Colonoscopy and Sedation

With all upper endoscopy (transnasal endoscopy (TNE) and transoral endoscopy (TOE) gastroscopy) you will experience some soreness of the throat due to the endoscope rubbing against the wall of the phyrnyx (throat) before intubating the esophagus despite using KY gel. As with all procedures the skill of the endoscopist minimizes any trauma caused by the gastroscope.

In the UK we use Xylocaine 10mg Spray, each dose (one spray) contains 10 mg of lidocaine and a maximum of 20 sprays can be given per procedure. In my experience only about 4 to 5 sprays is effective in reducing or eliminating any gagging caused by the gastroscope. We have patients that have a gastroscopy with only the use of Xylocaine spray . Some patients don't tolerate this well as it causes numbness of the tongue and they believe they cannot swallow as they lose the sensation of swallowing. Some even feel that they cannot breathe and start to panic. It does not affect your ability to breathe or swallow. So this is not for everyone . Most people opt for conscious sedation for transoral endoscopy. We use a combination of Midazolam (Versed) and either Fentanyl or pethidine (Demerol). For patient unable to tolerate an upper endoscopy ( transoral gastroscopy) we used Propofol for a General anesthesia (GA) but we must have an anesthesiologist to administer and manage the airway either by intubation with an Endotracheal tube (ET tube) or a laryngeal mask airway(LMA).

For TNE where the smaller (diameter 5.9 mm compared to 8.8 mm) gastroscopy is inserted via the nostril to look inside the throat, esophagus, and stomach without the need for sedation or general anesthesia. Prior to the procedure you will be required to drink anti-foaming/mucus medications (containing water mixed with Infacol and/or Carbocisteine). The purpose of these is to clear any bubbles and mucus away from your gullet, stomach and small bowel,giving the endoscopist improved views. For the procedure, you will be given a local anaesthetic spray (Lidocaine with decongestant (Phenylephrine to eliminate any discomfort) to numb your nostrils. The spray wears off after 30 minutes and then you can eat and drink again.

I'm having my first colonoscopy in September. I assumed I would be sedated and already have a friend lined up to drive me home. Kind of nervous but also excited. Do you feel anything afterwards?

@shyladypatient, MrsFn had her first colonoscopy last Fall. Everything was good. She had no problems being awakened from the sedation. She also reported no sensations of feeling anything in her bottom afterwards.

They don't do sedation in Europe. So I did it without. Glad I did.

I have insisted NO sedative , was fun! looking forward to the next time

I've had three colonoscopies already. I was given sedation to where I was somewhat awake for one of them. The other two I was just out.. For the one I was somewhat awake, I absolutely remember a moment where they were working around a corner and it was painful.. I remember telling the doctor what I was feeling. I'm sure I'll be completely out for every further exam like this. Not a fun experience, but the prep is the worst part of it.

Got home from mine about two hours ago. To preface this I had a traumatic experience with surgery and general anesthesia when I was 15. The first EGD I had last year reactivated it. So I went into this with it scheduled for no sedation and still stressed.

It was mildly uncomfortable at times, my wife has given me enemas that felt worse. It was really cool watching my colon on the screen and seeing them remove the one polyp I had.

Butt more importantly, this was weirdly and honestly a no shit healing experience for me. I'll be back in five years and I'm kinda looking forward to it.

I would have prefer sedation when having a colonoscopy as I would rather have a good sleep than remember the experience. I also would thnk that fasting for a day or more coupled with a series of enemas would completely clean out the lower plumbing as preparation for a colonoscopy. However, I have NO medical experience ,or knowledge and no one should take my feelings abour preparation without consulting first with their medical provider.

When I had my colonoscopy, I didn't know that sedation was an option.

The doctor had me face the wall while she did the procedure. The machine projected the image on the wall.

I didn't feel a thing, and enjoyed the show.

@Denise I did use a couple enemas, the big thing is they need the cleansing to be top down. Plus from what I've read modern medicine doesn't want to subject people to enemas like a lot of us enjoy, doesn't trust people to do them at home, and so osmotic/saline laxatives basically are an enema. Instead of introducing water from an outside source, your body's own water is the source which makes hydration so important.

Having had 2 colonoscopies I was semi sedated both times. I remember they rolled me back into the room, then stuck something under my tongue. After that I was rolled on my left side, I could hear them but drifted in and out. And to be very honest I could have probably cared less what they were doing back there.