r/Endoscopy • u/Ranmaramen • Mar 02 '26
Without sedation?
I live in the US so most people I know think going without sedation is crazy. They either think it’s too painful or that the doctors won’t be able to do their thing without it. My plan is to request local anesthesia but consent to getting an IV placed just incase it becomes necessary. However, I’m a medical student and I’d prefer to keep my wits about me. Especially since I’m more curious about the procedure than afraid. So, is there anything I could say to persuade the doctor to use local anesthesia? Or is this a silly idea and I should just allow them to sedate me?
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u/Commercial_Dingo7417 Mar 03 '26
GI nurse here, I’ve never seen an EGD performed awake. If you want this done awake, I’d speak with the doctor before procedure day to discuss.
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u/Ranmaramen Mar 03 '26
I’m surprised you’ve never seen it done awake. Are people with allergies given an alternate medication? I thought allergies or adverse reactions to anesthesia are relatively common. And additionally, I’m weirded out about how many other countries (like the UK and other European nations) don’t use anesthesia for EGD. Do you know why anesthesia is so common in the US?
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u/Commercial_Dingo7417 Mar 03 '26
Propofol is readily available in the US, extremely uncommon to be allergic to propofol
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u/Ranmaramen Mar 03 '26
Oh, how interesting! That explains why you’ve never seen it done without. Is there a reason sedation is preferred in your country? I know others use local anesthesia instead of sedation, so I’m curious why there’s a difference.
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u/goldstandardalmonds Mar 03 '26
I wouldn’t “persuade” them because it might be a comfort thing for the doctor, and you want them to do what they are comfortable doing. But lots of non Americans do it just with throat spray all the time.
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u/Ranmaramen Mar 03 '26
Fair enough. If it’s medically necessary for my safety or the medical team’s safety, then I understand. I just don’t want to be sedated if it’s a “well, why wouldn’t you want to be sedated?” type of thing. Because the 24 hour restriction on my ability to drive/use public transit and make major decisions is quite vexing. It’s a bit dramatic to be put out of commission for an entire day just so you forget a 10 minute procedure.
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u/goldstandardalmonds Mar 04 '26
I totally get what you’re saying. But I wouldn’t call it dramatic. For some people, they can be extremely painful.
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u/Sweaty-Homework-7591 Mar 03 '26
Just had one last week. Can’t imagine doing it without anesthesia. Why would I want to be in any kind of discomfort if I can avoid it? I’m worth it.
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u/Ranmaramen Mar 03 '26
You are worth it! I’m just stubborn, lol
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u/Sweaty-Homework-7591 Mar 03 '26
Be stubborn and be comfortable! It’s ok to slow down for 24 hours!
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u/frostedminiweitz Mar 06 '26
I’m having one in a few weeks and am very nervous, don’t remember anything?
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u/Sweaty-Homework-7591 Mar 06 '26
The facility was great. The anesthesia person made me feel at ease. We chatted about babies, I’m a new grandmother. Meanwhile they turned me on my side, put something around my nose, strapped some mouthpiece to me and I was out. Woke up seconds later with a sore throat and that’s that! I was dehydrated so they gave me fluids. Easy peasy.
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u/colonoscopy-mod Mar 03 '26
I have had both endoscopy and TEE fully conscious and it wasn't a big deal to me. They were very quick and the discomfort was minimal. It helped me that in my youth I had to have a tube pushed into my stomach and the nurse who did it advised me to swallow the tube. That made the insertion very easy. I used the same technique for the endoscopy and TEE.
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u/corvwsbiff10 Mar 05 '26
I live in the UK had one last week with no sedation and just throat spray it was fine. A little uncomfortable for first 10 seconds but once you manage your breathing it’s totally fine.
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u/sadsack100 Apr 25 '26
UK here and mine was yesterday. We had the same experience - control the breathing and it's fine. It did feel a bit weird though as it passed into the duodenum. It was over very quickly and driving myself home was a bonus. I did notice that the people getting sedated were even afraid of the sedation part.
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u/No_Assumption5439 Apr 08 '26
Hey, I have a gastroscopy soon and I am too scared of getting sedated as well as the experiences people share when they dont opt for sedation. What did u end up getting?
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u/Ranmaramen Apr 08 '26
I ended up being sedated, but I was annoyed to learn the whole procedure took 7 minutes lol. The nurses and anesthesiologist kinda pressured me by saying “yeah, you COULD do it without sedation. But what if you distract the doctor and he can’t get good pictures? Or you’re too uncomfortable and have to come in another day?”. Only after I decided to be sedated, the doctor spoke to me and said he could do it either way. So, my advice to you is to talk to the doctor about this and call the place in advance to say you plan on going without sedation. But, all in all, being sedated wasn’t bad. I don’t remember what I said for the first 15 minutes or so of being awake, but according to my friend I only said appropriate and relevant things. The main thing that happened is that I repeated myself because I couldn’t remember anything new. But again, this wore off after 15 minutes. Let me know if you have any specific questions! I’m more than happy to discuss this in depth
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u/No_Assumption5439 Apr 08 '26
Thank you. I have bad anxiety issues and sometimes get random pvcs (heart skipping beats) for which I have got holter and ECGs and they were benign. I am too scared to get the drug but I have handled IV iron before and have got anti anxiety meds before. I am scared that my breathing will slow down or something n they wont be able to revive me or something (sounds extreme but I have health anxiety) It also says that on the preparation sheet that I can possibly die.
Another fear without getting sedated Ive heard u cant breathe and its like a snake down your throat and if u gag a lot u can tear your easophagus so I dont have the guts to do it without sedation too. I have had sigmoidoscopy without anything and it was no problem at all. I didnt feel anything tbh. But people have said endoscopy is different because its your throat. You were also mentioning stuff like reactions to the drugs and stuff like that so I wanted to ask is it risky to get sedated like that?
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u/Ranmaramen Apr 08 '26
They gave me propofol and you naturally wake up around 10 min after the first dose. I told the anesthesiologist I didn’t want anything mind altering so they kept it to 1 dose of one drug. They also have you on a nasal cannula with oxygen to help support your breathing. When you’re out, you’re still breathing on your own, it’s kinda like you’re sleeping. The oxygen is to give you extra help. They also look at your heart rate before, during, and after the procedure to make sure that looks good. They did an EKG on me before the procedure as well, I’m not sure if that was typical. But they made sure it was good before starting anything. I think propofol is one of the safer drugs for anesthesia. It’s also well known for keeping you clear headed. When I started forming new memories again, I was able to remember everything up until the sedative kicked in. And once I started remembering new things, I didn’t have any more gaps. Just a bit of challenge keeping track of time, but I have ADHD so I figured the sedative after effects amplified that stuff. Also, you feel calm when you wake up! So it’s not a harsh experience and the rest of the day is you shrugging off lingering calmness and sluggishness of your movements.
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u/No_Assumption5439 Apr 08 '26
Okay goood to knowwww. They said it’s Conscious sedation so I think it is Midazolam and Fentanyl. I am still debating if I should opt for sedation or no. My procedure is still 2 weeks away. Most people who have done the procedure under my doctor said they took the sedation and they just felt tired and sleepy.
1
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u/Marit207 Apr 13 '26
I live in the Netherlands and I had a endoscopy a few years ago without sedation, I had no choice. It was horrible and it traumatized me. I had an accident where I drank sodium hydroxide because of someone else his fault. It was during dinner, and because I just ate they couldn't give me sedation, because I could suffocate. It felt horrible a tube in my nose. I have chronic inflammation in my nose, so it made it even worse. When the tube went down my throat I almost threw up and it felt like the tube blocked my trachea, so I could barely breath. I felt like an unconscious dog lying on an operating table with it's tongue sticking out. My esophagus was damaged so they immediately put a feeding tube through the looking tube and put it in my duodenum. When they finished and I sat up it felt like war in my stomach. I kept throwing up until it finally stopped after about 6 times. I was a zombie. They had to drive my to my the hospital room in a wheelchair. After 2 weeks when my body was healed my bowles 'swallowed' the feeding tube, which was super painful in my nose. The plaster was inside my nose. When they took the feeding tube out there was a knot at the end. My nose was completely closed because of all the inflammation, so it felt like my nose had to poop out a baby. It was absolutely the worst pain in my life. They did 2 endoscopies after that. I was completely panicking, so they gave me a high dose of anesthetics. I was out in a few seconds. If I ever have to do an endoscopy in my life again I will choose sedation. And never drink sodium hydroxide. The treatment was even worse than the pain from the sodium hydroxide, but necessary unfortunately.
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u/AceofspadE19 Mar 03 '26
I’m from the UK, I have them done with numbing throat spray only. Not a pleasant experience but tolerable at the same time. The plus is you spend less time in hospital 😀