You have an appointment for a procedure under deep sedation, in Amsterdam UMC, location VUMC. What is sedation? Why is sedation necessary? What is the medication used for the sedation? Are there any side effects? This leaflet answers these questions and more.

What is sedation?

Sedation is the administration of sleep medication to lower your consciousness so you are in a sleeplike state. In addition to sleep medication, you will also receive painkillers to make sure you feel less to no pain during the procedure.

The sedation is performed by a sedation specialist. This is a specially trained anesthesia assistant, who works under the responsibility of an anesthesiologist.

Why sedation with Propofol?

Sedation makes it possible to preform procedures that would otherwise be painful/unpleasant, without pain, fear or stress. Because you are "sleeping" you will notice very little to nothing of the procedure. The drug used to lower your consciousness is called ‘Propofol’. The time for the drug to take affect and wear off is very short. This makes it easy for the sedation specialist to adjust the depth and the duration of the sedation. You will sleep for the entire procedure and wake up quickly afterwards. Usually, you will be fully awake half an hour after the procedure.

Preparation

Health questionnaire

A few days before the procedure you will be called by the anesthesist. They will ask you about diseases and physical condition.

After the sedation

After receiving sedation, you are not allowed to return home unaccompanied. If there is no one available to escort you home from the endoscopy department, we unfortunately cannot proceed with the sedation and will have to reschedule your appointment.

On the day of your appointment, please provide us with the contact information of your accompaniment. This way we can inform them about the pickup time and location, so they do not have to wait at the endoscopy department for the length of the procedure.

Please be aware that you are not allowed participate in traffic for at least 12 hours and it is not recommended to work or consume alcohol during this time.

We also advise you to arrange company for the first night after the procedure and not to make any important decisions on the day of the procedure, as you may experience short term memory loss.

Dietary restrictions

  • Examination before 12 noon am: The day before the procedure you are allowed to eat until midnight. From midnight up to 2 hours before the procedure you are allowed to drink clear liquids, with a maximum of about 200 ml. Examples are water, clear fruit juice, coffee and tea without milk. Sugar is allowed.
  • Examination after 12 noon pm: You are allowed to have a light breakfast at least 6 hours before the procedure. This consists of a cup of tea without milk with a cracker/biscuit. Afterwards you are not allowed to eat anything, but are allowed to drink clear liquids (around 200 ml) up to 2 hours before the procedure. Examples are water, clear fruit juice, coffee and tea without milk. Sugar is allowed.

If you have an appointment for a colonoscopy, please follow the dietary instructions from the leaflet ‘Colonoscopy’.

Different rules apply in case of disturbed or delayed gastric emptying. Please let us know if this applies to you.

Jewelry, make-up and other items

  • We kindly request you to take off any jewelry and remove your contact lenses before the procedure. You will be able to wear your glasses and hearing aid until the start of the procedure. If you wear glasses, we would like to ask you to bring your glasses case.
  • Make-up and nail polish should be removed because the sedation team should be able to see the natural color of your skin and nails.
  • Do you have dentures? We will ask you to remove them shortly before the procedure. If you have dentures, please bring your denture tray.
  • Please wear comfortable clothes and do not wear sweaters that are too warm.
  • We would like to ask you to bring a bag in which we can put your clothes and other belongings during the examination.

The procedure

The Propofol will be administered through an IV in your hand or elbow. This will cause you to fall into a sleeplike state. Before or during painful moments a painkiller (Alfentanil) is added via the IV. To support your breathing during the procedure, extra oxygen will be given through the nose. During sedation, the sedation specialist monitors the depth of the sedation, your blood pressure, blood oxygen level and heart rate. You continue to breathe spontaneously and your reflexes remain intact.

After the procedure

After the procedure, the sedation specialist will stop administering the Propofol, after which you will wake up quickly. You will then be taken to the recovery room where your condition is will be monitored. If your physical condition is okay and you are awake enough, the IV will be removed. After consultation with the sedation specialist and the doctor you will be allowed to leave the department with your escort approximately an hour after the procedure. This could be longer depending on the examination.

Complications

After receiving the sedation, nausea can occur. If necessary, you will receive medication against the nausea. You may feel drowsy for a few hours after sedation.

Though very rare, in some cases problems with breathing or heart function can occur during the procedure. If so, the sedation specialist is able to treat these problems immediately.

If you experience any severe complaints at home after the procedure, please contact our Emergency Department:

Location VUMC: 020-4443636

Questions?

Do you still have questions after reading this leaflet? Please contact our Endoscopy department

VUmc: 020-4441125

With every visit to the Amsterdam UMC, please bring:

  • A valid ID (passport, ID-card, driver’s license)
  • A current overview of your medication
  • A proof of insurance