I was wondering if I could get some general input from GI nurses and or CRNAs who provide procedural conscious sedation and pain control for colonoscopy. Since I get this exam yearly after avoiding extensive cancer surgery, I try to get as many patient who need the exam to get one. An increasing number of people do not want the amnesia/memor loss associated withh Versed (Midazolam) and opt for the exam sedation-free. I am one of them. The question often comes up with patients who do not want sedation: can they just get pain control (fentanyl)? I understand the synergy between the midazolam and the narcotic and understand that the patient be quite are of the exam, but I agree with the patients who have had or heard about negative experiences with Versed (and the number is increasing daily). So, question #1:
For colonoscopy in a patient declinig sedation, do you see any reason why they could not just have fentanyl? This option would get a fair number of patients screened who do not want sedation. Recently, a patient told me that the GI lab at our hospital told her: either accept sedation or you won't get anything for pain. Seems a little one-sided to me, but I called to schedule a colonoscopy and was told the same thing. One GI nurse said it might be a way to convince everyone to accept sedation also. If true, this is bad, leading to many not getting the test.
question #2 (for CRNAs):
For colonoscopy where propofol is given, do you also administer a narcotic (ie fentanyl) or just use propofol? I'm asking because I have noiced an increase in patient dissatifaction with colonoscopy with propofol when fentanyl was not used; and this is important to me since many patients pay extra for it when I suggest propofol. Up until recently, every patient who had colonoscopy with anesthesa coverage (propofol) was satisfied; now I am running into a lot of patients who had propofol and would never consider another exam because of painful memories. And when I review their charts, they are always the ones who got propofol without any narcotic.
Thanks in advance for your inpt. I personally would never do the exam with sedation, but I have to keep my personal opinions out of my work, although it is refreshing to run across so many patients who will not accept Versed because of its well-documented, negative reputation (askapatient or versedbusters). Thanks.
Mar 17, '09
The ONLY reason we tell people about this evil poison called Versed is because it's virtually ruined our lives. I had no issues whatsoever with memory loss, anxiety, paranoia, PTSD, severe panic attacks, etc until this drug was pumped into my veins w/o my knowledge or consent (I was lied to and told it was Valium!!) It almost killed me. I don't remeber my children growing up, major events that have happened in my life, Versed and the moron's that almost killed me with it took ALL of that away from me.
I wouldn't wish what happened to me to happen to anyone...that's why we tell people to refuse this crap, it's DANGEROUS!!!!
If you haven't had this happen to you, you're totally clueless.
If I can save a person from going throught the living hell I've gone through all these years, I'm happy.
Last edit by ElvishDNP on Mar 17, '09
: Reason: getting personal