Versed/Fentanyl vs Propofol?

[koobair]

What is the standard at your work for patients? For me, when I've had scopes I've always had the Versed/Fentanyl. Is one better than the other? What do you find patients do the best with? What would you want if you had a scope?

[brownbook]

Generally speaking propofol sedates you immediately and doesn't leave a lingering sedated feeling. If another dose is required during the procedure the propofol will take effect immediately so the procedure is finished quicker.

Versed and fentanyl take longer to sedate a patient, if another dose is required during the procedure again it will take longer to re-sedate the patient so the procedure may take longer. Versed and propofol tend to leave more of a lingering sedated drowsy feeling in recovery.

So theoretically speaking propofol is quicker and leaves less of a sedated feeling than versed and fentanyl.

However my last colonoscopy went great except I have no memory of waking up, getting dressed, etc. so the effects of propofol can certainly stay with a patient for a while.

When, if, I have another scope I will do what ever the provider/anesthesiologist/nurse recommend. I would not tell them what to do.

[murseman24, MSN, CRNA]

RNs can do versed/fentanyl, anesthesia are the only ones supposed to be using propofol. If in an endoscopy center that is trying to save on cost by using RNs and not anesthesia, that is where you will most likely see versed/fentanyl. Propofol is much preferred by the GI docs satisfaction, as the patient moves less and are sedated much quicker, but patient outcome doesn't improve with propofol administration, and some metrics show worse outcomes, even with anesthesia administering it