Anesthesia for Endoscopy: Sedation, Propofol, and What It Feels Like

Tatiana Yepes
Tatiana Yepes
anestesia endoscopia
Patient Guide · Silo Endoscopy · Colombia 2026

Endoscopy anesthesia: how it is administered, what it feels like, and the types available in Colombia

The most common question before an endoscopy is "where do they give me the anesthesia?" — here is the complete answer: what type of sedation they use, how it is administered, what it feels like, and what happens if you do not want sedation

Endoscopy anesthesiaWhere endoscopy anesthesia is givenEndoscopy sedation ColombiaPropofol endoscopyEndoscopy awakening 2026
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GSMED Imaging medical team — endoscopy with sedation Colombia
Based on: ASGE Guidelines on Sedation for Endoscopy 2025, ESGE Guideline on Sedation and Anesthesia in GI Endoscopy 2023, and endoscopic sedation practice in Colombia.
May 2026ASGE 2025 · ESGE 2023 · Colombia
ℹ️ Notice: This article answers the most common patient questions about sedation in endoscopy. If you have questions about your specific case, consult the doctor who ordered your endoscopy or the anesthesiologist on duty.

Fear of endoscopy — especially of "having a tube put down my throat" — is the main reason patients avoid or postpone a procedure that could save their lives. The good news: in Colombia, the vast majority of endoscopies are performed with sedation, and most patients remember absolutely nothing of the procedure.

1. Where do they give you the anesthesia for the endoscopy?

The direct answer: in a vein in the arm or the back of the hand. The nurse places a peripheral venous catheter (a small 20–22G plastic tube, about the thickness of a fine needle) before the procedure begins. The intravenous sedation is administered through that catheter. There is no general anesthesia with intubation, no gas mask, and no spinal injection — it is a standard peripheral venous line like the one placed during any hospitalization.

The anesthetic throat spray — why they give it before In many endoscopy centers in Colombia, before starting a gastroscopy, a local anesthetic spray (lidocaine) is applied to the back of the throat and pharynx. This superficially numbs the throat mucosa to reduce the gag reflex that occurs when the endoscope passes through that area. The spray stings a little for 5–10 seconds, then produces numbness that lasts 20–30 minutes. It is not the "main anesthesia" — it is a supplement to the intravenous sedation. Your throat will be numb, and you should not eat or drink anything for 30–60 minutes after the procedure until the effect wears off and you regain your swallowing reflex.

2. Types of sedation in endoscopy — which one will they give you

Type of sedation Drugs What it feels like Who decides
Minimal sedation (anxiolysis) Midazolam only (2–5 mg IV) Relaxation, calm, mild drowsiness — awake and communicative. You may remember the procedure. Lower-level centers / doctor's preference
Conscious sedation (moderate) Midazolam + opioid (fentanyl, meperidine) Deep drowsiness, responds to verbal commands, may remember fragments. Very relaxed and cooperative. The most common standard in Colombia — without an anesthesiologist present
Deep sedation with propofol Propofol ± midazolam ± ketamine Completely asleep — remembers nothing of the procedure. Rapid awakening (15–30 min) without a "hangover". Administered by an anesthesiologist · Standard in advanced centers and therapeutic procedures
General anesthesia with intubation Propofol + muscle relaxant + orotracheal intubation Asleep, assisted ventilation, complete unconsciousness. Only for complex ERCP, difficult ESD, high-risk patients, or pediatrics

3. Propofol — the most complete sedation with the fastest recovery

Propofol is the drug that has most improved the patient experience in endoscopy. Its advantages are unique: it works in 30–60 seconds (the patient counts to 3 and is already asleep), its effect disappears in 15–30 minutes after the last dose (unlike midazolam, which can take 1–2 hours to be completely eliminated), and it produces practically no memory of the procedure. Its disadvantages are equally clear: it requires an anesthesiologist to be present throughout the procedure to monitor the airway, and it has a higher cost than sedation with midazolam alone.

Can I ask to have the endoscopy done without anesthesia?
Yes, it is possible. Endoscopy without sedation ("without anesthesia") is performed in some centers and countries as an alternative for patients who prefer it — especially for gastroscopy with small-caliber endoscopes (transnasal, 5–6 mm) that produce much less gag reflex. In Colombia, the usual practice is to offer sedation to all patients, but if you specifically do not want sedation, you can request it. Most of the discomfort of a gastroscopy without sedation occurs during the first 20–30 seconds while the endoscope passes through the pharynx — once it reaches the esophagus, most patients tolerate it reasonably well. Colonoscopy without sedation is more uncomfortable and less recommended for long or therapeutic procedures.
Is sedation for an endoscopy dangerous?
Sedation for endoscopy in the hands of the appropriate staff and with the correct monitoring is very safe. Serious complications (respiratory depression, significant hypotension) are rare — the rate of major sedation complications in endoscopy is less than 0.1% in centers with proper monitoring (continuous ECG, SpO₂, NIBP). Factors that increase the risk are morbid obesity, sleep apnea, severe heart or respiratory disease, chronic opioid use, and advanced age. If you have any of these factors, inform the doctor and the nurse before the procedure.
Endoscopy systems with safe sedation — GSMED Colombia
Endoscopy equipment that includes a vital signs monitor, capnograph, and integrated documentation system for safe sedation.
Request information →

Sources

  1. ASGE. Guidelines on Sedation and Anesthesia in GI Endoscopy. asge.org. 2025. ASGE 2025
  2. ESGE. Guideline on Sedation and Anesthesia. esge.com. 2023. ESGE 2023
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