We recommend that endoscopy rooms (or units) should stock flumazenil and naloxone; and all endoscopy clinical staff should be aware of where they are stored and how to access them in case of sedation-related emergencies.（Evidence level: Very Low；Recommendation grade:Strong).

We recommend that all cases of benzodiazepine or opiate toxicity, requiring the use of reversal, should be reported through local incident reporting systems, and any lessons learnt disseminated.（Evidence level: Very Low；Recommendation grade:Strong).

We do not recommend routine benzodiazepine reversal after gastrointestinal endoscopy of patients receiving conscious sedation with a benzodiazepine.（Evidence level: Moderate；Recommendation grade:Strong).

In the critically ill patient requiring emergency endoscopy, we recommend discussion with the anaesthetic team about the choice of sedation technique and the appropriateness of escalation to critical care.（Evidence level: Low；Recommendation grade:Strong).

There is no evidence to suggest the combination of throat spray and sedation increases the risk of aspiration, although we advise caution in those at increased risk of aspiration.（Evidence level: Very Low；Recommendation grade:Strong).

We recommend that deep sedation may be required for specific upper GI procedures, such as polypectomy/ resection of neoplasia, endoscopic bariatric surgery and foreign body retrieval.（Evidence level: Low；Recommendation grade:Strong).

We suggest that minimal/moderate sedation is usually adequate in diagnostic EUS and level 1/level 2 ERCP.（Evidence level: Low；Recommendation grade:Weak).

We suggest that complex ERCP, therapeutic EUS and combined EUS+ERCP procedures are performed with deep sedation/general anaesthesia.（Evidence level: Low；Recommendation grade:Weak).

We recommend that conscious sedation, deep sedation and GA are all options for DAE. The choice of sedation should be dependent on patient and procedural factors and local resources.（Evidence level: Low；Recommendation grade:Strong).

We recommend unsedated transnasal endoscopy as an acceptable alternative to conventional oral endoscopy for routine diagnostic upper endoscopy.（Evidence level: Moderate；Recommendation grade:Strong).