Sedation for Endoscopy in the Obese Patient

Prior to performing an endoscopic procedure on an obese patient, it is imperative that the physician obtain a thorough history and physical. Special attention should be placed on cardiopulmonary processes, such as undiagnosed obstructive sleep apnea, obesity hypoventilation syndrome, and pulmonary hypertension. These and other commonly obesity-related illnesses place the obese patient at greater risk while undergoing moderate or deep sedation. Proper training in basic and advanced life support, as well as a thorough understanding of cardiopulmonary monitoring and interpretation of untoward events, is required to safely conduct both diagnostic and therapeutic endoscopic procedures. This chapter will highlight the proper documentation and patient education required prior to performing an endoscopic procedure as well as the technical aspects within the endoscopic suite. Special attention will be placed on commonly used medication and monitoring technology to safely and effectively carry out the procedure.