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This document is an update of guidelines for sedation and anesthesia in endoscopy prepared by the Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy (ASGE). In preparing this guideline, a search of the medical literature was performed by using PubMed from January 1980 through August 2017 that related to the topic of “sedation and anesthesia for gastrointestinal endoscopy” by using the keyword (s)“sedation,”“anesthesia,”“gastrointestinal endoscopy,”“endoscopy,”“endoscopic procedures,” and “procedures.” The search was supplemented by accessing the “related articles” feature of PubMed, with articles identified on PubMed as the references. Pertinent studies published in English were reviewed. Additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When little or no data existed from well …