Includes: gastroscopy, colonoscopy, ERCP, hearing tests, interventional radiology, MRI and CT scans, etc Often outside theatre – consulting rooms, XR dept’s, etc Still needs to be safe for the patient Anaesthesia in remote locations

4 Aspects to consider: 1. The facility:  Standard equipment necessary: O 2 source and reserve, suction, monitoring, ambu bag, resuscitation equipment (drugs, defibrillator) communication method to call for help  Problems related to a specific venue: 1. MRI: small area, difficult access to pt, no ferromagnetic equipment, noise pollution 2. Radiology: radiation pollution, small area, difficult access to pt, dark (don’t see disconnections)

 Needs of the surgeon:  Pt needs to lie still  Pt sometimes prone – sedation difficult (airway Mx)  Manipulation of blood pressure (e.g. when stent = deployed)  Pause in respiration (e.g. when stent = deployed)

 Factors related to the pt:  Some pt can’t lie still (Parkinson’s, orthopnoea, GORD) – consider GA as opposed to sedation  Contrast related side effects (iodine allergy, renal failure)

 Anaesthetic considerations  Often day case surgery (use short-acting drugs)  Check availability of reversal drugs for sedation agents (Naloxone, Flumazinil)  Options for sedation: Benzodiazepines, opiates, propofol, ketamine, chloral hydrate, dexmedetomidine  Options for administration: IV bolus, TIVA, TCI