The Leeds Teaching Hospitals NHS Trust


Sedation and pain relief options


All endoscopic procedures can be associated with some discomfort but there are a number of options to minimise this. Your patient information leaflet explains these options in more detail and there is information below. If you have any questions or want to discuss your options please contact the pre assessment team or you can discuss them with the nurses or the endoscopist on the day of your procedure.

Throat spray

This is a spray that numbs the throat and therefore minimises the discomfort in the throat during Gastroscopy.

For the procedure you are completely awake and feel bloated due to the air, whilst this can be uncomfortable, it is not painful. A diagnostic gastroscopy usually takes less than 10 minutes and the spray wears off after approximately 60 minutes.

The benefit of having throat spray is that the you are able to go home more quickly, you do not require a friend or family to accompany you and you can drive a car or operate machinery straight away after. For this reason many people choose throat spray for diagnostic gastroscopy.

Sedation

With sedation you receive an injection of one or a combination of drugs to relax and reduce discomfort. Commonly in Leeds we use a drug called Midazolam (a sedative or relaxing drug). Sometimes this may be combined with a strong painkiller called Fentanyl.

The doctor or nurse providing the sedation will discuss with you what is best on the day. These medications are designed to make you feel comfortable and relaxed but are not anaesthetics and it is not intended to put you to sleep.

Sedation may provide a more comfortable procedure but has the disadvantage of requiring a more prolonged recovery in hospital. If you have sedation, you will need to be accompanied home and have someone to  stay with you for 24 hours.  You should not use public transport to return home and you are not permitted to operate machinery or drive a car for 24 hours after sedation.

In addition certain patient groups may be more at risk from the effects of sedation such as patients with sleep apnoea or breathing problems including asthma or COPD. If you have any of these, they will have to be taken into consideration when the sedation drugs are being chosen and administered and it may be necessary to use lower doses or not at all. This will be discussed with you by the referring doctor and the endoscopist on the day.

Gas and air (Nitrous Oxide or Entonox)

If you are having a colonoscopy or sigmoidoscopy, you will be offered gas and air which is commonly used to relieve labour pain. You inhale the gas using a hand held mouth piece. This provides very rapid pain relief but also wears off quickly. You are entirely awake during the procedure and can go home rapidly after. No other precautions are required so many people find this a more convenient approach.

General anaesthesia

This is when an anaesthetist puts the patient fully to sleep. This is a more specialist and prolonged process than sedation. In general this is reserved for complex endoscopy procedures that are likely to take a long time and is only rarely appropriate for a short or diagnostic procedure.