Abstract
Objectives: As per ‘Evidence Based Medicine’, premedication or sedation is not necessary for upper gastro intestinal endoscopies. We are presenting our experience with more than 3000 upper gastro intestinal endoscopies done by us over a period of six years in a district head quarters hospital. Methods: All the patients were screened to rule out co- morbidities. They were prepared with over night starvation. Each patient was given pre procedure counselling about the actual procedure and in what way he is expected to cooperate during the procedure. Their baseline stress level was accessed before admission and those who were found to be uncooperative or demanded pre medication or sedation were referred to the centre were the procedure is done under sedation.
Results: While performing upper gastro intestinal endoscopy without premedication or sedation the scopist was comfortable and all the patients also cooperated well during the procedure.
Discussion: Unless the requirements defined under ’S3 Guideline: Sedation for gastrointestinal endoscopy 2008’ of Riphaus A et al, are met with, sedation should either be avoided or, if sedation is indicated and/or the patient wants sedation, the patient should be transferred to a facility that does fulfil these requirements. Upper gastro intestinal endoscopy without sedation is considered to be a safe, quick, and well tolerated procedure. The avoidance of sedation related morbidity and mortality is an obvious advantage and undoubtedly saves significant time and cost.
Conclusion: Our study adds to the ‘Evidence Based Medicine’ in favour of performing simple procedures like upper GI endoscopy safely and cost effectively, without any form of premedication or sedation.

Key words: Upper Gastro Intestinal Endoscopy, Premedication, Sedation, S3 Guideline.