they begin to panic, which greatly interferes with the research and can distort its results. If a person is put to sleep, such problems do not arise.
And yet, sleep diagnostics are most widespread in the “digestive” sphere. In addition to gastroscopy, colonoscopy, an examination of the intestines using an endoscope, is now in great demand. Experts believe that the development of this area can yield good results in the prevention of various intestinal diseases, and especially cancer. Most people perceive colonoscopy as an extremely unpleasant, painful procedure and therefore put off both their visit to the doctor and the examination itself for years. And at the same time they waste precious time: a tumor detected in time can be effectively treated, but if it is advanced, it is extremely difficult to solve the problem. Colonoscopy in a dream allows you to avoid pain, and therefore fear. Having learned about this technique, people finally decide to undergo an examination.
When is fibrogastroscopy with sedation prescribed?
In addition to the above reasons for performing FGDS in sleep, when it is necessary to perform therapeutic manipulations in the stomach, esophagus or duodenum, there are also situations when the use of anesthetic drugs is required. Also, in a state of medicated sleep, the procedure is performed for children, people suffering from mental disorders or diseases that cause head tremors, for example, Parkinson's.
Since it is very difficult to conduct an examination or treatment when the patient is restless, and besides, there is a possibility that due to his uncontrolled movements he will be subject to injury to the organs of the digestive system. Medication-induced sleep is best suited during an examination when a person is very afraid, because not only will he not be able to ensure the passage of the endoscope normally, but uncontrollable panic may also develop in the process.
Local anesthesia
The simplest and most common way to make an unpleasant diagnosis a little easier is local anesthesia. Typically, a lidocaine spray is used for this. The medicine is applied to the root of the tongue, which reduces its sensitivity and completely blocks the gag reflex. Thus, the doctor easily inserts a flexible hose with a camera into the esophagus. The action of the anesthetic gives the doctor enough time to examine the mucous membrane of the stomach, esophagus, and, if necessary, parts of the duodenum.
Since local anesthesia has virtually no contraindications, it is used very widely. Usually the price of gastroscopy in clinics is indicated taking into account this type of anesthesia.
Why is it better to do gastroscopy in a dream at the Swiss University Clinic?
- Our clinic is equipped with expert-class equipment, gastroscopy under anesthesia is performed using a flexible fiber-optic endoscope manufactured by Pentax (Japan), this innovative equipment allows you to detect even the smallest pathological areas.
- When performing endoscopy under sedation, anesthesiological assistance is provided by anesthesiologists with extensive experience, who have performed thousands of procedures.
- If further examination is necessary, you can count on our specialists. Our clinic conducts a lot of research, you can quickly undergo the necessary examination and get advice from an experienced doctor.
- Our diagnostic department uses a modern multi-stage disinfection system in accordance with international standards, so the procedure is absolutely safe.
What is gastroscopy
Gastroscopy is a type of study in which a visual examination of the gastrointestinal tract is performed. For these purposes, a special probe is used - a gastroscope, inserted into the stomach through the mouth. This is a flexible tube with a soft coating on the outside and fiber optics inside, designed in such a way as not to damage the internal organs of a person.
There are three types of gastroscopy:
- FGDS (Fibrogastroduodenoscopy ) . Examination of the stomach and duodenum.
- FGS (fibrogastroscopy ) . Stomach examination.
Which type of endoscopy will be required should be determined by the doctor during a preliminary consultation.
