I was reviewing the comments about the commonly used sedation meds for colonoscopy and was surprized to see how many patients are not satisfied with the various protocols (pain and unwanted amnesia, hangover from Versed/fentanyl, unable to be awake/alert with propofol etc). A number of patients want to be awake and aware but pain-free during their colonoscopies, but are often told that this is impossible. As an insider, it's hard for me to accept "sedation" -versed/fentanyl) when you know that this combo is basically used to induce (maybe) amnesia of a painful event and may not be effective in some patients. Seeing many of these exams with the usual "sedation" is sobering. I was surprized when my gastro told me that getting a colonoscopy awake, aware, pain-free without amnesia or hangover would be no problem. The anesthesiologist administered a remifentanyl infusion and titrated the dose per my instructions. Pain-free, no drowsiness, no creepy amnesia no hangover and I was able to leave immediately after the test. Has anyone else heard of this option? The anesthesiologist told me that remifentanyl is perfect for someone who want to be awake but that it's sometimes discouraged since it's expensive. This makes no sense since having anesthesia involved doubles the cost of the colonoscopy anyway; I would never have this exam any other way. When I talk to others who had bad experiences with colonoscopy sedation, they can't believe how well mine went. Is remifentanyl a secret option?
I'm sure it's a cost thing. Most things in health care are, as we know, about money, not about what's best for the patient. I had an upper GI with versed, fentanyl, and benadryl (no propofol), and I remember nothing... I was happy as a clam when I woke up. If they didn't have pictures I would swear it never even happened. I had someone drive me home, but that wasn't a hardship. I wouldn't have it any other way, really. I would rather be completely unaware, but that's just me. What do you feel like on the remifentanyl? Do you remember everything? Is an anesthesiologist required for this alternate protocol? My procedure was done in a GI lab with a procedural sedation nurse, not an anesthesiologist. Maybe that is the reason this is not routinely done?
Last edit by CarryThatWeight on May 7, '12
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Last edit by Jacksmack on May 17, '12
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