Colonoscopy Sedation Medications
by Hospital Ratings & Reviews
Filed under Health-E Living
Options for Sedation During Colonoscopy Procedures Part I
The Colonoscopy screening exam is one that is vitally important to one’s health, and having a colonoscopy is one of the best ways of detecting and eliminating any pre-cancerous growths in your colon area. But it is also important to understand what types of medications will be given during your procedure so that you are fully informed about what to expect with regards to what drugs you will be given to manage your pain during your procedure and to know in advance that some doctors will use different medications.
1. Most Used Drug Combinations During A Colonoscopy: Fentanyl and Versed
Fentanyl which is an analgesic drug or drug given to control pain, and Versed, which creates amnesia, or loss of memory in most patients about the procedure that they are having done.
Fentanyl, also known as Actiq, Duragesic, Fentora and Sublimaze and is most routinely used in an operating room setting for the anesthesia and also in intensive care units. It is also used very frequently with cancer patients to treat cancer pain.
Versed, otherwise known as Midazolam, is a medication that is commonly given to patients undergoing colonoscopy or other outpatient surgical procedures. It’s primary use is that of an amnesiac drug, or a drug that will cause you to forget. What many patients are not aware of is that if you are given Versed it does not necessarily mean that you will not have pain, but it may cause you to forget pain. Most of the time patients have no difficulties with the fentanyl/versed combination. However, because of Versed’s effect on the memory, some patients report memory issues for months and years after having a procedure done, and in most of the reported cases, these patients were not adequately informed about the possibility that Versed could cause some longer term memory issues. Additionally, I have heard of some patients who reported mood issues and anxiety for weeks or months after taking the drug. Now, every drug can certainly have side effects and each drug can effect a patient differently, but I believe it is the absolute right of every patient to know in advance of a procedure the types of sedation that will be used, and the right to question their physician and ask for an alternative form of sedation to be used, if the “normally used” method is not an acceptable risk to the patient.
In our earlier article about understanding medication options we explained how critical it is for patients to find out in advance of the expected procedure, what medications will be used. It is simply not fair, in my opinion to expect a patient to make an informed choice right before a certain procedure is done.
Our next article, “Colonoscopy Sedation Without Versed, ” will focus on some other options for colonoscopy sedation that do not include Versed.
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I’m sorry to read so many bad stories about colonoscopies; just had my 3rd (In Australia, so things may be different here) same Dr, different anaesthetists and all were completely fine with sedation and pain relief. ie I do not remember anything! This time I did ask to be a bit conscious, which the anaesthetist was quite happy about, so I remember lying sideways, then waking up; apparently I did not tolerate light sedation so I had the full works again. The anaesthetist suggested asking for pain relief only next time, if I want to see what’s happening. There must be hundreds ? of thousands of colonoscopies performed each year, and on this site you hear the bad stories mainly. It’s OK, all you anxious people out there! Fred
Folks: look at a common thread here: doctors and hospital insiders” don’t want Versed for themselves. People who administer sedative/anesthesia drugs often extol Versed’s virtues and basically try to give it to every patient. It makes their job easier and any mistakes or carelessness will probably not be remembered by the patient. And if a patient complains, the so-called anesthesia providers can claim that the patient doesn’t remember events clearly. I doubt that a more abusive scenerio could be imagined and this seems to be the standard in many hospitals. If you don’t want Versed, don’t take anyone’s word for it…list Versed as an allergy, you got it at the dentist once and it gave you hived and you had trouble breathing. Write “I’m not consenting to Versed” on the consent before signing it.
I’m 55 and have avoided colonoscopy (despite bleeding) for years; until my new PCP (a wonderful,young doctor, scheduled me for one despite my objections…she’s hard to argue with)…One thing that impressed me: she asked me: “why is a smart (thanks) guy like you with a medical degree so damned insistant at avoiding a lifesaving colonoscopy”? Answer: “I don’t want the sedation drugs; I have seen too many patients experience severe memory issues etc”. She agreed. Midazolam (Versed) is out of the question; how about propofol? Sure, will it be administered by an anesthesiologist? Probably not, a nurse (CRNA) will give it…unacceptable, not safe IMHO. But many patients do well with nurse/CRNA-administered propofol…yeah, and most people who drive drunk don’t get hurt….so the CRNA is out. I get a real anesthesiologist and tell her that I want to be awake and without memory impairment……at first she says “sign this blanked consent” and I’ll take care of you…..nope; we finally agree that only a remifentanyl infusion would meet my requirements but she balks because of cost. cost? adding an anesthesia provider to the colonoscopy doubles the cost; why use cheap drugs? she continues to argue until she learns that I’m a doc then the remifentanyl is o.k. but I kick her to the curb and go drug-free, uncomfortable but doable..the anesthesiologist is apologetic but mad that she didn’t get paid.
I had my first colonoscopy yesterday at age 59, they found 10 popyps. They used versid but I was totally conscious and aware throughout the procedure and remembered every detail when it was over. It was kind of interesting watching the monitor and seeing them grab the polyps with the loop. There was one polyp that they were having trouble getting to and they had me roll on to my stomach and while one guy pushed up on my stomach the doctor rammed the scope really hard and it was extremely painful. Next time I am going to insist on propofol.
I had my colonoscopy this week and my GI doctor used Propofol. Didn’t remember a thing, and it was not traumatic at all. I’m glad that I asked about it and that I had an option of not having to be medicated with Versed. Appreciate everyone’s comments and help.
I chose no sedation and I’m glad I went that route. I had become terrified of the exam after reading many horrifying accounts on the internet. I was determined to do it without drugs through and wanted the benefits of the test. I was willing to go through some pain in exchange for not feeling sick afterward or having my pain ignored as apparently happened to some people for whom the drugs did not work (and the Docs rammed them).
Everyone at the hospital was supportive of me. The nurse told me to expect some cramping and to be prepared to take lots of deep breaths and work through it when it happens. I told the Dr. and the nurses I was committed to getting through the test but if the pain got too severe to let me rest for a minute before trying again.The Dr. said he would stop the test if he felt there was any danger.
As the scope first went in there was no pain and just wasn’t a big deal (thin and lubricated). As the scope rounded the first corner there was cramping but I got through it easily with fast deep breaths. The straightaways were easy then at each corner I had more cramping than the one before. The last 2 were harder but manageable. Only on the last one did I flinch and say ow. It took a lot of deep breathing, determination and nurses distracting me to get through the last one but as soon as the scope rounded the last corner the pain went away and I was fine. At no point did I think I made a mistake by not taking drugs. The actual exam occurs as the scope is withdrawn. This did not hurt at all. I also did not have pain with the inflation or feel as blown up as I thought I would.
It was great to walk out clear headed and feeling fine. The only lingering effect was a slight gasiness and feeling a bit tired from the fasting. I probably could have gone to work if I had to but instead decided to take the afternoon off.
If I had been told the exam was painless, was unprepared for the pain and didn’t do the deep breathing then then the exam would have been horrific. I think this it what happens to the people who take versed but feel the pain through it. IMO far better to be clear headed and deal with the pain. Any woman who has survived severe menstual cramps will know how to get through this type of cramping pain.
I was very concerned about the drugs I would be given and talked to my doctor most of the time I was there about it. I had taken 2 other people to their procedures and did not want to have what I called the amnesia drug. The doctor looked at me like I was crazy as if he had no knowledge of such a drug. I trusted him. Take my advice if you have concerns about anesthesia don’t trust any doctor. Have him write down what drugs he will be giving you and research it. I was given these drugs with out my knowledge and then dress and escorted out of the building before I knew I was in the world. I had this done five days ago and I am still suffering from anxiety. This web site says this can go on for weeks or months. I wish I had not trusted a stranger and researched the drugs on my own.
I appreciate that there are several health care professionals here who are sharing their opinions about Versed during colonoscopy procedures. My father in law is a physician and he has told me that he would never have Versed himself. He’s a surgeon and I guess likes to be in control of everything:-) But seriously, I pressed him for more info and although I didn’t get as much info as I’d like, he said that the memory loss issue is a valid one. Knowing that I guess I would skip the Versed personally and just get some pain control.
I had a colonoscopy several months back and also had severe vomiting that lasted for a few days afterwards. My doctor didn’t discuss any side effects and I was given Versed they said to “make me relaxed and comfortable.” Well, first, it didn’t really make me relaxed, I also “woke up” a few times during the procedure and I do remember crying and asking them to stop. So I can relate to many of you who had a bad experience with this medicine.
Turned 50 last year but didn’t have my colonoscopy until a few weeks ago. Guess I’m late in finding this out about the differences in medicines that are used. Wish I had known about this website earlier. I didn’t have any trouble or issues at all with the Versed. But think I would respect my doctor more if he had told me about the side effects. I did, have lots of issues with the prescribed preparation. It looks like I have to go back for a repeat colonoscopy in 5 years, so I will definitely be using another preparation for that particular test. I got very ill from the GoLightly.
My doctor said that I’d be given a medicine to help me relax and not be in any discomfort, but I was quite uncomfortable because instead of being asleep I was aware of what was happening and was crying during the colonoscopy. I wish I would have known that Versed sometimes isn’t a great medication to use before I had the procedure.
Gerald, what type of side effects did you have after getting Versed? I had some problems with my balance and memory after this medicine, as well as getting a feeling of not being able to breathe and feeling very anxious and panicky. I think this was in part, because I “woke up” during the procedure and was in a lot of pain and wasn’t expecting that as I thought I would be comfortable.
I was having side effects from versed a week after my colon exam.Thanks to this web site I learned more
about the sedation than my Doctor shared.Thanks for the info.Gerard Murphy
Also wanted to write in and just say thank you for each and every single person who has shared their tips and trials about getting informed for colonoscopy testing and screening. If it weren’t for finding your help I would certainly not have been informed that I needed to get more information up front from my doctor. Still can’t quite grasp why we are not told by the medical community about the dangers of certain medications. But thank you everyone, you have made my road much easier.
Spent the past several days reading about the colonoscopy medicines and made a list of questions I am going to ask my doctor. I’m concerned that because generally doctors in my town aren’t very open to questions, that I may be faced with either just taking the sedative that they use or trying to drive 4 hours to find another specialist in a larger town. Those of you who have more choices in doctor options are very lucky. Plus, I’m wondering if my insurance will even cover a physician who is further away. I have some more checking to do. Thanks go out to all of the other patients who are telling your stories. Without you, I’m sure I would be just another case to a local GI, and I would not know what to even ask about side effects or anything about getting ready for the colonoscopy either.
I very much understand the concern about getting any type of medication and not being fully informed about the risks from our doctors. But I also want to share that I didn’t have any trouble with my colonoscopy or the Versed that I was given. For me, it was nice not to know what was happening. Although I wish I would have been informed in advance of the potential for risks, now that mine is over I am very relieved. Next time, with my repeat colonoscopy I would probably go for some other type of medicine or just try it without medicines although I would be quite scared about doing the procedure while awake.
Colonoscopy testing is not something I’m looking forward to doing, but my 50th birthday is right around the corner. I guess years ago I would go to the doctor and just assume everything would work out ok. But my neighbor had a bad experience with Versed, so I am looking into other options. I am hoping that I can find a doctor who will actually listen. Sounds like finding the right GI doctor maybe the most difficult part of all this. Thank you for sharing about your experiences. This has helped me so much.
Today I had my consultation with the GI physician for my colonoscopy. I was asking of course about which medications he generally used and was told there were “no choices” at all, just Versed. I got up and walked out of the office and since I had paid my co-pay at the beginning, told them I wouldn’t be coming back. Guess I have to find another doctor.
My colonoscopy was one without any medicines back in June. Because I had read most of the postings here on this site beforehand and spent a few weeks interviewing prospective GI doctors, I was confident that I’d be able to handle any discomfort from the exam. It wasn’t as bad as I had thought it would be. I guess I prepared myself for more pain and cramping then there actually was. At one point during the colonoscopy the doctor let me know that I’d probably feel some discomfort and pressure but I tried to relax and breathe through it and it wasn’t that bad. I was also more frightened of ongoing effects from a medicine instead of some mild to moderate discomfort from a procedure. Not sure if it’s just me but I think that doctors here in the US are much much too fast at just writing a prescription for everything. And not taking into account some of the interactions or side effects from these prescriptions. It is good to ask questions and I’m very thankful so many times over for finding this site and being able to learn so much from all of you. If it hadn’t been for those of you who had problems who took the time to share your stories, I would have never known to ask about having a colonoscopy without medicines.
I was also considering asking my doctor to do the colonoscopy without any medicines. But my cousin, who’s a Physician’s Assistant, says that I should at least get pain medication so that the pain will be more manageable. I guess I am afraid of not remembering, but I’m not opposed to having the pain under control so I may just do this.
My appointment is coming up next week with the doctor. I’ll talk about options with him.
I’m going to ask if my doctor will just perform my colonoscopy without any medications that can make me drowsy or cause me to forget anything. I would like to know what is happening during the exam and be able to remember the conversation with the doctor after the colonoscopy is finished.
This is certainly an issue for me if I’m not being told about how dangerous some of the medicines are for a colonoscopy. Makes me wonder what else I’m not being told about with regards to my healthcare. I was only looking up some research about colonoscopies because my brother is going to need one soon. And I’m only a few years younger so was also reading about the procedure so that I’d know what to expect when I turn 50. To the medical people on this thread, thank you for sharing your expertise with us. And to the fellow patients–I’m so glad that you didn’t keep quiet about your experiences. This is really good information for many of us who don’t know anything about colonoscopies or other procedures.
Getting a colonoscopy is frightening enough. Now I find out that I’m not even being told about the risks from the medications that are used? I think that is very disturbing. I had my evaluation for a colonoscopy this week and not anything was talked about in terms of side effects of the medications used for sedation. I was just told that I’d be given something to help me relax and would be totally comfortable.
One of my co-workers sent me here to read about having a colonoscopy because I’m supposed to have either a sigmoidoscopy or colonoscopy in the next few weeks. I had already met with my gastroenterologist and he never mentioned anything about the sedation I would be given. Because I’m an engineer, I tend to pay attention to the details, so it’s good that I read up about the problems with some of the medicines that are used and will not have any type of procedure where Versed is used. I can’t imagine trying to do my job with memory loss.
Polly, I’d sure rather go to the dentist for a cleaning also then go through a colonoscopy. When I had mine I didn’t have the pain that many of you describe. But I did get the memory lapses, brain fog, and just overall feeling of having been violated in some way. And I was more upset with the fact that no one told me these things were all side effects and possibilities with the Versed sedation.
Maybe the physicians do get higher reimbursement rates if they don’t have an anesthesiologist involved. So a colonoscopy procedure could make the doctor more money if they don’t have to have another department in on the procedure handling the sedation. Anyone know how to find out about this?
I do think this is about profits and not about what’s best for us as patients when we are not given informed information about medicines. When I go see my doctor now sometimes it’s I feel like they are only interested in their agenda–not mine.
I went in for an appointment and I talked to the intake nurse. She did medication history and prep details. I called back again and tried to go over medication choices and it was like I was an idiot for even asking about it, and that I shouldn’t bother myself or her over it.
I never saw the Dr. ,who I guess just shows up before the procedure. Do they expect that we won’t ask for options because it’s such a “minor” test? I was made to feel that there was no risk at all to the whole thing. I know that she was witholding information to calm down an anxious patient. Actually,the colonoscopy itself doesn’t bother me, but I’ve had 2 medication reactions in the past and the Dr.’s say “hmmm,that doesn’t usually happen,you’ll be alright” then they go home while I’m left riding it out untill it all gets out of my system.
I’m wondering if they use Versed because they won’t need an anesthesiologist.
I’m writing in to say thank you to everyone here. Without your telling your stories I would never have known to ask questions of my gastroenterologist. In a little more than 3 weeks I’ll be going in for my very first colonoscopy. I don’t want to do it, but I know it’s important to be screened, so I’m going to follow through. Turns out my gastro normally uses Versed but he’s willing to let me have the propofol. So thanks to you!!!! I am not going in being uninformed.
Did anyone who’s had a colonocopy and was given Versed have problems with memory but nothing else? I didn’t think I had any issues during the hospital visit for the colonoscopy itself, but I am having alot of problems with my memory. Also, I just seem to be exhausted. Not your normal tiredness that comes with a hard day of work, but almost like a foggy, groggy feeling that I can’t seem to shake off.
Last week I went in for a routine colonoscopy. First one I had ever had. I definitely wish I had found out about Versed before having this done. I was well aware of what was going on during the colonoscopy, but I guess because of the medicine, was unable to properly say what I needed to say, and instead I simply cried and screamed for parts of it. I heard the doctor telling the nurse to give me additional medicine. Nothing seemed to help then they told me that they couldn’t give me anymore. It was awful.
For my colonoscopy this fall my preference is for no sedation at all. I was told that the doctor can use a smaller scope (to ask for a pediatric scope) to be used during the colonoscopy exam and that I should be fine. I just am not too concerned about discomfort, and am more worried about bad side effects from medications.
Does everyone think that it would be worth it to drive an hour and one-half to get to a gastroenterologist’s practice that offers something other than Versed for sedation? I’m in a small town and all of my local physicians think that Versed is the best thing ever to use for colonoscopies. I am worried about the potential side effects and would rather drive out of town if that would be useful. But I also don’t want to overanalyze this and thought I’d ask you all for your thoughts. For anyone who has had Versed, do you think knowing what you know now, would you drive out of town to avoid this?
Based on my husband’s experience with a colonoscopy, if the doctor isn’t willing to answer your questions, then yes, I would start over and find another doctor. Patients are becoming more informed these days and it is perfectly normal to ask questions. Being treated as if we are not supposed to ask questions would send me running out of that office. And I’m sorry that you had this experience. Good for you for listening to your gut.
I met with my gastroenterologist yesterday. He said they use Versed at the practice and I ‘shouldn’t worry’ about anything. But I am worried! I was treated as if my concern about Versed wasn’t warranted, and now I think I may have to start all over to find another doctor.
I had my colonoscopy exam a few months ago without sedation. Just pain control. It was not something that was pleasant but certainly not something in my opinion that was unbearable by any means. And getting screened is the most important thing. I agree with the others who say that colon cancer is an awful illness. I thought I could put up with some inconvenience and a bit of discomfort just to know I wasn’t living with something that could turn into cancer someday.
My colonoscopy was done with some Valium and the fentanyl. My gastroenterologist was patient and gave me the pros/cons of not having really strong sedation, vs having the pain control and light sedation so that I was aware and awake. My insurance wouldn’t pay for the propofol sedation and looking back on it, it wasn’t a bad experience for me without being asleep. But this probably does depend on one’s doctor and if they are rushed and in a hurry, I can see where the procedure could be painful.
My husband was prescribed the tablet (Visicol), not quite sure if that’s the correct spelling, for his colonoscopy preparation instead of the drink that they normally do. But I noticed that there was another article here which said that the FDA says that the tablet can be dangerous for people over a certain age. My husband is 64, and I wonder if there could be a safer way for him to get ready for his colonoscopy. Does anyone know what I should ask or have suggestions if we are concerned what to do?
Re: Colonoscopy and Sedation
I’ve spent days reading over all of the discussions about pros and cons of different sedation type medications for colonoscopies and have concluded that I wish to try just the pain medication fentanyl. I think if the doctor is a good one and uses what has been discussed here in terms of the small pediatric scope, that I will be better off not having the sedative medicines. My colonoscopy is scheduled for a few weeks from tomorrow and I’m still quite nervous about my decision, but I think that will be in my best interest not to undergo the sedation.
RE: Is Fentanyl considered a sedative even though it is given for pain control
This is a really good question and I will do my best to answer. My ex-husband was an anesthesiologist and I am a nurse so I have some information about these types of questions.
First, fentanyl is in a class of medications called synthetic opiates and is primarily given for pain control ie: analgesic properties. It is considered more potent than morphine and is used during procedures and to manage pain post surgical procedures. Now, opiates including fentanyl can have some effects that are sedative on the body, but in general these types of narcotic agents are not considered to be very good sedatives. Meaning that they can have side effects that cause sedation, but are typically not used as a primary means of causing sedation. There are other medications that do a better job of primarily functioning as sedative agents. Hope that helps!
If fentanyl alone is used,wouldn’t that count as a sedative as well as a pain control drug even though it’s classified just as a pain control drug?
Thanks everyone for all the tips and help with learning more about the questions I should ask about having a colonoscopy, to the types of colonoscopy preps that are better, and finally, to learning more about the sedation types of medications that are used during a colonscopy. I had my colonoscopy procedure this morning, with propofol, and I had no problems or anything with it. I woke up and felt like I had a good nap, wasn’t groggy and even went back to work this afternoon to catch up on some paperwork. Definitely the hard part for me was doing the prep, but even that wasn’t as bad as I thought. I used the Miralax Dulcolax prep instead of the GoLytely that my doctor initially wanted me to use. He was ok with me doing the Miralax Dulcolax one as long as I cut down on my food intake several days before.
Re: Versed for Colonoscopy
I have the same question about using Versed for Colonoscopy. What could be in this medicine that causes such terrible reactions in some people? And my doctor also told me it was something that was fairly quick acting? So why then are people so groggy for the remainder of the day after having a colonoscopy with Versed? My cousin actually had his colonoscopy at the VA Medical Center and they don’t use Versed there, but they use Valium and fentanyl. He wasn’t “out of it” for the rest of the day and did remember what the doctor told him after he woke up following the procedure.
Jack, I’m scheduled for a colonoscopy in two weeks and called my doctor’s office today and they said they use Versed. I didn’t know about Versed until finding this material on this website. It is kind of frightening though to hear all the accounts of people having trouble with using Versed as sedation. Do you think Valium would have the same bad effects as what people are reporting with Versed?
Versed is in the same drug class as Valium. Think of it as a more powerful, shorter term Valium. It’s primary
use is NOT as an amnesiac. It is used to reduce anxiety. You could do the same thing by drinking a six
pack of beer. If you drink the beer, you are likely to forget some of the things you did, also. But you rarely
hear the beer companies advertising beer as an amnesiac.
RE: Getting a Colonoscopy and Asking Questions
I’ll be in the same situation sometime this summer when I turn 50. And like so many of you–I’ll be investigating my options and will not simply expect that the doctor will do the right thing. I’ve learned a great deal from reading about your experiences. It is so brave of you all to share what happened with Versed and to also help some of us who’ve not been down the road before about asking questions to know that not only is it ok to do. But necessary. I’m leaning towards really trying to find a doctor who will not use any types of sedation. I’ve had three children and consider myself to have a high tolerance for discomfort. The one thing that bothers me is getting a medicine that could have long term effects.
Reading about preparing for a colonoscopy made me very nervous and then I found this page and saw how that it can make a big difference what medicines are used during the colonoscopy for the sedation part. I don’t understand why Versed is used if it is so bad. That is really terrible in my opinion to have something used if the effects are so poor.
Re: Versed for Colonoscopy Sedation
Sarah, I had Versed and had no problems with it at all, so I guess I want to say not everyone has a bad experience with Versed. However, because you are saying that your doctor won’t even discuss sedation options, that is a bad sign in my opinion. I totally agree with you that it is important to have frank discussions with your physician and if they are not answering questions–then yes, they will lose patients and people will go somewhere else. There are enough reports of people having poor experiences with Versed I think that it makes sense to question it and see if there is something else available that could be safer. I’m sorry you’re having such a hard time with your doc. Hope you can find someone else who is more open to discussions about colonoscopy options and medications used for colnoscopy.
hi how can I get in touch w/Luanne;I have questions regarding the sedation aspect of colonoscopy. thanks.
Versed is the only medication that my gastroenterologists doctor’s office said they are going to use. I am so upset and going to ask my husband about driving 60 miles away to the next town to find a physician who will give me more options when having my colonoscopy. I thank you for bringing this information to the forefront.
Meeting with the gastroenterologist in two weeks to talk about other sedation options other than Versed. His group still uses Versed although the other group in town has all switched to propofol. I’m really going to push for not getting sedation at all but will ask him what he can use to control the pain. The reason I’m using this gastro instead of the other group that’s switched to propofol is that the other group’s doctor’s won’t even discuss options with a prospective patient. I decided I didn’t need to discuss anything with them either if they weren’t interested in talking with me:-)
Had some health issues for about 2 years then in March of 2010 underwent a colonoscopy exam. Had no problems at all with the Versed. Don’t remember anything though about the doctor talking about the polyps he removed. And the rest of the day was totally shot. Went home, got something to eat and was a couch potato for the rest of the day. If there was a medication that would not cause me to lose the entire day like this I’d try it.
I think there are a few things that matter when you’re having a colonoscopy
1. Having a good GI doctor: This means not only competent but someone who is honest and who will tell you the truth about choices starting with sedation etc.
2. Having a good facility: Making sure that the staff is competent and doesn’t freak out if you’re not having Versed. I had mine and when the doctor said that I wasn’t having Versed, this got the nursing staff in a tizzy.
3. Making sure that you get information from the choices available to you for colonoscopy prep, to sedation, to recovery, and how these choices can affect your return to work etc.
Re: Versed and Fentanyl not working
Sarah, Just hearing your story makes me cringe. I guess I just don’t understand why patients would be forced to go through such pain when it’s not necessary. That’s horrible that you also went through that kind of treatment. I think if that happened to me I would be so scared to go in ever again and have anything done. Are you finished with these kinds of procedures or were you told that you need more follow up? And do you have any advice or words of wisdom for what you would do if you had to have either a colonoscopy or endoscopy done? Do you have thoughts on propofol or other options? Thank you for discussing this. I’ve been terrified to have a colonoscopy since my husband also had terrible problems with Versed. I keep avoiding it but ultimately one day I’m going to have to go in.
I also experienced a traumatic event with versed/fentanyl not working. I was scheduled to have BOTH endoscopy and colonoscopy. they tried the tub in my throat and I pulled it out….said sedative wasn’t working, so went on to do the colonoscopy….major pain and I even asked if it was supposed to hurt that bad. The doc/nurse said sedation must not be working we will give more.
they tried the endoscopy again and has to hold my hands down to stop me from trying to pull the tube out as i had done during the first one…..I was crying and in pain and they just forced me through it…not a good experience
Re: What is the pain level with a colonoscopy
Polly, Candy and everyone else who talked about this. I am so glad to have your comments. Even if I read something where the colonoscopy did not go well, just having info about it helps me so that I know what to ask when I go in. Polly, thank you for telling me the pain level compared to childbirth. That also gives me a clue about what to expect should possibly the sedation not work, or if I choose not to have it. Polly that is really awful that you went through such an awful experience. I hope that you know how much your wisdom is helping others by your being willing to be so open about your situation. May you have healing….
Hi,hoping someone can respond back to me as i have my first colonoscopy coming up soon:
Hi,wondering if you know where/how I can access a list of GI drs.,specifically ones that will work w/me regarding type of sedation or lack thereof in addition to these drs. having had being used and referred by other people(patients and their families). thanks,M.Reiter
Re: How to Prepare for Colonoscopy and What Prep Should I use?
Meagan, my daughter is only 18 and has had 4 colonoscopies already so I can understand how hard this can be. I agree with Luanne who said Dulcolax Miralax prep works really well. Do be careful about the tablet prep. Here is a post giving more information about that:
http://www.hospitalsoup.com/health-e-living/colonoscopy-prep-is-your-doctor-giving-you-the-whole-story/
And Here’s info about the Dulcolax Miralax protocol to prepare.
http://www.hospitalsoup.com/health-e-living/preparing-for-a-colonoscopy-making-preparing-for-a-colonoscopy-easier/
I’m also glad to help support you if you need further information. I know it’s hard but the best thing to do is to either bring someone with you to the appointments who can be your advocate and ask questions or to advocate for yourself in getting answers. It’s easier to have someone with you I think, even just for support, but make sure you get your questions answered. It’s your body so you deserve to know what your options are and then make a plan WITH your physician, not have the physician make their own plan.
Re: What to Ask for Before Colonoscopy
Hi Meagan, I’m so sorry you’ve had all these experiences already at such a young age. I didn’t start having bowel and abdominal issues until later in life, but I know it is a difficult thing to go through.
First, the easiest prep in my opinion, after many many colonoscopies, is to do the Miralax Dulcolax prep. If you need more info on that let me know and I’ll send you the info. My gastroenterologist lets me use that one because it works, is the easiest on my “old” body, and most old timers with colonoscopies generally recommend this one over most of the other ones. The pill prep I think can be dangerous to the kidneys so I stay away from that one.
But find out what prep you had last time. One of the worst I think is also something called GoLytely. I can’t tolerate that one, so find out which one you had and then let me know if you need more help.
Versed, is not a great option for sedation either, in my opinion. It supposedly will make you have amnesia but this does also not always work and it does nothing for the pain. I prefer the propofol because it doesn’t leave me groggy at all, and I have no pain with those exams.
If propofol for some reason is not an option, then I have also had exams with just some Valium pre-procedure to relax and some fentanyl during the procedure for pain.
Please write back and let me know how your appointment goes this afternoon and if you need anything else, please ask.
I am 26 years old and have never had a colonoscopy. I was diagnosed with Crohn’s disease at 24 and have many issues with all the testing I needed to get done before I had the diagnoses. I have had to eat radio active eggs, drink barium and take many x-rays, swallow a camera pill and many others that were very uncomfortable. When I drank the barium and they took moving x-rays of my stomach they found over 10 polyps. I tried to have a colonoscopy about 2 years ago but the liquid prep made me so sick I couldn’t drink it all. My doctor informed me on my last visit that there was an alternative prep that is a pill. I hope that this prep will be better. On my first endoscopy I don’t remember anything, they told me to lay down and the next thing I remember is them telling me I was all done. I didn’t have any issues with the drugs given to me during this procedure. The second endoscopy was done a few months ago and it was awful! I remember everything and my doctor was not being gentle with the tube (I think she thought I wouldn’t remember any of it). Since I was awake, I fought the tube going down and I believe thats what made it so painful. Even after the procedure my throat hurt so much for days after. I have an appointment this afternoon and will ask what drugs she gave me last time and what drugs they plan to give me for my colonoscopy. I think I’m going to ask about the propofol to make this a little easier. I’m a little scared about the entire procedure, prep and all. I feel like I’m so young and I shouldn’t have to be dealing with any of this. If anyone has any advice or comments please don’t hesitate to write back.
Anna, the pain level is different for everyone. I “woke up” during a colonoscopy, and would rate the pain level for those couple of minutes as a ” 9 ” . ( In comparison, childbirth pain to me was an “8″ at it’s worst.)
Versed is not a pain killer, and while medical people have been trained to tell patients it is given to help them relax, in truth is it used to make the patient compliant, with amnesia of their experience. That is a benefit to the medical team, but not necessarily a benefit to the patient. What bothered me was the lack of compassion from the doctor & nurse when I WAS awake, no doubt because they didn’t expect me to remember it. According to my records, I was given more Versed at that point ( remember, no pain-killing properties) instead of more pain medication. I remember feeling my body go slack, but no relief from pain, and then blackness coming over me. I can’t help but wonder if I was in pain the whole time.
My problems with Versed have to do with the deception surrounding it’s use, and almost universal lack of true informed consent. I would possibly consent to Propofol in the future, but only if I had a doctor who was competent, honest, and compassionate…whom I could actually trust. Where do I find one ?
Having a colonoscopy in two weeks. Going to call the doctor’s office and ask if he will do the exam with pain control only, and NO Versed or other types of sedative medications.
Seeing the gastro this week about a colonoscopy. I’m 52 years old and this would be my first colonoscopy of my life. I really need to minimize my time off work so I’m hoping that the one I’m using will not use Versed so that I can go back to work after it is finished.
How much pain could there be having a colonoscopy without Versed or any of the sedatives? I mean, on a scale from 1-10, (one being no pain and 10 meaning that it is the most awful pain ever) how much pain could there be?
Re: Propofol for Colonoscopy Sedation
My husband’s gastroenterologist said that their practice had stopped using Versed at all and that all doctors in their group are now using Propofol for all patient colonoscopies. I guess we will find out how he responds. DH’s colonoscopy will be scheduled sometime during the next 3 weeks. I’ll let everyone know here how he does. Have found the help and info here really useful. Thanks!
Propofol was used during my colonoscopy testing. Reading through several of the comments from people talking about their experiences it looks like most of the problems were from people getting Versed. I didn’t have a bit of trouble with propofol. Anesthesia was there to give it to me, and I woke up and could remember everything up till the part where I had the medication. No problems luckily either with my exam itself, so the whole thing wasn’t bad at all. The prep was for sure the worst part for me–once that was done, I had no problems.
My colonoscopy was performed without any medications at all. I had some mild discomfort, but it wasn’t anything that I wasn’t prepared for. After having 3 children, the colonoscopy was not bad. My body doesn’t respond well to medications and side effects was something I was concerned about. My gastro warned me that it would not be a pleasant procedure, but all in all it is something I would do again without being sedated.
Re: Medication that Katie Couric Rec’d for Colonoscopy
Hi Angie, I don’t know about the medicines that Katie Couric had during her colonoscopy but when I had my last colonoscopy exam I was given fentanyl for pain only. I put in writing no sedation at all, and wrote in specifically on the informed consent form under no circumstances was I to have Versed or other sedation type medicines.
Has anyone had a colonoscopy with just the medicine that Katy Couric received so that you can talk and see and understand everything that’s happening during the examination?
Re: Gastroenterologist appointment for Colonoscopy
Hello Alexandra, good luck with your physician’s appointment. Just to let you know I had my colonoscopy a few weeks ago. I opted for no anesthesia at all and it wasn’t bad. My doctor took her time and didn’t rush through the procedure which I think helps. I got some pain medication and she used a pediatric scope. I would ask what size scope they are going to use because I think the pediatric scopes are also less painful.
Going next week to see the gastroenterologist for a consult for a colonoscopy exam. Have my list of questions. Everyone wish me good luck getting all of them answered. Generally they come in for a moment and then they are gone. This time I’ll be prepared. No Versed for me:-)
Re: FAP Patient and Colonoscopy with Propofol
What an awful experience for you to go through. I am so sorry that you experienced such incompetence from people who were supposed to know what they were doing. What you are saying makes total sense to me. My husband went in for a colonoscopy last year and didn’t want sedation because he’s an engineer and a pilot, and because he has a high pain tolerance and didn’t want to be “out of it” all day. Although he got the exam unsedated, I think they were rougher than they needed to be to “prove a point.” I thank you for sharing your story because unless patients speak up–things like this will go on in silence.
I avoided colonoscopy even though I am highest risk because I have a few friends (a doc and a nurse) who have long-term memory loss from Versed. This is a fact. I reluctantly agreed to colonoscopy with propofol only and the experience was a total disaster. I’m 51, a guy in great health (other that FAP) and my wonderful PCP (the nicest, most knowledgeable physician that you have ever met, plus she’s just plain nice) scheduled my overdue colonoscopy………I told them that I wanted an unsedated exam (I have a job that prohibits drugs; I’m an airline pilot and have a Ph.D in biochem, so I’m no idiot)……unfortunately they talked me into propofol (100kg, 6’1″ HEALTHIEST GUY THAT THEY HAVE SEEN)….the anesthesiologist who was supposed to be in charge basically turned the case over to a CRNA (who said that her 2 years of nursing school anesthetist training made her an “anesthesiologist”) totally blew my case. She started a propofol drip, and then proceeded to give me 3 80mg propofol bolus doses that dropped my BP thu the floor requiring massive doses of pressors…but she kep on giving me this stupid drug. I was gasping for air, severe chest pain abt still begging for her to stop…..I got over 500mg of propofol and woke up (much, much later) feeling run over by a truch, jaw bruised and heard the GI doc teling the CRNA to “stick to nursing, you won’t touch my patient again”…….she also yelled at the top of her lungs: he had an incomplete exam and now he will never come back for a repeat colonoscopy…….I was told to write on the consent: “I’m consenting to anesthesia only from an anesthesiologist not a CRNA” and to make the provider co-sign the consent….
My wife had propranolol for her colonoscopy a few years ago. I can’t remember exactly but I think she was told about the medication during her consultation with the doctor in his office. I was serving in the military at the time so I wasn’t able to attend the doctor’s consultation with her. She also said after the colonoscopy though that it was not a bad experience at all. In fact, she was able to drive herself home and do some kind of volunteer work later that day.
Cynthia, It was very reassuring to read that you had a colonoscopy with the propranolol and that your experience was ok. So good to know that there are some people who come through the exam ok. Did you have to specifically find a doctor who would give propranolol or did your doctor just use this always in the practice? Were you told information about the propranolol before the procedure so that you knew you would not be groggy all day etc? Any other help or advice you could share would be so welcomed. I’m just nervous about this and having more information helps me be less frightened. Thank you again for the help.
Proprananol was used on both of my colonoscopies and I highly recommend it. It was a piece of cake and don’t even dread the third one I have coming up in 2012!
My 50th birthday is next week and my family doctor wants me to schedule a colonoscopy. Had my annual physical a few weeks ago and got a referral form to see a gastroenterologist about scheduling the colonoscopy. I called the office to schedule an appointment about the colonoscopy test and asked some questions of the receptionist. Unfortunately, she wasn’t helpful and said I’d have to talk to the doctor during my initial visit. And she seemed very disinterested in getting my questions answered. Anyone else have this experience.
Lauren, I think you are right on track with listing out some of the most used choices for getting a colonoscopy. I’ve worked in the hospital for 8 years and normally Versed and a pain control medication is used, but more and more I’m hearing that patients are not pleased with getting Versed. Most of the gastroenterologists where I work are using the Proprananol now, but occassionally I think they don’t use anything for a sedative effect and just use something for pain. Whatever your decision, I think it is wonderful that you are researching options for yourself before you ever get to the doctor’s office. I always wish more time would be spent on giving everyone choices instead of just telling someone what they will be getting in terms of medication.
Thank you for sharing the info about getting a colonoscopy. Something that is puzzling to me is that I have read here about some people not having pain at all, whereas others say the procedure can be painful if you remember. Does the doctor who performs the procedure make a big difference in terms of how slow they proceed with regards to the amount of pain that one may feel with a colonoscopy?
I am still so upset this is difficult to write, but I feel I should let someone else know. I received Versed with a colonoscopy and although I was told I would not remember it–I most certainly felt and heard everything. I couldn’t move but also could not talk. It was really an awful experience and when I tried to talk to my doctor about this, I was told everything went well and there was nothing to worry about. I would encourage anyone who is getting a colonoscopy to do everything possible to avoid Versed.
So basically the choice of colonoscopy sedation medications is either getting Versed, Proprananol (not sure if I spelled that right) or having something like pain control only or possibly no medicine during the colonoscopy? I am turning 50 next month and while I want to be responsible and get checked out I sure am not very keen on getting something like Versed and having bad side effects from it.
I was shocked about how dishonest that many GI doctors are about colonoscopy sedation! Even after agreeing to do my exam without sedation (I have one friend who had long-term memory loss from Versed, and she’s a physician); on the day of the exam they coerced me into signing a sedation consent “just in case”. I reminded everyone that I wasn’t supposed to get any drugs and I thought that everything was fine. Then as I got on the table, the GI doc told the nurse to “lets get him relaxed”. As she approached my IV port with a syringe, I grabbed her wrist and asked her what was going on? Next thing I know, another nurse and the doctor grab my wrist and in the struggle, my IV cannula came out and both got stuck with a bloody needle. The doctor was silent until I got up and demanded an explanation; he had none. I stormed out; when I got home I got a call asking me to return for a blood test, I hung up and told them that I’m expecting a written apology from the doctor…The nurse who got stuck is freaking out, but I’m not going back. The hospital’s legal counsel said that even though I signed a consent to agree to testing in case of a needle stick, that I can withdrw that consent at any time and that’s what I did…..there is nothing that they can do. if they treated me like a human being, I wouldn’t be so stubborn. when did medical care in the USA become such a nightmare??? This is a true story and it happened last week. I have never been so angry in my life. The only comment from the doctor is: “yes, we agreed to no sedation, but we got you to sign a consent so any oral promises are invalid, we know better than you do…..”
Is it best to ask for no sedation at all so that there would not be any problems in being groggy for the entire day after getting a colonoscopy? I’m not going to want Versed that part I’m sure about, but I don’t think I need to be all sedated after the actual procedure is done. I was told that a colonoscopy only takes about 20 minutes and I can’t stand the fact that I’d be “out of it” on sedation medicines for the entire day.
I called and asked a local gastroenterology clinic (the one that has most of the doctors in town who do colonoscopies) about sedation choices and I got a fairly rude scheduler who said they no longer use Versed (which is a positive in my opinion) but that propofol is always used and they “dont take any special requests” for other types of sedation. I think they are getting too big for their britches or maybe they don’t need any new patients. Regardless, maybe they don’t need my business and if I have to travel to have a colonoscopy done without sedation…I’ll do so.
Trysta, How is your mom doing today? I just saw your message and wanted to ask you if your mom was doing better? The description you mentioned about the eye dropping is quite concerning. I hope you got some care from her physician and/or took her to the ER if the physician wasn’t available. The droopy eye can happen if someone has a stroke so I am just hoping and hoping that everything turned out ok for you. My dad had a stroke that was not treated until it was too late so I am always thinking it is better to get something checked out than be sorry. My dad was very stubborn and refused to go to the hospital, but if someone is having a stroke, there are medicines that can be given to prevent further damage but they must be given right away.
Please do write back and let me know she is.
Hi, my mom had a colonoscopy today. I am in town just for a few days to visit and thought that after this in and out visit she would be herself. Normal. Functioning. Not the case at all. Her left eye is lazy and looks as if it’s drooping off to one side. She cannot keep a conversation. She cannot stop vomiting. I made her asparagus and potatoes for dinner, she vomited shortly afterwards. I then brought her some soup, vomited after that, too. It’s now been over 12 hours since the procedure (they removed few small polyps) and is doing worse than at the dr’s office. I feel that people should be more aware of this procedure. How serious it can effect certain people and I really wish my mother would have listened to me before getting this procedure! I mentioned that a colonic is much safer and less invasive, and even purchased a 200 billion 10+probiotic for her to take. I sure hope she is feeling better by morning. My father had knee replacement surgery last week, now mom’s down and I have an 11 month old. sheez
RE: Is it ok to have a colonoscopy done by a General Surgeon
Karen, Gastroenterologists are trained specifically in the areas of the colon, and although technically a general surgeon “could” do the exam, I wouldn’t personally want anyone else than a Gastroenterologist performing a colonscopy if it were me or my relatives having one. If your insurance reimburses for the exam either way, then I would insist on finding a gastroenterologist to perform the colonoscopy. In my opinion, it’s just safer that way, less chance of complications, and much better in terms of the physician actually having experience with what is normal/vs abnormal once they’re in there taking a look.
I am scheduled for an appointment with a surgeon about having a colonoscopy and was wondering if it is ok to have a colonsocopy with a general surgeon instead of a gastroenterologist?
Oops, I forgot to add that his whole procedure lasted about 15 minutes. Seems like an awful lot of meds for a 15 minute colonoscopy.
Hi Janie. Our “informed consent” was greatly lacking as well. We have no idea why he was given Lusedra as well and unfortunately, we were caught so off-guard by it, we didn’t think to ask. The anesthesiologist showed up at the last minute and just said this was what she was giving him. He did have a pre-op appointment 2 weeks before and he was told he would be given Versed and Fentanyl, and if needed, propofol, but Lusedra was never even mentioned. And he was never told that any of these drugs were optional. A general surgeon did the colonoscopy (we are retired military and the procedure was done in a military health center. No choice of doctors here.) I am going to post our whole story and hope that folks learn from our mistakes. We should have asked more questions and didn’t. I am furious at myself for letting that happen.
He seems to be doing fine other than a 90+ minute memory loss. So far, no other residual effects – thank God.
Thanks for writing.
Thank you Cara and Angie. I appreciate any drug dosage information I can get. I am trying to get copies of my husband’s medical records to find out what dosages he was given. I will use your info as a guideline to see what he should have received if he had just gotten the Versed and Fentanyl and compare it to what he actaully was given in addition to the Lusedra.
Thanks again.
I am sorry this is so long but I feel it is really important for everyone to know about another drug that my husband received for his colonoscopy – Lusedra. I want everyone to learn from our mistakes.
This was my husband’s first colonoscopy so neither of us had any idea of what was really involved. He is retired military and we get our health care at a military health center (no choice of doctors here. A general surgeon did the colonoscopy, not a gastro-enterologist.) He had been told 2 weeks in advance that he would receive Versed and Fentanyl. The nurse called the Versed an “I don’t care” drug. He was NOT told that either drug was optional, nor was he told any of the risks associated with these 2 drugs. I am not sure if amnesia from the Versed was mentioned or not. I do know that he wanted to be relaxed, pain-free and didn’t want to remember the actual procedure.
On the day of his colonoscopy we had to wait 2.5 hours for his procedure to begin. The hospital was running behind and the nurses who usually administer the meds (Versed and Fentanyl) right before the procedure starts were busy. An anesthesiologist was called in to help out. She shows up at my husband’s bedside right before he was to go in for his procedure with 3 syringes already filled with meds. As far as I know, she had no idea how old my husband is, how much he weighs or what his health status is. She tells him that this drug is an “I don’t care drug”. I had to ask what the name of it was – Lusedra. She proceeded to tell him that: it was a new generation of drugs in (I believe) the propofol family; it doesn’t cause vomiting; it will decrease the amount of the other drugs needed (meaning Versed and Fentanyl, but I don’t believe she ever mentioned either of those drugs by name); and it wouldn’t give him that drug “hangover” associated with other meds. She asked if we had any questions. Well, this all happened so suddenly and so quickly that we didn’t have time to think and so we weren’t ready to ask any questions. And my husband was so eager to just get the thing done and over with that he foolishly signed the consent form. She NEVER told him the risks involved with any of the drugs he was given, nor how these drugs would affect him, nor what side effects they may cause. And he was NEVER told that any of these meds were optional. We have no idea what dosages he was given of any of the 3 drugs and we were never told why he was being given the Lusedra in addition to the other 2. No truly “informed consent” here.
The Lusedra started to affect him almost instaneously. And the anesthesiologist waited until he already had the first part of the dose of Lusedra to tell him that a side effect was itching (I had to ask where – it is in the perineal area and by that point he was already feeling it). He immediately had trouble keeping his eyes open, thinking and speaking clearly. She asked him how he felt and of course he thought he felt fine because he was already so spaced out. She then gave him the second part of the dose, quickly followed by the Versed and Fentanyl. By the time he was taken back for the colonoscopy, he was almost completely out of it. The procedure lasted all of 15 minutes. When he came back, he appeared to me to be completely unconscious and unresponsive. The nurse jostled his arm to get the BP cuff on and my husband just laid there. When the doctor came to speak with me, he laid his hand on my husband’s thigh and spoke his name and my husband didn’t even twitch. My husband did not move a muscle (except for his chest going up and down with his breathing) for over 30 minutes. The nurse said nothing about whether this was a normal reaction or not and unfortunately I was not thinking clearly enough to ask. Eventually the nurse started trying to wake him up and I would say it was about 10-15 minutes before he could keep his eyes open and talk somewhat coherently. He asked me the same question four times. He has no memory for about a 90+ minute time period. Once the Lusedra started, his memory ends. He remembers nothing for about an hour after his procedure ended which includes at least 30+ minutes after he “woke up” and we were on our way home. His mind was unclear until he woke up the next morning. So much for no drug “hangover”. He is very bothered by how long he was “out” and how much time he has no memory of.
I honestly believe he was extremely over-medicated for a procedure that should have lasted 30 minutes or less, and I think he had an adverse reaction to the Lusedra. I mean, being relaxed is one thing, being unconscious is an entirely different response. We tried asking the staff some questions a couple of days after the procedure and got nowhere. I suppose he could call the surgeon, but are doubtful he could answer our questions anyway. At this point, my husband believes that this Lusedra is a new drug that the anesthesiologist wasn’t overly familiar with and that she was trying it out on patients to see how they react. I tried to explain to him that it would be illegal for her to do that without specifically telling him it was a trial and getting his permission, but he still believes it anyway. And the more I think about it, the more I am starting to agree with him. He also wonders if someone “screwed up” with his drugs.
I am furious with myself for not asking more questions and protecting my husband. Something I will always regret.
The good news is that other than the 90+ minute memory loss, he seems to have no other residual effects – thank God.
I have decided that when the time comes for my colonoscopy, I am refusing any sedation whatsoever. I may take pain medication (and even that is still debatable), but I want to be awake and aware of what is going on and what is being done to me. Or I may see if virtual colonoscopy is an option for me.
Re: Proper Dosing of Fentanyl and Versed
Cathy, why did they your her husband Versed, Fentanyl, and LUSEDRA. This seems like it would not be needed to have all three of these medicines. Was he given any information about the sedation by the doctor doing the exam? Did your husband have an office visit prior to actually doing the procedure and was sedation ever discussed? Was it a gastroenterologist doing the colonoscopy? And who was responsible for giving him the medications? Was anesthesia involved and if so do you know the type of medical provider who administered the medications?
My husband was not given any informed consent about his sedation meds. I was in the room in the hospital with him when the nurse shows up after taking his glasses from him and then thrusts a sheet of paper in front of him and asks him to sign. That is not, in my opinion, informed consent. I found this website after that happened and I am advocating that all of us make sure that we are given information about the medications that are provided by health care providers.
I am sorry your husband had a bad experience, and hope that he is doing ok now.
Re: Dosing Guidelines for Versed and Fentanyl
Cathy, here’s some guidelines for dosing Adult Dose
Comments
Midazolam
(Versed)
0.02-0.1 mg/kg IV initially; if further sedation is required, may repeat with 25% of initial dose after 3-5 min; not to exceed 2.5 mg/dose (1.5 mg for elderly persons) and 5 mg cumulative dose (3.5 mg for elderly persons)
Onset: 1-2 min
Duration: 30-60 min
Respiratory depression or hypotension may occur, particularly when rapidly administered or combined with fentanyl (may need to decrease midazolam dose); does not provide analgesia; action reversed by flumazenil
Fentanyl
Adult Dose: 1-2 mcg/kg slow IV push (over 1-2 min); may repeat dose after 30 min
Onset: 1-2 min
Duration: 30-60 min
May cause chest wall rigidity, apnea, respiratory depression, or hypotension; elicits minimal cardiovascular depression; may cause dysphoria, nausea, vomiting, or EEG changes; action reversed by naloxone
Re: Dosing of Fentanyl and Versed
Oh my goodness Cathy that sounds like your husband had a traumatic experience. Please do share it. I am supposed to have my first colonoscopy in a few months and I am very scared about it.
Regarding dosing information here’s some starting doses for Midazolam (Versed). I have asked my friend who’s in the medical field to help me find info on the Fentanyl dosing….and will post as soon as he emails me back.
Adult and Pediatrics Versed (Midazolam Dosing)
Intravenous midazolam has been associated with respiratory depression and respiratory arrest, especially when used for sedation in noncritical care settings. In some cases, where this was not recognized promptly and treated effectively, death or hypoxic encephalopathy has resulted. Intravenous midazolam should be used only in hospital or ambulatory care settings, including physicians’ and dental offices, that provide for continuous monitoring of respiratory and cardiac function, ie, pulse oximetry. Immediate availability of resuscitative drugs and age- and size-appropriate equipment for bag/valve/mask ventilation and intubation, and personnel trained in their use and skilled in airway management should be assured (see WARNINGS). For deeply sedated pediatric patients, a dedicated individual, other than the practitioner performing the procedure, should monitor the patient throughout the procedure.
The initial intravenous dose for sedation in adult patients may be as little as 1 mg, but should not exceed 2.5 mg in a normal healthy adult. Lower doses are necessary for older (over 60 years) or debilitated patients and in patients receiving concomitant narcotics or other central nervous system (CNS) depressants. The initial dose and all subsequent doses should always be titrated slowly; administer over at least 2 minutes and allow an additional 2 or more minutes to fully evaluate the sedative effect. The use of the 1 mg/mL formulation or dilution of the 1 mg/mL or 5 mg/mL formulation is recommended to facilitate slower injection. Doses of sedative medications in pediatric patients must be calculated on a mg/kg basis, and initial doses and all subsequent doses should always be titrated slowly. The initial pediatric dose of midazolam for sedation/anxiolysis/amnesia is age, procedure, and route dependent
Hi. Could anyone please tell me what the standard dosages of Versed and Fentanyl should be for a 53 year old man, in good health, weighing about 210, undergoing a colonoscopy?
Also, does anyone know anything about the drug called LUSEDRA? My husband received this drug in addition to Versed and Fentanyl for his recent colonoscopy. We weren’t told why and soon I will post our horror story about this.
Difficult decision to make now about my colonoscopy. I’m glad I have the info but this will complicate things as now I have to ask my physician many more questions. Thank you to everyone who’s helped out by telling their story.
I’ve been reading all your info and postings about Versed. Does anyone know percentage wise how many people have difficulties with using Versed as the sedation during a colonoscopy? I’m supposed to have one early next year and I want to make sure that I’m clear on the risks before choosing a medication for my colonoscopy. Guess my next challenge is going to be finding a doctor.
RE: Colonoscopy Free or Low Cost Exam Information
Hello Amber, please send a comment back with your zip code as we will need this to look up resources for a low cost or free colonoscopy for you.
Need Colonoscopy and am 55 years old. I’ve never had a colonoscopy and was hoping someone could tell me how I could get one if a person can’t afford one. If I could get info about this I’d be very thankful. Thanks!
Re: What to do if you’re allergic to pain meds and don’t tolerate anesthesia well?
Hi MA, I’m a nurse so I’ll do my best to help you come up with some possible solutions.
First, are you allergic to all pain medications or just certain ones? If certain ones which ones are you allergic to?
And with regards to anesthesia have you had anesthesia more than once and had a bad experience? Do you know what medication were used when you had a hard time with it? And what exactly happens to you after waking up from anesthesia that is alarming? Sometimes people have medical conditions that require certain extras to be done during a procedure. For example, some people may require more hydration than others, or a different type of hydration. If I know a little more about what you were given before and what happens I may be able to suggest some things that you could ask for prior to aggreeing to a procedure that could help.
I am allergic to pain medications and don’t tolerate Anesthesia very well. I am scared to have a colonoscopy but know that I need one. Any suggestions?
I found this site while searching for help for my husband. I had my colonoscopy about 4 months ago and had no issue with it. I was given Versed, don’t remember anything and didn’t have any pain. Didn’t know that there could be problems with the drug, and probably would have never found out had it not been for my husband. His situation was different. My husband’s colonoscopy was a few weeks ago and he has had a variety of problems. First, he said he woke up during the procedure in severe pain. He was not warned that this could happen and it was upsetting. Then he has bowel problems, with diarrhea and cramping ever since. I wonder if he could have gotten something from the scope that could have caused this. He’s never had any issues before and this was just a routine colonoscopy not for any symptoms. He says his memory is very poor now and he’s having trouble recalling things for work. Like I said I didn’t know about Versed before and it sounds like we should have also been told about this. Anyone have bowel issues after getting a colonoscopy?
Re: Versed and memory problems
Anita, I’ve been waking up at night with nightmares and I just can’t shake the awful feelings I have had since my colonoscopy. My memory seems to be slipping as well but I don’t know if it’s because I’m not getting much sleep or from the Versed. Looking back I wish I had been informed about this BEFORE I had the procedure. Just wanted you to know you’re not the only one, and I hope things will eventually get better for anyone who has been affected by this drug.
Now I’m worried about my past colonoscopy. I had Versed and have been having lots of memory problems. It’s probably just a coincidence but I think we should be told from our doctors about the potential for these things to happen. I wasn’t “told” at all, but was given this sheet of paper on the morning of my colonscopy and told to sign it. Because I wear contact lenses and had been instructed to take those out I couldn’t even see anything and had to have the nurse tell me wear to sign. Guess that’s what “consent” has come to.
Re: having a colonoscopy with sedation
Jessica I’m so glad that you wrote in. From reading the different opinions here it seems as if some people are having no trouble at all with the colonoscopy even without pain medications or things like the sedatives or Versed, while others are in extreme pain. I’m very nervous about this because i’m “overdue” for my colonoscopy and while I’m pretty sure I don’t want Versed, I really am not looking forward to this procedure if I’m going to be in lots of pain either.
My dad had his colonoscopy without any sedative type medicines. He is a retired Respiratory Therapist and said “No Way to Versed.” The important thing though is to make sure that your doctor gives enough pain medication–just because you don’t want sedation does not mean that you wish to be in pain.
I must admit I found this information alarming. To know that there are so many times where a doctor does not inform us about the choices and safer choices for us when having these kinds of procedures done like, for instance, the colonoscopy. Thank goodness that we are being told of these options now. I am grateful to know.
You have some valid essential points regarding colonoscopy. Look forward reading much more from you in the future.
I found your website on google and read a few of your other posts about colon cancer. I just added you to my Google News Reader. Keep up the good work. Look forward to learning more about my health in the future from your resources here.
I’m heading into the hospital for a colonoscopy and endoscopy on the same day, which by the way is on the 3/11/2010
To be honest I’m utterly terrified at what could go wrong with the sedation side of things, not least because I’m already on sedatives and sleeping tablets for anxiety and insomnia.
The letter I got back from the hosiptal told me to bring a list of my meds, but they have not disccussed with me what kind of drug I’m going to be given or what the side effects could be, mind you I’m having this done on the New Zealand free healthcare system, and feel like I can’t make a fuss, plus if they screw it up, you can’t sue here, even if you go via the private sector.
I am still deeply disturbed from reading all your stories. Is anyone willing to share the names and cities of their doctors? I think that other patients should know about this when selecting a physician and simply writing to a doctor who probably is not going to care or listen may not be the best use of your time. By honestly letting other patients know however, about your experiences, maybe we could prevent these horrendous things from happening to another person.
Here’s another disturbing thought: How many other people have endured excruciating pain during a procedure with Versed, but just have amnesia of the experience ? Annie, they probably ignored your screams & pleas to stop because they didn’t expect you to remember it ! I expect I had a similar experience, but without the recall. How else can I explain the nightmares, terror, fear, and mistrust of doctors I have now ? I vaguely remember telling the nurse (after the procedure) that ” I will never trust a doctor again.” I cannot recall why I said that to her. And while I have no explicit memory of the procedure, I believe I have implicit memory of a traumatizing experience, and my conscious mind cannot figure out what happened….
I am truly sorry about what happened to you. It’s important for you confront the doctor about it.
My heart aches for what you must have gone through. And no that is not what should have happened. A persons pain should always bee controlled. I don’t know what else to say. I am really upset to hear this is going on. I have friends on the medical field and I’m going to ask them about this.
I agree this shouldn’t have happened. Are there not any protections we have against this?
Re: Excruciating Colonoscopy
Annie, That sounds awful. I am appalled that you suffered through that. Were you given any other options for sedation, or what information were you told about your procedure? I had something similar happen to me, but not at the pain level that yours was. Sometimes I don’t know if I can trust anyone in the medical field again after what happened. But I’m really interested in finding out what other people were told in advance of getting their colonoscopies. I wasn’t informed about my choices…didn’t know there were other things for sedation.
Thank you for talking about your experience. This, I think is the only way other patients will know.
Again, I’m so sorry for what you experienced.
I recently had my first colonoscopy. I was given 3 mg of versed, and 100mcg of Fentanyl. I could not believe what I endured for 40 straight minutes, Excruciating pain, unberable for the entire 40 minute exam. I am a very mature female, have been through many medical problems in my life, including the removal of a brain tumor. Never Had I screamed in pain, begging for more meds, or to stop the procedure. My screams were ignored. I felt tortured for the entire 40 min exam. Does this seem normal? The test came out fine, no problems. I will ever have this procedure again, too traumatized
Anna:
Re: privacy concerns.
I understand totally your concerns about privacy during your colonoscopy. I had the same issue and felt extremely uncomfortable especially since I was sedated with propofol and had no idea what actually happened to me. You may want to check out Part II of this blog. I recently posted essentially the same question and got a reassuring answer from another poster. I am sure the issue of respecting the patient; i.e. keeping them covered during the exam, differs from one doctor and/or facility to the next but with the current HIPPA laws regarding patient privacy (even though they don’t specifically address modesty) providers probably take more care to avoid any possible complaints. Hope this helps you. Just know that you are not alone in your concerns.
I would’ve had no idea about the different types of medicines that people are given during a colonoscopy. My husband’s 50th birthday is coming up in a few months, so I guess it’s good that I read this now. He hasn’t scheduled his colonoscopy yet, but when he does this will be very valuable info to know.
Re: Colonoscopy Sedation Questions
I am also concerned about patient privacy during one of these procedures. If anyone is in the medical field and can speak to this issue, I would greatly appreciate some additional information on this. I too had Versed during my colonoscopy and was disturbed to find out I can’t recall any details.
Re: Versed and Other Sedation Meds
You know it’s one thing if we as patients choose to have these drugs. But to not be told is just really bad medical practice. If there’s nothing to hide then why not tell us what our options are. But I guess if profits are the only thing that’s important, then it would make sense to have everyone so sedated that they have no idea what’s happening to them..and then just move everyone in and out of the procedure room as fast as possible. Kind of sickening if you ask me.
I found your blog on google and read a few of your other posts. I just added you to my Google News Reader. Keep up the good work Look forward to reading more from you in the future.
I had my first screening colonoscopy yesterday. I elected not to have meds and was wide awake. I had very little discomfort. My doc was great. It was interesting watching the screen and had a running commentary from the Doc. She told me when I should expect some discomfort and was right on, but no big deal. I was able to leave right away afterwards with no recovery time and walked out without a wheel chair. I would definitely do it awake again.
Re: Propofol instead of Versed
Rose, that’s good news. I’m very glad that your GI is not using Versed. My husband’s last colonoscopy he was given propofol and no Versed and he was up and about very quickly. And wasn’t all foggy thinking or anything the rest of the day.
Do you know what bowel prep your GI told you to use? This makes a big difference also, and I’m wondering if the more progressive GI’s are offering their patients choices in bowel prep.
My GI doc automatically said he was using propofol and sending me to the hospital where they have anesthesiologists. I didn’t even have to ask! So I guess I’m having the better of the two, and didn’t even have to ask. Lucky for me:)
It’s obvious that many doctors use midazolam (Versed) because an amnesic patient is cooperative and it’s makes their job easier; little or no thought is given as to what consequences the patient may experience from this drug. Reading the negative comments about Versed is quite telling; reading the many hundreds of Versed horror stories on askapatient.com or on versedbusters is downright scary. I can’t see how anyone can dismiss these negative Versed experiences; why would anyone lie about something like this? It’s obvious that Versed is a terrible drug for many people and that it is overused, especialy in colonoscopy. I recently saw a GI doc who said that Versed was great; then I pulled out a printout of 500 Versed horror stories fromaskapatient.com and asked him to explain why so many people have terrible experiences with Versed. He couldn’t. He told my wife that he personally had Versed for his own colonoscopy and when she said that she had difficulty believing that, he invited her to check it out (she’s a nurse at the same hospital). When he called to convince me to keep the appointment for my colonoscopy, my wife got on the phone and asked him once again if he had received Versed for his own colonoscopy; again he said: “of course”. My wife replied that he was lying since her cousin was the anesthesiologist who administered the propofol during the doctors colonoscopy. So he lied. All he would say was that propofol was an option if I wanted it. I asked him directly: “why did you lie to me about receiving Versed yourself”? He was clearly at a loss for words, mentioning something about being a doctor and knowing better and that patients are better off not remembering the colonoscopy. What a lying scumbag. And propofol can be a dangerous option also if it’s not given by an anesthesiologist. Many places have nurses (CRNA) administer propofol since they are cheaper than an anesthesiologist. CRNA can legally give propofol, but I don’t want anyone but an anesthesiologist administering this drug (and so did the GI doc who lied about getting Versed). See a pattern here everyone? Colonoscopy is a big profit-driven business; profit is everything, patient safety (using CRNA vs anesthesiologist) and preventing patients from horrible drug side-effects (Versed) don’t matter.
Hello Paula,
I’m not in Minneapolis, but I can tell you that I think it is worth it to find a doctor who will use something other than Versed. My sister lives in Ohio and made the trip to the Cleveland Clinic and had a colonoscopy using propofol instead of Versed, but she had to specifically request that type of sedation.
There was a quote I read made by a pharmacist who said ” Versed (Midazolam) and Fentanyl are the choice of proecedural sedation for colonoscopy patients…..whereas , “propofol requires more-careful hemodynamic and respiratory monitoring…….” and this may “NOT BE AVAILABLE in all practice settings.”
When you analyze what he’s saying what he means is that Versed (Midazolam) and Fentanyl combo for colonoscopy sedation is the #1 choice because a) everyone has it …in all practices, and because it is used so much there’s no special training over and above what’s required for medical personnel to have about using what’s called “conscious sedation” , and it doesn’t require another provider to administer it..meaning that your doctor can have his nurse administer it etc. Just because it is the #1 used medication, doesn’t mean it should be the # 1CHOICE for patients. In fact, unless we ask questions we will be given what’s most convenient for the doctor
HOWEVER, behind the techo-babble about PROPOFOL….if you look at the meaning behind the words, you’ll see that there are two issues why health care professionals may be opposed to propofol
#1. It does require more careful monitoring.. But his can be a blessing for patients. Because it requires more careful monitoring it also requires someone who is TRAINED to administer anesthesia. This means getting someone else involved in the procedure..which can complicate matters for your doctor if he/she is not properly setup to have someone available to do the sedation using propofol who is an ANESTHESIOLOGIST, or CRNA, again these people are TRAINED to do anesthesia and would only be responsible for monitoring you.
#2. The Second objection with some provider’s use of propofol can be found in these words (“May not be available in all practice settings. ” So in reality what we’re saying is that not all doctors have the capability to use propofol in their practice. But larger facilities like the Cleveland Clinic, in my opinion, DO have these capabilities, so if we are ASKING before scheduling an appointment do you provide anesthesia with propofol instead of VERSED, then we can save ourselves alot of time by using that criteria for us as patients to rule in or rule out a gastroenterologist BEFORE we even book an appointment, based on their answer to that specific question.
Because you’re in Minnesota —I wonder if finding out if anyone at the Mayo clinic could offer you a colonoscopy procedure without getting Versed. It’s similar to the Cleveland Clinic in that patients from all over the world choose these larger facilities, and they may be more qualified and capable of providing the propofol for you as a sedation choice.
Does anyone know of a good doctor in the Minneapolis Area who will do a colonocopy without Versed? I will need to have a colonoscopy done sometime this summer but I am opposed to having the sedation using Versed. My family doctor is trying to tell me it’s “fine” but I don’t care what he says, I would prefer that another anesthesia be used. My brother in law had his colonoscopy last year and had the sedation where you need the anesthesia person involved and had no troubles at all. He did however have the GoLytely prep which I will try to avoid after reading the info about patients finding the Miralax type easier to complete. I’m really nervous about getting this done and I hope I can find a decent doctor.
I had a colonoscopy back in February with Versed. I will not have this medication ever again, and did not know that there were other choices. My doctor, nor his staff, nor nurse ever told me, even though I have a family history of colon cancer and have to be screened regularly. Apparently, they had used Versed on me 5 years ago when I was last screened, and I can’t recall any problems, but after this last experience, will never use it again. Why isn’t it required that we are told about these other options before we have a procedure?