Having an endoscopy under general anaesthetic

[Petal02]

I’ve been having indigestion symptoms on and off for a while, and I’ve been terrified that my GP will send me for an endoscopy. I’m a huge wuss when it comes to anything medical, and even though the doctor hasn’t recommended this procedure yet, just the ‘worst case scenario’ thoughts have been keeping me awake at night. I’d manage OK if they knocked me out completely, but I gather than most hospitals offer sedation, which might not be enough for a highly-strung coward like me …….

However I’ve just phoned our local BMI Hospital, I spoke to the secretary of one of the gastro specialists, who confirmed that endoscopy with a general anaesthetic is available for nervous patients, and that it costs £1396. The specialist in question also practices at two local NHS hospitals, so hopefully that’s good. But this information has really calmed me down – obviously I really hope I don’t need an endoscopy, but if I can have this was a general anaesthetic for £1396, then that’s such good news!!!

Am I being ridiculous? I can’t help being such a coward, but if I’m properly knocked out then surely it won’t be such an ordeal? And DH will drive me to/from hospital, and keep an eye on me for as long as is required, so I won't be trying to drive or use power tools!!!

[ChoccyLabsAreFab]

I had an endoscopy last year. I opted for throat spray only as I wanted to find out if anything was wrong at the time rather than waiting for the results and I didn't want to stay any longer than I had to. I was very, very nervous but, I have to say, that whilst it was pretty vile, the whole process took under three minutes so was amazingly quick. I would do it again that way if I had to!

[highlandcoo]

hi OP don't blame you for being concerned. First time I had a tube down my throat with no sedation just the throat spray - the consultant took me by surprise at initial visit - and as I have a strong gag reflex it was truly horrendous. Never never again would I agree to that.

I now have endoscopies every couple of years under sedation. All gowned up with an anaesthetist and I am completely under - to all intents and purposes it's just like a GA but without the extra risk and you bounce back more quickly. I am not the least bit aware of what's going on.

My procedure takes place in a private hospital in London {(Cromwell) so not sure if that makes a difference or not.

Really sympathise with your fears and hope you arrive at a decision that's right for you.

[Petal02]

I now have endoscopies every couple of years under sedation, all gowned up with an anaesthetist and I am completely under – to all intents and purposes it’s just like a GA but without the extra risk and you bounce back more quickly, I am not the least bit aware of what’s going on

Highlandcoo, what you’ve just described would be absolutely fine for me; I just want to be completely out of it, I don’t mind how it’s achieved or what it’s called! Do you know what your type of sedation is called, is it the deep sedation or propofol?

I’m guessing it’s the propofol – from what I can work out, that’s the "heavy duty/disable an elephant" kind of sedative that requires the presence of an anaesthetist?

And if you don’t mind me asking, how much does it cost each time?

[sadie9]

What Highlandcoo is saying is. The first one she had she had No Sedation - so yes she felt the tube going down.
The rest of them she says were fine is the bog standard With Sedation endoscopy where she WAS ASLEEP. The one that every hospital does day in and day out.
Yes they wear gowns, yes you are in theatre with the consultant and theatre nurses and there is a monitor on you checking your blood pressure etc. You are sedated, you are asleep.

[Indantherene]

Coincidentally I am sitting in a private hospital with my DS who is slowly coming round from an endoscopy.

He had sedation and doesn't remember anything after having the throat spray. He's only just making sense now after coming back from theatre about 40 minutes ago.

[Petal02]

Sadie9 – I’m confused about ‘bog standard sedation’; from what I’ve read, if you have the bog standard stuff, then it can be administered without an anaesthetist, which is why this is the usual NHS offering. And reports of this seem to be decidedly mixed – some people are nicely knocked out, and some people seem to be almost immune to it. I’ve read many tales of patients who don’t feel any effects of the sedation until they’re in the recovery room, which is rather too late!

But if Highlandcoo had an anaesthetist present, I’m wondering if she had the deep sedation, (propofol?) which doesn’t seem to be routinely offered by the NHS, because obviously this will increase costs.

[sadie9]

Oh, I see. I don't know if the bog standard sedation is administered without an anaesthetist. I would think there has to be one there for it, but I really don't know. So I should probably shut up now trying to tell you what to do. There must be some way you could get to actually speak to an anaesthetist and ask them. Or someone else in the hospital who could get you the information you seek...

[Petal02]

I'm really grateful for all the responses - and have made a decision: Unless the NHS will offer me a GA, thus negating weeks of pre-appointment worry, I will be going to our local BMI Hospital.

I realise there's every possibility I could be OK under standard sedation, but because it's clearly not guaranteed, then going privately is the only acceptable route for me.

And of course I don't even know if I'm going to need an endoscopy yet ...... !!!

[gingeroots]

All the endoscopies I've had done have been routine in NHS hospitals .

They've all had an anesthatist present ,everyone in gowns ,including me .None of them have involved a GA .

They do calculate how much drug to give you by your buils/weight /height . I always ask them to make sure I'm out of it and to ensure that whatever drug they're using is sufficient to make sure I don't come round while they're still conducting the procedure .

[Piemernator]

In my very first career I worked in a day surgery unit assisting at sedations and general anaesthetics. I would never opt for a GA unless necessary. I had a minor gynae op a couple of years ago under local though offered local, epidural or general.

Have you ever had a GA? Obviously you won't be under for long but people's recovery can vary quite a bit. I feel ropey for days afterwards and there are always risks. They are very small and though you are obviously suffering from more than general worry and its actual anxiety it is more risky having a GA than a procedure under sedation.

[sadie9]

Before any procedure like this there is a big chat and consent form signing with one of the attending or junior consultant (?) . So plenty of time to ask them questions, explain your fears and request the charging Rhino dose.

[cuntinghomicidalcardigan]

Just make sure you ask about any extra costs before going private. The consultant may well want you to have a private consultation as a new patient, the book a followup privately.for the results. If (God forbid) they found anything then there may be pathology charges for the cost of analysing a sample. I used to work as Secretary for the private practice of a general surgeon.

Hope it all goes well and easily for you. For what it's worth there was never a single complaint from any of the patients in that practise, and there were hundreds (the majority) who only had sedation.

[Nospringflower]

The sedation I had was administered by nurses in a room before you went into the endoscopy suite. They tried very hard to persuade me not to have the sedation and only to have the throat spray due to needing to recover afterwards.

As I said above I was awake throughout and the person carrying out the procedure told me their findings prior to me leaving. The staff were great at trying to help the process.

[user1488829813]

Hi-I'm in exactly the same position- having symptoms and knowing deep down I'll end up having an endoscopy. I'm terrified ! Does anyone know which consultants in the West Midlands offer this procedure privately with general anaesthetic ? I know one contributor said she had spoken to a medical secretary who said this was possible. I'd be grateful for any help as I can't face this procedure without one !

[Petal02]

user I've only just seen your post (it's an old thread)! Have you made any further enquiries? My local BMI hospital offers a GA,

[Petal02]

Sorry, pressed send too soon - there must be a BMI hospital in the West Midlands area?

[Crumbs1]

Has your GP actually suggested a gastroscope? It reads as if not. Maybe discuss your anxieties and the treatment plan with your GP. The NHS is well,practiced in management of nervous patients.

[silentsigh]

I've had a few endoscopies on the NHS (at St Georges Hosp and King's College Hosp, both in London). I had them all under full GA with an anasethetist. I told them it was either a GA or not happening at all so they alllowed the GA, thankfully. I believe if you are insistent about it they will.

[Bloopbleep]

I've had endoscopy with sedation and a nasogastric tube without and neither were that bad. The sedation was lovely. I was aware but I didn't care. I'll be honest I gagged a bit but as soon as they passed the point of the gag reflex I felt absolutely nothing. With the nasogastric tube I had no spray or anything. They kepT telling me to swallow to ensure it went in the right place and aside from being aware of something in my throat it didn't hurt or feel uncomfortable and I was totally unaware of it being anywhere deeper than the back of my throat. The endoscopy was over so quickly that it really wouldn't have been worth the hassle and risk of a GA.

[Legalmum26]

I have had an endoscopy under sedation and it unfortunately was one of the worst experiences I've had having had multiple surgeries, several of which I was awake during.

I was due to have another one carried out under sedation and had a severe anxiety attack which meant I had to stay in hospital overnight for monitoring even though I'd not had the procedure done. My consultant therefore suggested I have the procedure carried out under GA (NHS Procedure). I'm going in for the procedure in a couple of weeks - No way was I going to have another done under sedation!
There are limited numbers of surgeons who will carry this out under general I was told it was due to the size and skill of the team required.

Speak to your consultant - they are the only ones that can answer the question.

[alittlequinnie]

I had one under sedation - awful - was kept waiting for four hours before I went in and then pushed through really really fast. The nurse couldn't find a vein for the canula and really hurt me. I could feel myself panicking and asked them to wait a minute but they didn't. They sedated me and it knocked me out instantly.... but I woke up half way through and ripped the tube out of my own throat because I didn't have a clue what was going on - the tube feels like a broomstick going down your throat. They went mad at me for trying to pull the tube out but I was acting on instinct. The result was they only got the camera half way down my throat and 5 years later they are still refusing to do the test, despite my vomiting every 4/5 weeks for 2/3 days at a time none stop. I would go for the throat spray next time.

[AndreaNF]

Hi Petal02 came across your post just this morning - hi! I was researching as my partner has had 2 endoscopies just recently both unsuccessful due to his extreme gag reflux. Poor him it was so distressing - anyway he too would like to have GA as we really need this test due to very severe GERD symptons which are making his life so awful (on top of COPD and asthma amongst other ailments I am so sad to say) - did you manage to get your GA on the NHS? Thanks in advance am so stressed for him.

[AndreaNF]

Silentsigh you have given me a bit of hope as you have had endoscopies at St George's (where we attend) under GA - was this difficult to achieve? Can't really afford to go private. Thanks in advance for any advice.

[LadyoftheLake123]

I've not had a gastroscopy but have had a couple of colonoscopies, both under sedation. Both times I was awake and to greater or lesser extent aware of what was going on (although I think I might have drifted off a couple of times) but went from extremely nervous (pre sedation) to incredibly chilled out and really not caring what was going on (post sedation). If I ever had to have another one I'd definitely opt for sedation again rather than GA - GA is a major undertaking which will take a good few days to recover from, with sedation you should be feeling back to normal reasonably quickly after.

[LadyoftheLake123]

And the procedures were fine! Bit uncomfortable, but not painful, and over relatively quickly.