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Colonoscopy & Conscious Sedation

by GlennRoss GlennRoss (New) New

Help. I am an RN, 51 y/o and family hx of colon cancer. I'm scheduled for next week. GI Doc is insisting on sedation for the procedure. After extensive reading I can find no valid reason for sedation other than when the scope is placed. If I can do self hypnosis and tolerate dental procedures, MRI, Epidural Steroid Infusions, I think I can handle the scope insertion. Please give me your collegial / professional experience with patients who refuse sedation and outcomes; also, why do you think sedation is required for this procedure.? I think it is a revenue generator because I have this conflict on sedation for nearly every out patient procedure. Perhaps I'm wrong. Glenn

I have been a GI-procedure nurse for 3+ years. I have assisted in procedures when sedation was refused. While it is possible, I must say that I think the patient deserves sedation. The procedure is very uncomfortable. Insertion is usually well tolerated. The colon is expanded with air which causes a significant amount of cramping, and even the best GI doc can have difficulty manuevering the loops especially if the patient has adhesions (former pregnancy etc). But it is possible to go without... Good luck, bring a driver, just in case you change your mind.

Wow, i can't believe you want to have that

procedure without sedation. i have worked in the g.i. dept. assisting with those procedures since 1989,and i recommend sedation. the air that is used to inflate the colon can be very painfuland manuevering the scope around the turns in the colon can be excruciating. let me know what you decide.

my email address is ljenk@jps.net

I am an RN and I do conscious sedation in an outpatient surgery clinic. Of course when introducing anything intravenously there is a list of risks involved. First perhaps ask what medication are they using for conscious sedation. Propofol? Versed? Fentanyl? I administer both Versed & Fentanyl during procedures. Versed creates amnesia, while Fentanyl is used as an analgesic. I can say that in most patients it is a light sleep and they are easily arousable and can maintain their own airway without a problem. Patients wake usually within 20 minutes after the procedure yet do not remember experiencing the procedure ( a side effect patients are happy to have). The medications do stay in your system for 24 hours. The most common side effect is some post op nausea, which is not that common I have found.

As far as your colonoscopy. I have not experienced one personally, but from hearing the experiences of others I would most definately recommend undergoing sedation. I have been told that is can be quite uncomfortable. Sedation is NOT like General anesthesia!!!!!!!!

Good luck!

If the doc is "insisting" on sedation in spite of your desire to try the procedure without it, get a different doc. We do colonoscopies occasionally without sedation. Everyone is different and some people (especially men, in my experience ) tolerate the procedure with minimal discomfort.

Jerico, BSN, RN

Specializes in ER, NICU. Has 2 years experience.

Hmmmm....have heard of "Brave Hearts" in childbirth...but during a c.scopy?

Have seen several over the years. Most aren't all that "gentle" and sometimes they need to take biopsies of suspicious things. Picture REALLY bad "gas" when they pump that gas in. Not to mention I'd rather be a bit sedated when I toot all that gas back out! :uhoh21:

I think not.:nono::smiley_ab

BTW: Most will give you pictures and all afterwards if you want!:p

babynurselsa, RN

Specializes in ER, NICU, NSY and some other stuff. Has 12 years experience.

MMMMMM If I thought they were just trying to pump up revenue then personally I would opt for the sedation and skip the colonoscopy.

Seriously, I would not believe that the reasons for encouraging sedation is monetary. It probably has more to do with trying to perform a procedure that is uncomfortable and the time lost if a patient is squirming around due to the discomfort and then the time it would take to go ahead and sedate teh patient before they can move on to the next pt.

You have the right to refuse sedation. Though you aren't going to get any gold stars for toughing it out. You also don't get the bonus bucks of seeing a new life brought into the world maybe just a polyp clipped. I think that the sedation would be money well spent for me.

gwenith, BSN, RN

Specializes in ICU.

Please note - this thread is over 6 years old!!!

babynurselsa, RN

Specializes in ER, NICU, NSY and some other stuff. Has 12 years experience.

AACCKK TRhanks Gwenith. I usually try to glance at the dates.

This time I didn't.

I've had an unsedated colonostopy. It was similar to cramps you get in labor. My Dr said about 98% of his paitents have medication. Usallt the ones who don't have complications with the medications. The procedure is not very long, it is uncomfortable.

I have had ulcerative colitis since age 11, back in the dark ages, children were not sedated for that procedue..nor was I ever medicated for pain during my 6 week hospitalization, for that matter. The pain was incredible, as I had active UC at the time; I cried until a nurse yelled at me, then I shut up, because, as she so nicely put it, "does crying help?" .

Now I am 49, and I am supposed to have a yearly colonoscopy because of the increased risk of colon cancer due to the ulcerative colitis. I did not start having sedation for the procedure until it was offered to me, (I was about 30) Iniatially, the sedation must have been fairly light, because I remember waking up during the procedure and moaning in pain; the doctor's response was always, "it's almost over."

Over the past 10 years or so, I always get sedation-the last time it was a drip of ditropan(?) worked great/I had no memory at all of the procedure/minimal sleepiness after the procedure and no nausea!

Having had a colonoscopy with and without sedation, guess which one I would pick? (sedation, without a moment's hesitation!)

I had a couple of colonoscopies back in the early 1990s when I was having some sort of inflamatory bowel problem. Even with sedation they were EXCRUCIATING! They hurt so bad they could not be completed. The second time I screamed so much, they increased whatever sedation/pain med to the point that I stopped breathing. I know that happened because the pain went away, then started to come back as someone was telling me to breathe.

As a result, I have not had another one although I should probably do so.

I should have asked what medications they were giving me in the IV because I have been told now that my records were destroyed after 7 years. After doing some reading, I suspect I had a "paradoxical reaction" to the seditive.

Anyone remember what were the seditive and pain drugs of choice used back from about 1991 to 1995? If I have to have another procedure, I don't want the same seditive!

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