GDHT should be considered during surgery in high-risk patients to optimize cardiac index. A MAP of 60–65 mmHg and Cardiac Index [2.2 L/min/m2 individualized to the patient, should be maintained during surgery using appropriate vasopressors and inotropes as needed. Level of evidence: Moderate；Recommendation grade: Strong

Patients should have their glucose closely monitored and controlled in the range of 7.7–10 mmol/l, preferably with the use of a variable rate insulin infusion. Level of evidence: Moderate；Recommendation grade: Strong.

Transfusion of red blood cells should be restrictive (trigger Hb 70 -90 g/l), with exceptions based on individualized clinical status and comorbidities. Level of evidence: Moderate；Recommendation grade: Strong.

Each patient should be assessed for the optimal perioperative analgesic regimen, considering the presence of sepsis and coagulation abnormalities. Multimodal management should include acetaminophen and non-steroidal anti-inflammatory drugs if there are no contraindications.Level of Evidence: Low；Recommendation: Strong

We recommend that in patients with cognitive impairment and/or learning disability, an assessment of capacity is carried out to inform the discussion around choice of sedation.（Evidence level: Very Low；Recommendation grade:Strong).

We recommend that if during a sedated endoscopy, the patient appears to be tolerating the procedure poorly, the endoscopist should stop the procedure (if safe to do so) in order to assess the patient’s wishes and decide if the procedure should be abandoned and alternatives arranged.（Evidence level: Very Low；Recommendation grade:Strong).

We recommend that a minimum of two appropriately trained endoscopy assistants are required for endoscopic procedures in which sedation has been administered.（Evidence level: Very Low；Recommendation grade:Strong).

We recommend that sedation should be administered only if there is immediate access to the resources (staff and facilities) required to manage complications of sedation.（Evidence level: Very Low；Recommendation grade:Strong).

We recommend that all endoscopy staff responsible for risk assessing, administering sedation and monitoring of patients, undergo formal training in the recognition and management of related complications, and this should be a continuing process.（Evidence level: Low；Recommendation grade:Strong).

We recommend that only low-strength midazolam (1 mg/mL) be stocked and used instead of high-strength midazolam to reduce the risk of adverse events related to oversedation.（Evidence level: Very Low；Recommendation grade:Strong).