An endoscopy is a medical procedure used to examine the lining of the digestive tract, involving the insertion of a flexible tube with a camera through the mouth or rectum. The procedure typically requires conscious sedation to keep the patient comfortable. Due to the medications used and the nature of the examination, you cannot vape before an endoscopy. The inhalation of vapor, even without nicotine, introduces significant risks that can lead to the cancellation of your procedure or serious complications under sedation.
How Vaping Affects Sedation and the Airway
The primary medical concern with vaping before an endoscopy is how the inhaled aerosol affects the respiratory system and the body’s response to anesthetic agents. Vaping causes acute airway irritation and inflammation due to chemical components in the e-liquid, such as propylene glycol and flavoring agents. This irritation leads to increased mucus production and airway hyper-reactivity, which increases the risk of laryngospasm (tightening of the vocal cords) or bronchospasm under sedation.
When a patient is sedated, protective airway reflexes are diminished, increasing the risk of aspiration, where stomach contents or secretions enter the lungs. The irritated airway and excess secretions from vaping heighten the danger of aspiration pneumonia. Nicotine also acts as a stimulant, elevating the heart rate and blood pressure, which causes hemodynamic instability that complicates the safe administration of sedation. Furthermore, vapor chemicals can induce liver enzymes that affect how the body metabolizes anesthetic medications, potentially requiring drug dosage adjustments.
Required Timeline for Stopping Vaping
The specific time you must stop vaping is tied to the required fasting period before your procedure. All forms of inhalation must cease at the same time as the “nothing by mouth” (NPO) rule, typically 8 hours before an upper endoscopy. Many facilities require stopping all nicotine products, including vapes, after midnight the night before the procedure. This immediate cessation ensures the stomach is empty and the airway is clear of acute irritation from the inhaled vapor.
For maximal safety, especially concerning the cardiovascular effects of nicotine and chronic airway inflammation, medical experts ideally recommend stopping all nicotine use several weeks prior. However, the absolute minimum time for acute safety is aligned with the fasting window, often 8 to 12 hours before the procedure. Failure to adhere to the mandated cutoff time will likely result in the cancellation or postponement of your endoscopy, so always follow the precise instructions given by your physician.
Nicotine Replacement Products and Endoscopy
Non-inhalation nicotine replacement products (NRT), such as patches or gum, are sometimes considered to manage withdrawal symptoms. These products bypass the lungs entirely, so they do not pose the same risk of airway irritation or increased secretions as vaping. However, NRT still delivers nicotine, which is a potent vasoconstrictor and stimulant. Nicotine raises the heart rate and blood pressure, which can make managing sedation and maintaining stable vital signs challenging for the anesthesia team.
Therefore, the use of any NRT must be cleared directly with the anesthesiologist or the procedure team. The decision is made on a case-by-case basis, even though NRT is preferable to inhaled products. If permitted, NRT use will be carefully monitored, but some centers still advise stopping all nicotine-containing products, including patches and gum, after midnight the day of the procedure.