Can a patient refuse sedation? - page 3

My G.I. want to use Versed for a long colonoscopy. Even tho my last colonoscopy was painful,i don't think i want to be sedated with weird meds.... Read More

  1. Visit  brillohead profile page
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  2. Visit  oncall24/7 profile page
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    More and more patients are declining sedation for endoscopy and that's their absolute right. The endoscopist can refuse to do the exam unsdated, but he/she had better have a good reason for doing so..not just the usual "it's going to hurt".....If you absolutely don't want sedation, don't sign the sedation consent or cross out references to sedation in the general procedural consent.
  3. Visit  Mimi2RN profile page
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    I had a sigmoidoscopy in the doctor's office, w/o sedation. NEVER AGAIN. It was extremely painful, I almost passed out afterward. I have also had a colonoscopy w/sedation, and no problems. No, that's not correct, I was given morphine (I would vomit for hours after Demerol). Then I vomited till 5am.

    They know now to give me Fentanyl and I have no problem with Versed.
  4. Visit  CrohnieToo profile page
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    I've only had one sigmoidoscopy. It was quite an .... experience. It was done at Mayo Clinic in Rochester, Minnesota back in early 1976. I had NO idea back then what I was getting into!!! I stripped to a gown and my socks. A nurse instructed me to kneel on this church pew like contraption w/a tray or table for me to place my elbows. Then the doctor came in, the pew tipped down and my butt went up in the air. The sigmoidoscope was inserted. I had no pain and the only discomfort was my dread that I was going to expel a good bit of air directly into the doctor's face!!!!

    Knowing what I do now I appreciate that "pew" and being turned upside down as I'm sure that helps to straighten out the sigmoid colon and reduce the discomfort of the scope and as expected at Mayo the doctor was experienced and skilled and didn't get carried away with inserting air into the colon.

    And I'm pretty sure back then they didn't have the flexible sigomoidoscopes like they do now and that it was a rigid sigmoidoscope.
  5. Visit  gary130 profile page
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    I hope that it's not too late to ask another question on this thread......I general terms for colonoscopy drugs, if a person wants to avoid sedation (for valid reasons, is there any reason that they just couldn't get painkiller instead? The colon is smooth muscle and the action of narcotics on smooth muscle is well known; I know that most facilities use a combo of benzo/narcotic, but if a patient does not want sedation, why not consider painkiller only? Especially in a patient who had a drug-free exam recently with little pain, but now the doc doing the repeat exam wants to administer "something" since the first exam was technically difficult. Just asking in a hypothetical sense. Thanks>
    oncall24/7 likes this.
  6. Visit  CrohnieToo profile page
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    Yes, a colonoscopy can be done w/just a pain killer and no sedation. The examining doctor also has the right to refuse to do the scope w/o sedation in which case it would be necessary to find another doctor who would be willing to do so w/o sedation.

    A colonoscopy w/o sedation, even done w/a pain killer, is more time consuming and requires more skill and patience on the part of the doctor doing the scope.

    Even w/sedation and narcotic cannulating the ileocecal valve is not always accomplished. W/o sedation it is even more difficult for patient and doctor.
  7. Visit  brillohead profile page
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    Quote from CrohnieToo
    A colonoscopy w/o sedation, even done w/a pain killer, is more time consuming and requires more skill and patience on the part of the doctor doing the scope.

    Even w/sedation and narcotic cannulating the ileocecal valve is not always accomplished. W/o sedation it is even more difficult for patient and doctor.
    My GI had no problem whatsoever with my decision to be awake and unmedicated during my colonoscopy, and she chatted with me throughout the procedure, answering my questions and explaining what was what.

    She even has no problem with people being awake for upper endoscopy. As much as I would LOVE to watch that particular procedure (that's where my disease is manifested), the involuntary gag reflex and my inability to actually ask questions during the procedure make it a not so inviting idea -- I'll go ahead and take my happy juice for the upper end of things!
    tewdles likes this.
  8. Visit  Leelee2 profile page
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    IF I ever decide to have another scope I will be refusing sedation completely. After having been perforated in two places after my colonoscopy though, and having to have a bowel resection in two places, I think I'll pass on these type of "procedures". It really wasn't worth losing half of my large intestines.
    tewdles likes this.
  9. Visit  backscatter profile page
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    I must have had an awesome doc and nurses for my c-scope; I didn't get any drugs and it wasn't bad at all. After one of our primary care docs had long-term memory loss after a c-scope with Versed, I decided to skip it.
  10. Visit  oncall24/7 profile page
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    Quote from backscatter
    I must have had an awesome doc and nurses for my c-scope; I didn't get any drugs and it wasn't bad at all. After one of our primary care docs had long-term memory loss after a c-scope with Versed, I decided to skip it.
    You probably had a doc who took his/her time to do the colonoscopy properly and you must have an easy colon to navigate. Colonoscopies are done in most of the world (not the US) without sedation. Here in the US, sedation is the standard of care. Being a control freak, I chose an unsedated colonoscopy dspite the fact that my CRNA friends (yes, anesthesia docs have them) offered to stand by with propofol and fentanyl if needed. The drug-free exam was quite tolerable and it was nice to drive myself home. The GI doc who did the procedure was great, but she convinced me to get my next colonoscopy with drugs for several reasons: 1. it's easier for the colonoscopist to examine the colon of a sedated patient; believe it or not most endo docs don't like to cause pain and when they do an unsedated exam, they tend to rush...even when the patient lays there and suffers in silence (like I did). 2. with proper sedation, most patients won't remember the exam, if propofol was used they almost always have a great experience and most who get versed/fentanyl also have a good expeience. I personally hatet he idea of procedural amnesia, but now I realize that having a colonoscopy isn't about some esoteric patient preference, it's about allowing the GI doc to do a slow, careful examination of the colon (5 1/2 feet or more) without rushing. if the patient is proprly sedated, the GI doc can do his/her job. Off my soapbox. I just had a colonoscopy and need to repeat because of biopsy issues. The endo doc suggests sedation, which I again refused, but then I changed my mind. With propofol, it's possible to get safe, profound sedation during the exam with a safe airway and an almost immediate recovery (I have done this about a thousand times with my patients). And yes, a CRNA will be doing my colonoscopy sedation on 1-10-11; this is an appropriate role for the CRNA and I'm glad that Sue will be doing my case. Can a patient refuse sedation? Absolutely, I did for my first colonoscopy and for an ulnar nerve trans.......probably a bad idea.
  11. Visit  yiyayiya profile page
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    patient can refuse or ask for anything they want. It is your body and you say what is done to it and how. I personally will never have any form of invasive procedure for any reason but that is my choice, I'll take my chances.

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