We recommend that patients receive comprehensive information about what to expect from the sedation and sensory experience of the procedure.（Evidence level: High；Recommendation grade:Strong).

We recommend that patients are involved in shared decision-making, where possible, when choosing which sedative medication (if any) to proceed with during an endoscopic procedure.（Evidence level: Low；Recommendation grade:Strong).

We recommend that patient comfort should be continually assessed during the procedure and sedation/analgesia titrated appropriately.（Evidence level: Low；Recommendation grade:Strong).

We recommend that patient experience of comfort and sedation should be measured and recorded.（Evidence level: Low；Recommendation grade:Strong).

We recommend the use of non-pharmacological interventions, such as auditory or visual distraction, to reduce patient anxiety（Evidence level: Moderate；Recommendation grade:Moderate).

To reduce the risk of sedation-related complications, we recommend pre-assessment to balance the indication and intended aim of the procedure against the physical status of the patient.（Evidence level: Moderate；Recommendation grade:Strong).

In patients with obstructive sleep apnoea (OSA) and/or a high body mass index (BMI) (≥35 kg/m2) we recommend pre-assessment and enhanced periprocedural monitoring as these patients may be at an increased risk of periprocedural apnoea。（Evidence level: Low；Recommendation grade:Strong).

We recommend that all patients undergoing gastrointestinal endoscopy (sedated or unsedated) have monitoring of pulse, blood pressure, oxygen saturations and respiration rates as a minimum before and after the procedure. We recommend supplemental oxygen where any level of sedation is used.（Evidence level: Very Low；Recommendation grade:Strong).

ECG monitoring is not recommended routinely for patients requiring GI endoscopy with minimal sedation .（Evidence level: Very Low；Recommendation grade:Strong).

We recommend that where the endoscopist-sedationist administers sedation and also performs the procedure, there must be at least an appropriately trained second member of the team solely monitoring the patient’s status. （Evidence level: Low；Recommendation grade:Strong).