Colonoscopy and Sedation

Had my first colonoscopy recently. They said they would sedate me, but not completely. Some people are actually awake during the procedure but don't remember much. Others completely go to sleep during the procedure. I completely went to sleep and don't remember anything after the nurse saying, "see you in recovery."

Just had my first one done today 3/18/16 the prep was not as bad as I thought it would be. Was a prep called suprep a split dose took one at 4PM day before and then took one at 1AM this morning. The worse part was the fasting yesterday right around noon time. I was asleep but awoke once or twice during the procedure but they put me right back under. I woke up again just before the doctor removed the scope I felt it come out. all in all was not as bad as I thought it would be and sitting here about to have something to eat.

My last 2 scopings, I was not clean. I told my gastro. that I had drank all the PEG solution, fasted an extra day and had taken 2 large volume enemas, so he knew that I was trying to cooperate. He told me before my next scope, I should take another large volume enema the morning I was scheduled to come in. I suspect that my bowel resection for colon cancer may have left some pockets that don't clean out well.

As a medical sales rep. I was allowed to watch about 50 colons and 25 upper scopings. The gastro. was kind and gave me an ongoing commentary about what he was seeing. A good gastro. can do a colon in about 15 min. A general surgeon I knew let me watch him scope people; it took him about 45 min. to do a colon. They all woke up and were immediately given more Demerol and Versed I.V. to put them back under. Watching the TV screen was fascinating during these procedures. The most interesting were the "uppers', where the scope was down at the bottom of the stomach and turned around to view the esophagus up above. I have had an "upper" to examine an ulcer and my throat was sprayed with Xylocaine to numb the gag reflex. They still sedated me

BTW, before I was permitted to watch any procedure, the patient was asked if they objected to my presence; none told the Dr. and me "NO". Patient modesty was strictly adhered to, with all colonoscopy patients having their buttocks covered by a gown. The only one to briefly see their cheeks and anus was the physician.

I don't imagine I would have any issues if someone wanted to view my colonoscopy procedure.

. . . . A good gastro. can do a colon in about 15 min. A general surgeon I knew let me watch him scope people; it took him about 45 min. to do a colon. . . . .

How quickly they can do a colonoscopy has ABSOLUTELY NO BEARING on how good they are.

A careful exam takes time to look around and thoroughly examine all the walls. I would much rather have it done by the guy who takes 45 minutes than 15.

Most of the time, this procedure is performed with conscious sedation.. which means you are technically awake. The patient is usually given a cocktail of a narcotic painkiller, usually fentynal depending on the facility, combined with Versed, which is an amnesiac. So when you "wake up" and feel like you slept though the procedure, you were actually somewhat awake and just don't remember. This is a common way to sedate patients for most minor procedures. While its cool that the patient doesn't remember how miserable they were, it is kind of weird to watch someones reaction to the discomfort and then totally forget about it when the drug is reversed.

Had second colonoscopy a few months back without sedation and I thought the discomfort was about a 2 out of 10. Got dressed the drove to work to see a full days worth of patients. My only concern was the speed of the procedure. It Jimmy John's fast, really fast. I am worried they did not see everything

My last 2 colonoscopies were done without sedation. It is interesting to watch this procedure on the monitor. There was a

little pain a few times, but not more than

I have experienced from soapy enemas.

I would want to be awake and watch on monitor; plus I would like to have a copy to watch later...or to take to the next 'show'n'tell'.

Dan

I had my first colonoscopy without sedation this past March. It's not hard to do-just ask your doctor; they will either say they will or they won't. If they say no, ask them for doctors names that will do it sans sedation.

The two nurses I had accompany me were somewhat in awe that I was going without sedation-they'd never seen it before. Once the doctor started, she started introducing CO2 to expand the bowel as she advanced the scope. The major feeling was pressure building=the first pressure rise was going through the sigmoid area, the second going from the descending to the transverse colon. I had the doctor pause at one point for about thirty seconds to do some lamaze breathing and ease the pressure. I then gave her the go ahead to advance to the ascending colon. Once we got there, she showed me my appendix aperture and then proceeded to start removing the scope while looking at the colon tissue. I could see her introducing water at various times to clear some cloudy water still in the bowel.

Once she was done, I was wheeled into the recovery area just long enough to get my printed results. At that point I got dressed and left to have breakfast.

BTW: They did "prep' me with an IV port "just in case" I might want sedation or pain killers, so that was removed while in recovery.

Have had three with no sedation. No discomfort and very informative watching procedure, saw a polyp before doctor saw it once. The prep is worse than procedure. I believe it is better to keep all those sedation chemicals out of ones body, just my thought.

My one and only colonoscopy was at 51 years of age. I specifically asked to be awake for the procedure, so the gastro said they would administer a little less sedation, but I remembered nothing until the very end. I vaguely remember seeing the monitor as the scope was being withdrawn from my rectum.

As a consoIation, I did get a few pictures, which were fascinating.

And no polyps, which was good news.

So, 10 years has passed, and it's time for another. I would definitely like to be awake for this one.

I’ve had 2 colonoscopies so far in my life. My first in my early 30’s, and my last was a year ago. My first was under very mild sedation. In fact it was so mild, I thought they forgot to put the medicine in. I remember pretty much the whole procedure. There was some discomfort at some points as the tube was inserted and passed deep into my colon. There were also some crampy feelings as air was frequently introduced along the way. I watched the video of the procedure on a tiny monitor which was cool and surreal. My second colonoscopy was done under full anesthesia. Last thing I remember was the anesthesiologist putting the milky looking liquid into my iv. Next thing I knew I was waking up from the deep sleep in the recovery room. Seemed like only a minute had passed, but was close to an hour.

As an alternate to sedation in the UK , you can have Entonox ( commonly referred to as gas and air). Entonox is a ready-to-use medical gas mixture consisting of 50% nitrous oxide and 50% oxygen for use in all situations where analgesia and sedation with rapid onset and offset is sought.

Entonox nitrous oxide/oxygen mixture provides the pain relieving properties of nitrous oxide with the benefits of additional oxygen without producing unconsciousness. It is a widely used analgesic for acute, short-term pain relief in a diverse range of clinical situations, from painful procedures to childbirth.

A potent analgesic with a very rapid onset of action and is quickly eliminated from the body. It is widely used by midwives, hospitals and the ambulance service. It is used exclusively for short-term procedures inevitably involving pain, including (but not limited to):

-- Acute trauma

-- Tooth extraction and other brief procedures in dental work

-- Wound and burn dressing, wound debribement and suturing

-- Fracture and joint manipulation

-- Colonoscopy

-- Venopuncture

-- Labour

Key features include:

-- Predictable and reliable analgesia,

-- Effective pain relief and sedative effect without loss of consciousness,

-- Rapid onset and offset, which can lead to savings through reduced treatment time and increased patient turnaround,

-- Properties that help to reduce patient anxiety,

-- Easy, self-regulated administration,

-- Minimal side-effects

Contraindications:

-- maxillo-facial injuries,i

-- impaired consciousness

-- intoxication.

-- pneumothorax,

-- abdominal distension,

-- suspected intestinal obstruction,

-- bullous emphysema,

-- middle ear procedures,

-- following a recent dive or decompression

Additionally the patient mush be able to hold the mouthpiece independently and following instructions regarding its use , such as form a good seal around the mouthpiece , breathing in through the mouth , out through the nose .

My guess is that it might be like childbirth and relaxation is vital if going drug free. Maybe bring a (extremely good) friend to do the touch things?

Like the nitrous idea, but don't know if many offices would be set up for it (gas supply and evacuation needed)

I have had two and setting aside what I know as a health care professional the continued use of a standard colonscopy is antiguated and in my opinion barbaric and if you add anesthesia to it , just plain sadistic!

The new 4D virtual colonoscopies due a far better, much less invasive and give a much more visual and visible result, being able to "see" through the walls.

While the prep is pretty much the same, the procedure is far less dangerous and invasive and much less stressful.

Most HMOs and other insurers will cover it. Some with a fight. BUT, if your doctor writes the order specifically for a VIRTUAL COLONOSCOPY and will detail that you cannot sustain the effect anesthesia without undo risk, and he would require anesthesia, they can't turn you down.

Virtual colonoscopy is a relatively new procedure so there’s less information available about how accurate it is compared with some other procedures. But experts believe it’s safe and works well.

Research has looked at how accurate a virtual colonoscopy is at detecting bowel cancer or polyps compared with a conventional colonoscopy. This research shows that a virtual colonoscopy is comparable to a conventional colonoscopy at detecting larger polyps (over 6mm). But it isn’t as good at detecting smaller or flat polyps.

I know from clinical practice a Virtual colonoscopy can detect polyps caused by fecal matter , so a pesudopolpy . The gold standard is you old fashioned colonoscopy as you can directly see the colon as you navigate to the caecum and TI. I will admit that you can still miss colon polyps due to the anatomy of the colon.

If it were me I think I would prefer sedation but last time I had Midazolam (Versed) sedation, back in April for a Bronchoscopy, the damn stuff didn't really do much at all until after it was all over.

I had Midazolam for a bronch, too, and it did squat for me. They gave me double the regular dose, the dr said they could not safely give me any more.

I had Versed when I had an endometrial ablation and cone biopsy. It was a few years later that I finally remembering someone saying to the anesthetist "give her versed", other than that no memory loss - that I know of.

I may have to have some procedures in the near future and my gyn wants me to be sedated with propofol - when hell freezes over.

An injection or IV administration of midazolam ( Versed) takes effect in 5 to 15 minutes with maximum effect in 15 to 60 minutes and has effects lasting for about 2 hours but with a range of 1 to 6 hours. The amnesia effect lasts for 20 minutes to an hour depending on how it is administered.

So by the time it has its maximum effect the bronchoscopy is over . As a premed prior to surgery , you can give much larger doses, so that why Bbw4doc , you probability dont remember much , larger dose, longer procedure .

I agree propofol is a bit drastic for sedation for gyne procedures.

I have trouble remembering darn near a whole day, and was impaired for 3 -4 days from midolazam/Versed and forgot stuff that I knew before. Never again.

Don't know the dose. Probably should go buttonhole the doc who "really knew what he was doing and I shouldn't worry" even after I said I had sensitivity issues and find out.

Course I'd need to figure out who it was. You meet the surgeon before, but you're lucky if the anesthesiologist talks to you for 30 seconds the day of.

I've had 5 colonoscopies, the first couple with midazolam. That left me a bit groggy for a couple of hours and I didn't care for it. The last 3 were with propofol and I thought that was great. Almost instant recovery post-procedure and overall I was quite pleased with the experience.

For those who can undergo a colonoscopy without sedation, my hat's off to you. I had a flex sig without sedation once and had a lot of pain and cramping. I would not go through that again.

I agree with those noting the prep is generally the worst part of it all. And I can't stress enough the value of being screened. I'm one of those who always have polyps found on colonoscopy, as do about20% of people. I've seen a lot of people die of colorectal cancer. I do not want it to be me. The problem for those aiming to avoid a colonoscopy by undergoing a virtual procedure is that if you're one of those 20% or so with a polyp, you've got to do the prep all over again to have a standard colonoscopy for removal of it. One and done for me.

I’ve had two colonoscopy to date and both have been without drugs, because I wanted to see the inside of my colon as the camera travels from the Rectum to the Cecum. It wasn’t nearly as bad, as some of the three quart Ivory soap enemas I received from my RN grandmother with a 15 minute hold time in my late teens with her three quart pumpkin enema bag.

I have a cousin who's father died from colon cancer because he wouldn't go to the doctor. I can't bring myself to do the screening fecal test, let alone have a colonoscopy.

RN, what would be a good drug for sedation for gyn procedures? The way my obgyn talks, propofol is standard at the hospital here.

I have a cousin who's father died. . . .

Wouldn't that simply be your uncle?

With my sub's recent medical issue it has been brought to his PCP attention that a colonoscopy is going to be needed (he's over 50). Not sure when it will happen or if (colon cancer isn't in his family). Wil wait to see.

I have a cousin who's father died from colon cancer because he wouldn't go to the doctor. I can't bring myself to do the screening fecal test, let alone have a colonoscopy.

@bbw4doc You really should have a colonoscopy done. I've seen a couple people die from it and it's a agonizing, painful way to go. Not for me! That's why I've had two done, and the 1st one they snared 3 polyps out of me, and they said the one usually turns to cancer. The second one I was clean. Pretty simple procedure that's not painful and doesn't take long, worth getting it done. Besides, I have family history.

I lost my father to colon cancer because his idiot primary care doc told him he didn't need one. I have a family history and in November, I had my 6th colonoscopy. Fortunately, I have been clean since the first one and am now on a five year schedule. This last one was the most comfortable procedure of all. Joked with the nurses. Watched the propofol for go in and woke up smiling. It is an easy way to prevent a serious disease.

Here, you do the fecal test and if it's fine, then no colonoscopy. I can't bring myself to do that fecal test. I'll take my chances.

I've had four colonoscopys all without sedation. Never found it painfull enough to justify it. My practictioner is now using carbon dioxide and water to open the colon. Eliminates the cramping and flatulence caused by just air.

I just had a colonoscopy a few days ago where they use carbon dioxide for the gas ... at least for me, it didn't eliminate the flatulence. The nurses said it was quite common and usual.