You have an appointment for an endoscopic procedure under mild sedation. In this leaflet you will find information regarding mild sedation. The procedure can take place in location VUMC.

Why mild sedation?

The purpose of the mild sedation is to relax you and make you feel drowsy to make you more comfortable during the procedure. Most people fall in to a light sleep, but for some people it causes relaxation only. Usually people remember little or nothing of the procedure afterwards.

Preparation at home

  • It is important that you arrange someone who will be able to accompany you home after the procedure. They can wait in the hospital or could be called after the procedure to come and pick you up. It is very important to arrange an escort as you are not allowed to participate in traffic. If you cannot arrange an escort the examination cannot continue.
  • If you wear glasses, we would like to ask you to bring your glasses case
  • 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.

Dietary restrictions

  • Examination before 12 noon: 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: 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 come 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.

Are you taking medication?

Are you taking blood thinning medication? They can interfere with certain endoscopic procedures. It is very important that your doctor is aware of the fact that you are taking blood thinning medication, so any adjustments to your therapy can be made if necessary.

Are you a diabetic? Are you taking anti-epileptic or psychiatric medication? Also for these drugs an adjustment could be required and so it is important that you discuss this with the doctor. This also applies to other medications that you need to take. Please request an overview from your pharmacy to bring to your appointment. Are you taking any heart medication? You can continue using these and are allowed to ingest them with a small sip of water.

Before and during treatment

During the procedure your heart rate, blood pressure and blood oxygen level will be monitored. Before the procedure a sedative (Midazolam®) and possibly also a painkiller (Fentanyl®) will be administered via an IV. The amounts may vary depending on the procedure. The doctor and the nurse will talk to you during the procedure to guide you through it.

After the procedure

After the procedure you will be taken to our recovery room, where you must remain in bed for at least half an hour until the effect of the sedative has worn of sufficiently.

During this time, your vital signs: blood pressure, heart rate and blood oxygen level will be monitored. The mild sedation can cause decreased responsiveness and may cause you to feel drowsy and sleepy. Also, temporary forgetfulness may occur.

It is recommended for at least 24 hours:

  • not to consume alcoholic beverages
  • not to make important decisions
  • not actively participate in traffic
  • operate heavy machinery

Benefits

The sedative will cause you to feel drowsy and this helps to make the procedure more comfortable. It also has short-term memory loss as a side effect. This means that you will probably have less memory of what happened during the procedure.

Complications and Drawbacks

Administration of the sedative could cause you to breath more shallowly. It may then be necessary to support your breathing using a small tube placed in your nose. If the oxygen level in the blood drops too far, it may be necessary to neutralize the effect of the sedative by administering the drug Flumazenil®.

It could be that you are less sensitive to the sedative. Regular use of

sleeping pills, alcoholic drinks or stimulants can affect the effect of the medicine, which may require a higher dose.

In some circumstances, such as with poor heart and/or lung function, the doctor conducting the examination can decide not to give the sedative because of the increased risk of complications.

Some people show mild disinhibition symptoms due to the administration of the sedative. This means they react emotionally to certain stimuli.

Questions?


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

Location 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