An Overview on Anesthetic considerations for Upper Gastrointestinal Tract Endoscopy

Abstract

Upper gastrointestinal endoscopy requires careful anesthetic planning because sedation must provide patient comfort, suppress airway reflexes, and maintain cardiorespiratory stability while sharing the airway with the endoscopist. Sedation strategies vary according to procedure type, ranging from routine diagnostic endoscopy to advanced therapeutic interventions such as endoscopic retrograde cholangiopancreatography and endoscopic mucosal resection, where deeper sedation or general anesthesia may be required. This review summarizes anesthetic considerations for upper Gastrointestinal (GI) endoscopy, including airway management, aspiration risk, hemodynamic effects, sedation techniques, monitoring standards, and peri-procedural care. Special emphasis is placed on high-risk populations such as elderly and frail patients, those with cardiovascular disease, and patients with obesity or obstructive sleep apnea, in whom individualized anesthetic approaches and enhanced monitoring are essential to optimize safety and outcomes.