Somchai Amornyotin

By Somchai Amornyotin

Part of the book: Gastrointestinal Endoscopy

By Somchai Amornyotin

Part of the book: Endoscopy of GI Tract

By Somchai Amornyotin

Part of the book: Endoscopy

By Somchai Amornyotin

Gastrointestinal endoscopy (GIE) is a procedure for diagnosis and treatment of gastrointestinal tract abnormalities. This procedure requires some forms of anesthesia. The goal of procedural anesthesia is safe, effective control of pain and anxiety, as well as an appropriate degree of memory loss or reduced awareness. Generally, the majority of GIE procedures are performed by using topical anesthesia and intravenous sedation. General anesthesia is carried out in long and invasive procedures such as endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, and small bowel enteroscopy, as well in patients with history of failed sedation or drug and substance abuse, uncooperative or pediatric patients, and patients with cardiorespiratory system instabilities. The appropriate anesthetic agents for GIE procedures could be short acting, rapid onset with little adverse effects and also improved safety profiles. To date, the new anesthetic drugs and monitoring equipments for safety and efficacy are available. The present review focuses on pre-anesthetic assessment, anesthetic drugs used, monitoring practices, and post-anesthesia care for anesthesia innovations in GIE procedures.

Part of the book: Endoscopy

By Somchai Amornyotin

The geriatric population experiences significant alterations of numerous organ systems as a result of the aging process. They also have several co-morbidities including hypertension, cardiac disease, diabetes, cerebrovascular disease and renal dysfunction. Geriatric patients are considerably vulnerable and especially sensitive to the stress of trauma, surgery and anesthesia. A high incidence of postoperative complications in this population is observed. Appropriate perioperative care was required for geriatric patients. To date, development in anesthesia and surgical techniques has substantially reduced morbidity and mortality in the geriatric patients. Several anesthetic techniques have been utilized for these patients. However, anesthesia-related mortality in geriatric patients is quiet high. All geriatric patients undergoing surgical procedures require a preprocedural evaluation and preparation, monitoring patients during intraprocedural and postprocedural periods as well as postprocedural management. This chapter highlights the physiological changes, preprocedure assessment and preparation, anesthetic techniques, intraprocedural and postprocedural management in geriatric population.

Part of the book: Update in Geriatrics