Colonoscopy
Anesthesia type

MAC

Airway

Natural airway

Lines and access

1 PIV

Monitors

Standard ASA monitors

Primary anesthetic considerations
Preoperative

Watch for symptomatic anemia from GI bleed

Intraoperative
Postoperative
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A colonoscopy is a flexible scope that is inserted through the rectum to diagnose and treat problems with the lower GI tract (rectum, colon). It is commonly used to further work up patients with:

  • Bright red blood per rectum (BRBPR)
  • Melena
  • Unexplained constipation/diarrhea
  • Routine follow-up for patients with known polyps, IBD, other chronic bowel disease
  • Colon cancer screening (in US, every 10 years after age 45)

Preoperative management

Patient evaluation

System Considerations
Neurologic
Cardiovascular
Pulmonary
Gastrointestinal
Hematologic Anemia is common with lower GI bleed
Renal
Endocrine
Other

Labs and studies

  • CBC w/ Hgb

Operating room setup

  • Nasal cannula for oxygenation

Patient preparation and premedication

  • Bowel prep based on GI physicians

Regional and neuraxial techniques

  • N/A

Intraoperative management

Monitoring and access

  • Standard ASA monitors
  • 1 PIV

Induction and airway management

  • Small amount of propofol and lidocaine (for MAC)

Positioning

  • Left lateral decubitus

Maintenance and surgical considerations

  • Propofol drip (TIVA)

Emergence

Postoperative management

Disposition

  • PACU and home unless unstable anemia

Pain management

Potential complications

Procedure variants

Variant 1 Variant 2
Unique considerations
Position
Surgical time
EBL
Postoperative disposition
Pain management
Potential complications

References