What Kind of Anesthesia Do They Give You for an Endoscopy?

October 11, 2025 •

4 min read

In the United States, over 98% of endoscopies are performed with some form of sedation to ensure patient comfort [1.8.3]. So, what kind of anesthesia do they give you for an endoscopy? The options typically range from moderate sedation to general anesthesia, depending on the patient and procedure.

Quick Summary

For an endoscopy, patients typically receive sedation to ensure comfort and relaxation. The most common options include moderate sedation, often with Midazolam and Fentanyl, or deep sedation, commonly using Propofol. General anesthesia is rare.

Key Points

Main Types: The most common options are moderate sedation (conscious sedation) and deep sedation (Monitored Anesthesia Care) [1.2.1].
Moderate Sedation Drugs: A combination of a benzodiazepine like Midazolam and an opioid like Fentanyl is frequently used for moderate sedation [1.4.6].
Deep Sedation Drug: Propofol is the most common drug for deep sedation, valued for its fast onset and rapid recovery time [1.2.5].
General Anesthesia: Full general anesthesia is rarely used for standard endoscopies and is reserved for high-risk or complex cases [1.7.1, 1.4.6].
Administration: Anesthesia is typically given via an IV and is managed by an anesthesiologist, nurse anesthetist, or other trained personnel [1.2.1, 1.3.2].
Recovery: After sedation, you cannot drive for 24 hours and must have someone take you home [1.6.3].
Safety: While generally very safe, all sedation carries small risks of breathing or heart-related complications, which are closely monitored [1.5.2].

Understanding Anesthesia for Endoscopic Procedures

An endoscopy is a procedure that allows doctors to look inside your body using an instrument called an endoscope [1.2.2]. To make this process comfortable and anxiety-free, sedation is administered in the vast majority of cases [1.8.3]. The level of sedation can be tailored to the individual patient's health and the complexity of the procedure [1.3.1]. The options range from a light sedative to general anesthesia, with the most common choices being moderate or deep sedation [1.2.1, 1.7.2]. A healthcare professional, often an anesthesiologist or a nurse anesthetist, will administer the medication, typically through an IV in your arm, and monitor your vital signs throughout the procedure [1.2.1, 1.6.1].

Levels of Sedation Explained

The choice of anesthesia depends on several factors, including your medical history, any allergies, and the specific type of endoscopy being performed [1.3.2]. The American Society of Anesthesiologists defines a continuum of sedation levels [1.3.1, 1.3.5]:

Minimal Sedation: You feel drowsy but can still respond to verbal commands. This level is not commonly used for endoscopies [1.3.1].
Moderate Sedation (Conscious Sedation): You will feel relaxed and sleepy and may not remember the procedure afterward [1.3.2]. You can respond purposefully to verbal commands or a light touch. Your breathing and cardiovascular function are typically unaffected [1.3.1, 1.3.5]. This is a common choice for routine endoscopies [1.4.6].
Deep Sedation: You will be asleep and unlikely to have any memory of the procedure [1.2.1]. You may respond to repeated or painful stimulation, but you cannot be easily awakened [1.3.1]. Your breathing may slow, and you will be monitored very closely. Monitored Anesthesia Care (MAC) often involves deep sedation [1.4.6].
General Anesthesia: You will be completely unconscious and unresponsive, even to painful stimuli [1.3.1]. This is rare for a standard upper endoscopy and is typically reserved for high-risk patients, those with severe lung disease, or for particularly long and complex procedures [1.7.1, 1.4.6]. It often requires a breathing tube to assist with ventilation [1.3.2].

Common Medications Used for Endoscopy Sedation

Several drugs, often used in combination, help achieve the desired level of sedation and pain control. The most frequently used medications include benzodiazepines for relaxation and amnesia, opioids for pain relief, and propofol for deep sedation [1.2.1, 1.4.3].

Benzodiazepines and Opioids (Moderate Sedation)

For many years, the standard for conscious sedation has been a combination of a benzodiazepine and an opioid [1.4.4].

Midazolam (Versed): This is the most widely used benzodiazepine for endoscopy. It has a rapid onset, provides excellent amnesia (so you don't remember the procedure), and helps reduce anxiety [1.4.3, 1.4.4].
Fentanyl: A powerful, short-acting opioid, fentanyl is used for its analgesic (pain-relieving) properties [1.4.3]. It works well with midazolam to provide comfortable sedation.

This combination is considered very safe, and reversal agents are available (Flumazenil for benzodiazepines and Naloxone for opioids) in case of over-sedation [1.4.3, 1.5.4].

Propofol (Deep Sedation/MAC)

Propofol has become increasingly popular for endoscopic procedures because it allows for a deeper level of sedation and has a very rapid onset and a short recovery time [1.2.5, 1.7.3].

Propofol (Diprivan): This is a powerful hypnotic agent that induces a state of deep sedation or general anesthesia quickly. Patients wake up much faster and with less grogginess compared to the midazolam/fentanyl combination [1.4.4, 1.4.5]. Propofol itself is not a pain reliever, so it's often combined with a small dose of an opioid like fentanyl [1.4.3, 1.4.4]. Sedation with propofol is often referred to as Monitored Anesthesia Care (MAC) and is administered by an anesthesia professional [1.4.6]. One key difference is that there is no reversal agent for propofol; its effects simply wear off quickly [1.4.3].

Comparison of Anesthesia Types


Feature	Moderate Sedation (e.g., Midazolam + Fentanyl)	Deep Sedation (e.g., Propofol)
Level of Consciousness	Drowsy, sleepy, may be awake but relaxed; responsive to stimuli [1.3.2, 1.3.1].	Asleep, not easily aroused, no memory of the procedure [1.2.1, 1.4.7].
Common Drugs	Midazolam and Fentanyl [1.4.6].	Propofol, often with Fentanyl [1.2.2, 1.4.4].
Recovery Time	Longer recovery; may feel groggy for several hours [1.4.4].	Very rapid recovery and discharge; less grogginess [1.2.5, 1.4.4].
Patient Satisfaction	Generally high, but some patients may experience discomfort [1.4.6].	Typically higher due to deeper sedation and faster recovery [1.2.5, 1.4.5].
Administration	Can be administered by the endoscopist or a nurse [1.4.3].	Typically administered by an anesthesiologist or nurse anesthetist (MAC) [1.4.6].
Risks	Respiratory depression, though reversible [1.4.3].	Hypotension (low blood pressure) and respiratory depression; no reversal agent [1.4.3, 1.5.4].

Potential Side Effects and Recovery

Anesthesia for endoscopy is very safe, and serious complications are rare [1.2.2, 1.5.2]. Common, mild side effects can include nausea, a sore throat from the endoscope, and bloating [1.5.5, 1.6.3]. More significant risks, although uncommon, relate to the sedation itself and can include changes in breathing or heart rate and allergic reactions [1.5.1, 1.5.2]. Your medical team will monitor you closely to manage these risks [1.6.1].

After the procedure, you will be moved to a recovery area for about an hour as the sedation wears off [1.6.3]. Because the medications impair judgment and reflexes, you must have a responsible adult drive you home and should not drive, operate machinery, or make important decisions for 24 hours [1.6.1, 1.6.3]. It's best to rest for the remainder of the day [1.6.2].

Conclusion

The type of anesthesia used for an endoscopy is chosen to maximize your safety and comfort. While options range from no sedation to general anesthesia, most patients receive either moderate sedation with drugs like midazolam and fentanyl or deep sedation with propofol [1.7.1]. The trend is moving towards propofol due to its rapid recovery and high patient satisfaction [1.2.5]. Discussing your medical history and any concerns with your doctor beforehand will help them choose the best and safest sedation plan for your procedure.

For more information from an authoritative source, you can visit the American Society of Anesthesiologists page on Upper Endoscopy.

Frequently Asked Questions

It depends on the type of sedation. With moderate sedation, you are very drowsy but may not be completely asleep. With deep sedation using propofol, you will be asleep and will not remember the procedure [1.2.1, 1.4.7].

General anesthesia is rarely used for a routine endoscopy. It is typically reserved for very complex procedures, high-risk patients, or those with severe lung conditions [1.7.1, 1.4.6].

Moderate sedation with midazolam and fentanyl, and deep sedation with propofol (Monitored Anesthesia Care or MAC), are the most common forms of anesthesia for an endoscopy [1.2.1, 1.4.6].

You will be monitored in a recovery room for about an hour [1.6.3]. However, the effects on judgment and reflexes can last for up to 24 hours, during which you should not drive or work [1.6.1].

Common side effects are minor and may include a sore throat, bloating, or nausea [1.6.3]. More serious, but rare, complications can include reactions to the medication that affect breathing or heart rate [1.5.1, 1.5.2].

Conscious sedation (moderate sedation) makes you drowsy and relaxed, but you may be partially awake [1.3.1]. MAC usually involves deep sedation, where you are asleep and unaware of the procedure. It is administered and monitored by an anesthesia professional [1.4.6].

Yes, an endoscopy can be performed without sedation, though it is not common. A topical anesthetic is usually sprayed in the throat to help tolerate the endoscope. This option is sometimes used for high-risk patients [1.2.1, 1.7.1].