Average doseage of conscious sedation while doing endoscopy's - page 5

by lmbv55 | 126,287 Views | 85 Comments

I am interested in the average dose of conscious sedation that Endo nurses are giving. We use demerol and versed at my hospital and feel that several of our doctors need more education on conscious sedation but have no numbers... Read More


  1. 0
    I had a quick question. I'm allergic to nearly every kind of medication, and I was also sexually abused as a child. Can a colonoscopy be done without using versed or some other amnesiac drug? I'm more afraid of NOT remembering what happened than I am of pain.
  2. 0
    May I ask how reimbursement is on procedures that have an anesthetist present?
    We have a physician that wants anesthesia for every case, but we are concerned about reimbursement.
  3. 0
    Quote from Surreal_44
    I had a quick question. I'm allergic to nearly every kind of medication, and I was also sexually abused as a child. Can a colonoscopy be done without using versed or some other amnesiac drug? I'm more afraid of NOT remembering what happened than I am of pain.
    Yes, it can be done. It is best done w/some form of analgesia. I have my scopes (at my insistence) with just Demerol and occasionally a little phenergan when we get to the proximal transverse colon/hepatic flexure if the vagus nerve gets ticked off. Much depends on the skill and the patience of the person doing the scope. Not only am I awake and aware during the procedure and watching the monitor I bring my video cam and we videotape the monitor (I have a real jewel of a gastro!!). Be aware that I have a healthy colon. I'm not at all sure if one has UC or some type of rectal involvement that a scope w/o sedation/anesthesia could be safely done.

    You should find the following two articles of interest prior to discussing this with your gastro.

    A Study of Pain During Colonoscopy

    http://www.e-health-questions.info/h...&realm=default

    Why Colonoscopy Is More Difficult In Women

    http://www.e-health-questions.info/h...&realm=default

    Good luck and God bless.
  4. 0
    Quote from CrohnieToo
    Yes, it can be done. It is best done w/some form of analgesia. I have my scopes (at my insistence) with just Demerol and occasionally a little phenergan when we get to the proximal transverse colon/hepatic flexure if the vagus nerve gets ticked off. Much depends on the skill and the patience of the person doing the scope. Not only am I awake and aware during the procedure and watching the monitor I bring my video cam and we videotape the monitor (I have a real jewel of a gastro!!). Be aware that I have a healthy colon. I'm not at all sure if one has UC or some type of rectal involvement that a scope w/o sedation/anesthesia could be safely done.

    You should find the following two articles of interest prior to discussing this with your gastro.

    A Study of Pain During Colonoscopy

    http://www.e-health-questions.info/h...&realm=default

    Why Colonoscopy Is More Difficult In Women

    http://www.e-health-questions.info/h...&realm=default

    Good luck and God bless.
    I really appreciate your informative posts. You and another poster mention having bad reactions to Versed (referring to your first link). Although I have searched this site for days, I can not find the post I want. Anyway, as I recall, the poster explained that since Versed has no analgesic properties and reduces inhibitions, abusive behavior is to be expected when there is inadequate pain relief. Maybe one of the CRNAs or AAs will see this post and respond.

    Michael

    "Outside of a dog, a book is man's best friend. Inside of a dog, it's too dark to read."
    Groucho Marx
  5. 0
    I would love to know why versed is necessary for a colonoscopy. Why isn't a pain killer (i.e. demerol) enough on it's own? The implication is there is something we must forget (pain?).
  6. 0
    Quote from bbarbie1
    I would love to know why versed is necessary for a colonoscopy. Why isn't a pain killer (i.e. demerol) enough on it's own? The implication is there is something we must forget (pain?).
    It is assumed that patients do not want to remember the procedure. This was even the case for childbirth at one time. Since the pain cannot always be safely controlled with Demerol or Fentanyl, another assumption is that it is not pain if you do not remember it. I disagree with both assumptions. Versed is also used to control anxiety, although for me and many others, the creepy amnesia takes effect before any reduction in anxiety is noticed.
    Last edit by mshultz on Jul 17, '06 : Reason: Wrote "Versed" when I meant "Fentanyl"
  7. 0
    I had to BEG my husband to have his 50th birthday colonoscopy, and I am so grateful he had a great anesthesiologist who could use Diprovan!
    He does'nt remember a thing!
    But to say, CS can work well too, but often times the docs won't wait for the assessment part of titration, and sometimes you just need to tell the doc to hold on!
    I had a doc try to tell me that he could do an Endo without ANY sedation because it was SOO quick. Needless to say, I found another doctor!
  8. 0
    Quote from cateccrn
    ...I had a doc try to tell me that he could do an Endo without ANY sedation because it was SOO quick. Needless to say, I found another doctor!
    I assume this was for an upper endoscopy. According to my 15th edition of Harrison's Internal Medicine, upper endoscopies are routinely performed in Europe without sedation.

    I remember my EGD because the reduced amount of sedation (2 mg Versed + 50 mg Demerol; I was in the CCU) did not affect me. The procedure included Cetacaine throat spray and was quite tolerable, although my tolerance for this may be above average. I have read about upper endoscopies being done without the throat spray, but would never agree to that. If I were to have another EGD, I would refuse sedation.
  9. 0
    I have my EGDs w/o sedation/analgesia except for the throat spray at my insistence. The only difficult part is the gagging. There is no pain. The gagging is no fun but watching the monitor and seeing for myself makes up for it.
  10. 0
    I'm new here, about to have en endo and a colo same day for the first time. Problem is I've been taking versed (oral) 15 mg to sleep every night for the last 5 years (where I live is legal and I do have an rx). Would it be better skip this kind of sedation and go directly to propofol?
    thanks
    Mo


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