Propofol versus conscious sedation

What is conscious sedation?

Conscious sedation usually means moderate sedation. A medicine such as midazolam helps you relax and feel drowsy. A pain-relieving medicine, often fentanyl, may be added. The medicines go through a small plastic tube in a vein.

You can usually respond when spoken to, although you may remember little afterwards. Some people remain more aware or remember parts of the examination. We adjust the medicines to your response and comfort, rather than promising that you will be completely asleep.

Conscious sedation is directed by the proceduralist, the doctor doing the endoscopy, with a trained nurse monitoring you. The team watches your breathing, oxygen level, pulse and blood pressure throughout the procedure and recovery.

What is propofol sedation?

Propofol acts quickly and is often used for deeper sedation. This is deeper procedural sedation, not general anaesthesia. You continue to breathe for yourself, so a breathing tube is not routinely required.

The anaesthetist watches your breathing and can support your airway if needed. You are less aware of the examination and may have little or no memory of it. Its effects usually wear off quickly once it is stopped, although feeling awake does not mean you can drive.

For the propofol option we arrange, a specialist anaesthetist gives the sedation. This is a separate doctor who specialises in anaesthesia, sedation and looking after your breathing and circulation. The anaesthetist adjusts the medicines and monitors you while I perform the endoscopy.

Propofol is a medicine whose depth can be adjusted. The anaesthetist will explain the planned level and whether your procedure or health needs a different approach.

Can I have the procedure without sedation?

Yes. Some people choose gastroscopy with throat spray alone or colonoscopy without intravenous sedation. Whether this is suitable depends on the procedure, your health and your discussion with the endoscopy team. Tell us before booking so the team can plan the right approach.

Flexible sigmoidoscopy is shorter. Read about light sedation and having it without sedation. →

Which option is likely to suit me?

Many routine examinations can be completed comfortably with conscious sedation. Propofol can be useful for a prolonged or complex procedure, a previous difficult or uncomfortable examination, or significant anxiety. These are reasons to discuss the options, rather than an automatic requirement for deeper sedation.

In Australia and the United States, propofol-based sedation is used routinely in many endoscopy services. In the United Kingdom, conscious sedation with a benzodiazepine, sometimes with an opioid, remains more common.

Tell us about previous sedation, any bad experience, sleep apnoea, heart or lung disease, allergies and regular medicines. I consider these alongside the treatment planned. Some people choose gastroscopy with throat spray alone, or an examination without intravenous sedation, when appropriate.

Please discuss propofol with our team when booking. An anaesthetist needs to be arranged in advance and the available sessions may differ.

How am I monitored?

Both options require careful monitoring by trained staff, during the procedure and until you are ready to go home. Sedation is generally well tolerated. Either approach can slow breathing or lower blood pressure, which is why the team monitors you and can provide support if needed.

With deeper sedation, closer breathing monitoring and airway support may be needed. The team and equipment are arranged for the level of sedation planned. A deeper level is not automatically the safest choice for everyone.

Will my insurance cover the sedation I choose?

You can discuss either conscious sedation or propofol with our team. Some insurance companies have additional eligibility criteria for propofol sedation, so approval for the endoscopy does not automatically confirm cover for propofol.

From 1 April 2026, Southern Cross applies additional eligibility criteria for propofol and other deeper sedation. Ask our team which options are clinically suitable and confirm the criteria with Southern Cross before your appointment. Criteria checked 17 October 2026.

What do I need to arrange beforehand?

Follow the fasting and medicine instructions for your booking. Tell our team about diabetes or weight-loss medicines, blood thinners and any previous anaesthetic problems. Do not use a general online timetable to stop medicines.

For either intravenous sedation option, arrange a responsible adult to collect you and the support requested by the endoscopy service. Check those arrangements before the day. You cannot drive yourself home.

What happens after sedation?

You rest in recovery while the immediate effects wear off. Propofol often allows faster waking than midazolam-based sedation, but everyone is different.

Most people feel awake within about 30 minutes after the procedure, although the exact recovery time varies. The team checks that you have recovered sufficiently before discharge. Most endoscopies are day procedures.

Memory, judgement and coordination can remain affected even if you feel well. You should generally not drive, work, operate machinery, drink alcohol or make important decisions on the day of the procedure.

Most people can return to work the following day if they feel well. Arrange support at home as advised by your endoscopy service, and do not shorten these restrictions because you woke quickly.

I can usually explain the initial findings before you leave. You will have written information to take home because sedation can make the discussion harder to remember. Biopsy results come later, with recommended follow-up documented in the endoscopy and/or histology report once available.

Related information

• About gastroscopy
• About colonoscopy
• Bowel preparation options and tips
• Your preparation checklist
• Your endoscopy journey