In HospitalSoup.com’s series on the importance of getting certain screening exams, like colonoscopies, our nursing reporter uncovered some interesting information. Over 95% of all patients that we surveyed who had previously undergone a screening colonoscopy were not aware of what medications they were given, nor were they aware that they had a choice in requesting that particular medications not be used during their procedure.
Let’s first discuss some important facts about medication and how it is given in most cases when you are a patient in the hospital or in an outpatient surgical setting. Most of the time as a patient you are not told exactly what the name of the medication that you are being given. Additionally, let’s think about the setting and your frame of mind when you arrive for a procedure. First of all, you may have had to fast for a particular number of hours in preparation for a procedure. Certainly, the colonoscopy preparation procedure requires fasting as well as hours spent in the restroom so that one’s bowels are clean. Then, you generally either have to get up at the crack of dawn or well before dawn depending upon where you live, the traffic, and the time of your procedure, and finally when you arrive exhausted at the hospital or surgery center, you are then checked in, placed in a room, told to remove all your clothes, and put one of those very attractive hospital gowns on, and asked to sign a multitude of papers. Your glasses and personal belongings may even have been removed so that you are signing papers which you can’t even see, but in your tired and hungry state you may be so focused on getting out of the hospital that you’re not too concerned about what you are being given or the documents you are signing. The next step after you’ve handed over your glasses, stripped out of your clothes, and are possibly nervously awaiting your procedure, is that you will probably be approached by a nurse who comes in with a huge smile and pokes you in the arm to start your IV. You are probably then approached by either the same smiling staff member or another member of your medical team with an equally large grin that you will be “given something to relax”. Not one to want to ruffle any feathers and certainly wanting to be a “good patient” you probably simply say “ok” and may be totally oblivious to what happens next. And some of you may want it that way. But others, may want to know what’s in the IV before it’s being given, and you also may want to know that sometimes there are options for different medications that could be given if you as the patient had two things in your favor. Those two things are 1) the ability to know in advance what medicines are used for a particular procedure and 2) the ability and time to ask questions about the medications and to ask about alternatives prior to your being in a rather vulnerable position (ie: without your clothes, without your doctor there to ask questions of, in an unfamiliar atmosphere, around people who all see to be in a hurry, and feeling like you may be holding up the entire hospital’s schedule if you happen to open your mouth).
Now, please dear readers know that this article is probably going to ruffle some feathers in the medical community and this article may not be popular with some medical professionals. IMPORTANT: This is not meant to discourage anyone at all from having screening procedures, on the contrary, it is absolutely critical that you understand as a patient that having certain screening procedures like colonoscopies can be absolutely life saving! On the other hand what this article intends to do is to illustrate the reality of the fact that it is really critical we believe to provide adequate disclosure about medications that are given both before, during and after any type of medical procedure so that we as medical professionals do a better job of actually getting informed consent from our patients. Equally important is the knowledge that you as the patient, have every right to find out what’s being given to you while a patient in either a hospital, surgery center, or in any type of medical setting. Our next article will discuss the types of medications that are given generally to patients having a colonoscopy and options you need to know about before going to the hospital or having certain testing performed. Stay tuned, and let us know if you would rather understand what types of medications are used when you have a medical test performed, or if you’d rather know know.
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Re: Experienced Nurse/Patient
Thank you for posting. So helpful to finally know that I’m not the only one who had trouble with Versed. If you personally needed a colonoscopy or some procedure that required sedation do you have suggestions on which medications you would request that are safer with less side effects?
I work in a hospital and have seen many colonoscopies and have to say that the usual “conscious sedation” with versed/fentanyl is often a brutal joke….resulting in a patient who is actually wide-awake during the procedure, but rendered unable to speak, move or complain of pain, thanks to Versed/fentanyl. the patient can be screaming for the doctor to stop, but the Versed temporarily supresses this painful memory (and patient abuse) until the patient gets home. I would never consent to amnestic meds like Versed, and I put this on the consent and have the anesthesiologist also sign it.
That is why I have never had, nor will ever have, any form of invasive procedure and also why if I go to see any medical “professional” I demand to know absolutely everything and still will not consent to anything until I have had a chance to check it out on the internet. I also have an advanced directive set up to protect me as I dont trust 99% of medical people as far as I can throw them.
My doctor has been trying to get me to do a colonoscopy for 2 years now as I’m 52 years old. Because I was laid off for the past few years I’ve been reluctant to have to go into debt in order to have this test. Next week I have a few job interviews so it’s possible I’ll have insurance again and so was looking into which doctor to choose for the test if I can get insurance coverage. While searching for help on getting a colonoscopy I found this discussion. I’m nervous now about having Versed, but this isn’t the first time that I’ve heard of others having issues with a medication like this. My neighbor’s daughter is a CRNA and even she says that she won’t have Versed because I spoke to her about it and asked her opinion. I am thankful that you have shared your personal stories. That gives an older lady like myself the courage to speak up and ask for something else if I do get some health insurance again and can get the colonoscopy test scheduled.
I haven’t had a colonoscopy and I’m 56! The reason has been Versed. I went to the hospital 6 YEARS ago to get an operation on my broken arm. I explained my paradoxical reactions to anesthesia, going back to childhood. I break bones from time to time and have to have surgery… Anyway, I give permission for a nerve block and pain meds, which by long personal experience works best on people like me. No sedative drugs and no general anesthesia. There is study after study showing that this is the best way to do it for any patient, let alone one like me who fights the drugs.
After listening to me and hearing me state over and over not to use anything that would incapacitate me and no general anesthesia, guess what I got? Yup, “vitamin v” (a simple muscle relaxant) and then general anesthesia because I “didn’t object” after they gave me Versed.
My memory has never returned to normal. I used to have a genius IQ and now I don’t. I never had the extreme anxiety issues that I have now. I didn’t have nearly uncontrollable rage either. I was “a pleasant woman in no distress” before the crna decided in his infinite wisdom to assault me with drugs against my will. (I won’t have another crna either and trust me I will make sure that no nurse can masquarade as an anesthesiolosgist again like last time!)
The Versed didn’t cause amnesia and I listened in helpless rage while they talked about me. It was all very uncomplimentary and insulting. I obeyed them like a good dog, even though I was trying to DISobey them and leave the hospital. They lied about why they gave me g/a. I remember everything, so I could prove to them, item by item, that they were being somewhat less than truthfull (ahem) about events that transpired in the OR. I still can’t quite believe how I was treated by my esteemed medical workers.
The upshot of it, I will never have Versed again, under any circumstances, at any time. Nothing in my life would be worse than getting Versed. Not only was my “trip” horrifying, my personality underwent a severe change from happy, stable person to PTSD plagued lunatic, with the thinest veneer of self control. Horrible!
The good part. I called the colonoscopy people in Spokane Washington and guess what? When I specified an UNSEDATED COLONOSCOPY the chirpy girl on the phone said “sure, we offer unsedated colonoscopies! The DOCTORS have them all the time. We have a particular physician who does all of our unsedated colonoscopies!” No arguments, no platitudes, no acting like I am the stupidest person on the planet, at best an insane person, nothing like that at all! I might be having that colonoscopy. Just as soon as I’m convinced that it is actually medically necessary and not just a ploy to suck more health care dollars out of the patient. Can’t have my gp mad at me for being the dreaded “non-compliant” patient!
I received my medical degree in the Stone Age (I’m 57) so take what I say with a huge grain of salt. My career isn’t medicine, but in our rural community I still see lots of patients on weekends, mainly because nobody else is available…mainly family practice stuff. If you see me and you are over 50 I try to convince you to get a colonoscopy; for reasons that I still don’t understand, almost everyone actually gets one. Hey, I wear blue jeans without a necktie when I se patients, hardly anyone’s vision of a doctor. Anyway,I recently became aware that many patients were having horrible sedation experiences (PTSD, long-term memory loss etc) after getting a single dose of midazolam. What? Isn’t this a simple benzo? My patients can’t afford propofol; which they couldn’t get anyway because we don’t have an anesthesiologist at the endo center (crna don’t cut it for deep sedation working alone..sssshhh don’t tell my crna wife)….when I read that midazolam (versed) was considered a patient-control drug, I laughed..until patient after patient told me of their horrible midazolam experience..yes, and I “sold” them on versed/fentanyl sedation…what a mistake.
Harry, I’m glad you wrote in also. I work in a hospital and was very surprised when I found out about Versed also. I wouldn’t have even known to ask if I hadn’t stumbled upon this article. In fact, one of my co-workers told me about the articles on this website and to read them before my colonoscopy because her husband had really bad side effects from Versed. I didn’t think much of it until I started investigating further. Now instead of just assuming that it is the patients who are all imagining these things I tend to think there is something to this because of all the issues that are identified with Versed probably not being that great for patients, but being more of a benefit to the providers because they can push more patients in and out more quickly. And we all know that the quicker the procedures are done the more $$$$ is made.
I’m glad that I found this website before I allowed my EGD, colonoscopy and ortho scope/surgery to be done with midazolam. I’m a 57 year-old guy (with medical credentials), but I have gone thru life assuming that the providers who treat me will always do so with my best interest in mind….so I assumed that the thousands of “Versed horror stories” must be nonsense; right? After doing my homework and asking pointed questions of the anesthesiologist (I would NOT trust a CRNA to participate in my care), I learned several things: Versed is often added to induce “cover their ass amnesia” just to get the patient out the door, dazed, confused and temporarily amnestic. Then they get home and 10% have terrible mental trauma. No doctor that I know would consent to a colonoscopy with the usual versed/fentanyl cocktail…but routinely lie to their patients about versed and what it actually does.
To answer the first question: NO; To answer the second question: YES
The reason patients don’t know what medications they’re given is because no one tells them ! I was given Versed & Fentanyl for my colonoscopy, but ALL the consent form said was that I would receive “conscious sedation.” To me, “conscious” meant awake; “sedation” was something that would help me to relax during the procedure.
I was WRONG !!! To medical people, “conscious” is awake, feeling pain, with memory impairment, and “sedation” is a drugged-up frightening feeling where you’re practically unable to move, and unable to articulate any meaningful words.
I do not believe for one minute that medical people forget to tell us these things, or that they’re too rushed to do so, or that they think most patients won’t care anyway… I believe that they know many patients would have a problem with Versed if they knew the truth.
In my case, it was a “double-whammy” : Fentanyl made me extremely dizzy & nauseous for hours after the procecure ( no one thought to tell me I would be receiving narcotic pain medication either, and it is something I cannot tolerate !!); and Versed did not relax me, it created anxiety, fear, agitation, and severe depression for months afterwards. This ” routine screening procedure ” caused me more anguish than anything else in my life.
Re: Versed is Not The Gold Standard for Colonoscopy
Susan, I agree with you 100%. Why some physicians insist on giving Versed is beyond my comprehension. Well, on second thought — I guess maybe if more money is the issue and having zoned out, zombie like patients so that they can get procedures done faster is the goal, then the providers have succeeded.
But I can see really no benefit at all in getting Versed for the patient. There are other options–and finally, the practice in my area has stopped using Versed. So I guess that’s at least a small victory, that some offices are no longer using it. I send this thread and the other one on Versed to all my friends, family etc. Some of them really don’t want to know but I send it anyway. Thinking that the more people who do question what they are given the better off everyone’s medical care will be. I was glad to see your post Susan. We should all be standing up for ourselves and not accepting the status quo.
Norma,
Can you please tell me what are the other options. And do you know what katie couric used during her procedure? she looked very comfortable and able to communicate with her doctor.
Thanks
I can’t disagree more with: “Versed is the gold standard”. gold standard? this drug causes temporary amnesia and is often implicated in patient horror stories!
Kelly, I’m so sorry that you also had difficulties with Versed. And I am so thankful also that you’ve shared your story. I was wondering why I seemed to be the ‘only’ one who was having a hard time after my colonoscopy. Until I found this site. Hearing your detailed example helped me to put my own experience into perspective. And then reading about all the other patients’ who’ve obviously had very similar experiences just reinforces the fact that there are problems with this medication. I’m also thankful that you did not succumb to the pressure of simply signing a consent form that you were not comfortable in signing simply to appease a disgruntled medical practitioner. That alone is a huge accomplishment and what a great example for the rest of us who may have a tendency to simply ‘get something over with’ because of the situation we are put in when we undergo medical tests. I’m also glad your doctor was open and honest about Versed. Which seems to be the exception rather than the rule. My doctor insisted and still insists that Versed is the ‘gold standard’ in colonoscopy medications –and anyone questioning it is simply responding to inaccurate information. Which I do not believe for one minute. Thank you again Kelly for helping ‘the rest of us’ understand that Versed does not work for everyone, and even more importantly, can cause many problems long after your colonoscopy is over with.
I had a colonoscopy done years ago and had a terrible time with the long-term amnesia, depression, nightmares etc. that lasted for a long time after the procedure…and nobody ever told me that this happens to fully 10% of patients who receive Versed. I swore that I would never get another colonoscopy despite being high risk. Recent bleeding episodes caused be to see a gastro and she recommended an immediate colonoscopy. When I refused, she asked why and I told her that I had a terrible time with the sedation. I was shocked when she said: “you must have had Versed, a lot of patients have an absolutely terrible experience with that drug and it happens after they get home and when the supressed memories return”. She told me that they stopped using it several years ago. Luckily, i found this website and finally figured out what happened to me. My repeat colonoscopy was done with anesthesia standing by with propofol; they use a nurse with some training in anesthesia, but who isn’t an anesthesiaologist (I don’t think that is really safe, but the GI doc told me that she trusted the nurse giving the propofol since whe was a CRNA)..The doctor also told me that I could request a real anesthesiologist and that she would make sure that I got one, but that this was unecessary. I was honest with the CRNA about my concerns about having anyone but an anesthesiologist administer sedation and she seemed somewhat disgruntled about my decision and she seemed in a hurry to start the procedure. When she brushed off several of my questions and thrust the sedation consent into my hand, I was pretty upset and told her that I didn’t want her services. The doctor was o.k. with this, but the CRNA tried to get me to sign the consent “just in case”…one of the nurses told me that if I signed the consent that I would be billed for the CRNA service even if they didn’t do anything, so I declined. Finally, the CRNA stopped pouting and asked me about my bad sedation experience; then she finally understood why I was so hesitant to get sedation…She said that many patients have bad experiences with Versed. The unsedated test was easy, the doctor was great and other than a small argument with a pushy CRNA, the entire experience was great.
My first prep was w/cherry flavored NuLytely. I was so sick, so bloated, so chilled and cold, so nauseous I would NEVER prep w/it again. NEVER! I’ve done well w/Magnesium Citrate alone and w/PhosphoSoda alone. But now they are telling us how unsafe PhosphoSoda is and I believe have even taken it off the market. My gastro have a heck of a time convincing me to accept a script for HalfLytely. I fully intended to just buy two 10 oz bottles of Magnesium Citrate … but finally did cave in and bought the HalfLytely. Being half the volume of the NuLytely helped plus I opted to spread out the timing rather than trying to down so much liquid so fast AND I also did NOT chill it in the fridge but drank it room temperature. No chills and only the queasies and very little bloating. I could do the HalfLytely prep again. It had me running clean quickly and kept me running clean.
I’ve also read that taking the last dose of the prep w/in 4-6 hours at most of the procedure makes for a cleaner colon and better visibility for the scope. More than 6 hours after the last prep dose allows for some build up of secretions in the colon which can interfere w/the scope’s visibility.
Excellent material you’ve provided here. Thank you.
Hello Susan,
You are entitled to get a copy of your medical records. If you request them make sure to ask for your “Complete” Medical Record of this procedure and not just the summary. Most likely you did have Versed Sedation which is fast acting but the 1/2 life of Versed which is the time needed to reduce the amount of the drug in your system by 1/2 is from one to four hours. So potentially it could be affecting you for 8 hours generally, however, if you received Valium with it, than then 1/2 life of Valium is form 20-100 hours. Again this is just the time to reduce the concentration of the drug in your system by 1/2.
Your experience sounds very frightening. One of the reasons I dislike Versed for sedation is that it is given in a small dose initially, then is increased as needed during procedures such as colnonoscopy to maintain a certain level of sedation. Unfortunately for many patients like yourself, if you “wake up” during the procedure, the health care providers simply give you more of a dose to sedate you more. The other known problem with Versed as in many of the sedative type medications is that respiratory depression and/or respiratory arrest can occur.
In my opinion, that’s why having an anesthesiologist in the procedure room dedicated to only overseeing your heart rate, breathing, etc, and who is trained to administer anesthesia, is much safer than having the Versed administered under the direction of a doctor who is actually performing a procedure, and therefore is not focused totally on your breathing, etc, and who technically is not trained in anesthesia.
In the event that you ever need a colonoscopy again, you may want to set up an appointment in advance of your actual procedure date so that you can interview the doctor in advance and it is also a good idea to have someone with you in that meeting to help you ask questions about the types of sedation that are offered etc. And you can ask for propofol instead of Versed to be used, but if you go that route you may want to call and find out via a phone call from the doctor’s office if they offer alternatives to Versed and or propofol so that you are not wasting an office visit only to find out that a particular practice does not offer alternative sedation options.
I’m very sorry that your experience was traumatic. I think we can and should expect better from the health care professionals that we entrust with our care. If you get your medical records, or if you have other questions, please post again. Hope you are feeling better and thanks for sharing your story.
Hi Rebecca,
I just had my second colonoscopy. I asked what medications my doctor was giving me. I know the first time it was Valium and something else that caused me to sleep through most of it. I woke at one point listening to the the doctor talk and then went back to sleep.
This time she told me what she was giving me but she injected something that made me fall asleep right away. I woke up several times hearing someone yelling at me to breathe. It was quite scary. There was a catheter in my arm without an iv solution. She had several syringes in her hand at least three I was ready to leave soon afterward with a quick recovery but I wondered if what ever they gave me could stay in the body for more than 24 hours. I felt terribly exhausted for two days after the procedure. I was very weak. I don’t remember having any of this reaction the first time.
Hello Rebecca,
Thanks for the update on the info re: providing better info for colonoscopy patients
If there’s anything we can do to help, please let us know!
And any news you find out regarding the outcome on this or how things are progressing would be most appreciated!
Take Care!
Just a quick update: I am filing a grievance with my insurance co (Blue Shield of CA), mainly to see if I can get them to provide better information for colonoscopy patients. Wish me luck!
Rebecca,
I am very glad you posted your comments here. My colonoscopy is scheduled at the end of this month and I was terrified about it. I had several concerns and now having read all of material here and your comments I have typed up a sheet of questions that I will ask my doctor before allowing any type of sedative to be used. I am also very relieved that I found the info here on the Miralax/Dulcolax options for the colonoscopy prep. My husband had his colonoscopy last year and the preparation was just awful. But his doctor prescribed the GoLytely type and he was vomiting very nauseated and had I’m sorry to be so blunt…explosive bowel movements using the GoLytely. I think that’s why I’m so nervous about this. Thank goodness for the info that I learned this morning and I am definitely going to request the propofol anesthesia instead of the Versed.
Hello Rebecca,
Thank you so much for your kind comments and for letting us know that the materials on preparing for a colonoscopy were helpful. I wish you had been given this information in advance as well. Please feel free to continue to link to our materials and to let others know that there are choices when it comes to not only colonoscopy preparation, but in the sedation medications that are given.
Our goal is to continue to support positive change within the healthcare system so that all patients are given true “informed consent” for all procedures, with explanations of medication options, risks and benefits etc. We were dismayed by the “informed consent” that we see happening to patients undergoing procedures that require sedation that occurs at the last minute, on the day of a procedure, and usually with patients who have been asked to remove their glasses, contact lenses or other assistive devices and are as such not in any position to be able to give a health care provider consent in that condition. Furthermore, as you’ve noted, there are different options with regards to sedation, and although right now standards of care will vary from facility to facility, by educating patients to vote with their health care dollars–hopefully more patients like yourself will opt for procedures with health care providers who are open and forthcoming about choices and options in all areas of patient care.
Your story is a great example of how important it is to advocate for yourself, and although I understand how difficult it can be to do so in the current health care environment, thank you for sharing your info on how you made certain that your rights were acknowledged and protected by stipulating that you did not want Versed used, and that your choice was to undergo the colonoscopy procedure for “pain only”. Your story will no doubt help thousands of patients in the future because knowing that someone else has asserted their rights will help others to do so for themselves.
Take care, and thanks again for taking the time to write and share your opinion Rebecca!
This is a great resource; I just wish I’d know about it before my colonoscopy. It would have made my quest to be an informed patient much easier. As it was, I filled the prescription for the bowel prep that my doctor preferred to use (Moviprep @ $45), but I really wish I had known about the Miralax-Ducolax combination and lobbied for having that instead. NO ONE–not the doctor’s office, not my insurance company–ever made any information about alternate preparation formulas available to me.
I also did a *lot* of research beforehand about the sedatives and analgesics commonly used for colonoscopies. What I discovered about Versed caused me far more anxiety than the procedure itself. In fact, I refused to sign the informed consent form until I was in the OR and I had made sure the nurses and doctor were fully aware that I was stipulating “no conscious sedation with Versed; analgesic (fentanyl or demerol) for pain only.” Again NO ONE–not the doctor’s office staff, the surgical center, or my insurance company–ever made any information available about the sedation or analgesics might be used. It was always presented as “you will be sedated,” which is not an acceptable level of “informed consent” as far as I’m concerned.
I will be giving my insurance company (Blue Shield of CA) links to your web site as a model of the information and resources they *should* be providing to their customers.
Great website and very informative. I administer a lot of colonoscopy anesthesia and usually use propofol as a single agent. You go to sleep, the exam is done and you wake up quickly without hangover. But most patients have to pay a lot for this rather than the midazolam(versed)/fentanyl combo that most insurance plans cover. Fentanyl is for pain, pure and simple. Versed is to make the patient forget the procedue. Unfortunately, many patients who receive midazolam(Versed) have long term memory issues and other emotional problems (extreme anger, hostility etc). Personally, I would not use Versed. Your article mentions that Valium is less offensive than Versed. Not in my experience. Both are benzodiazepines and when given IV they both cause amnesia etc. Versed is the worse, but any benzo (valium, ativan etc) will do the same thing with similar side effects. Dirty secret: when done carefully, colonoscopy is not painful! I turned 50 and got one, no meds and it wasn’t bad. However, the exam was incomplete, probably due to my twisty colon. I have a repeat exam scheduled with fentanyl only. That’s the way to go if colonoscopy doesn’t gross you out and you want to be awake.
How do you find a gastroenterologist who will do an unsedated colonoscopy?
Hello Abbie, Thank you for your question regarding how to find a physician ie: gastroenterologist who will perform an unsedated colonoscopy. It can be a challenge to find a physician who is willing to think out of the box so to speak. The first thing to consider is exactly what you are referring to with regards to “unsedated”. There are medications that can be given during a colonoscopy procedure that will relieve pain but not provide “conscious sedation” meaning that your pain would still be controlled but that you would remain awake during the procedure and able to remember what occurs. Most patients writing in asking the question you are asking may want to know how to find a doctor who will provide pain control during the procedure but who will not give medications such as Versed, otherwise known as Midazolam which some patients report lower satisfaction rates with as compared to a complete anesthesia type medication such as propofol which requires a nurse anesthetist or anesthesiologist to administer.
So the first step as a patient is to consider what you are looking for with regards to finding a doctor:
1. Are you looking for someone to do a procedure with pain control only and no sedation?
2. Or to find a physician who will do the procedure with pain control meds and some sedation like Valium which will keep your muscles relaxed but will not cause you to forget the procedure and you will be able to talk to the doctor during your procedure
3. Other options are to find a physician whose practice uses propofol, which is the anesthesia used by President Bush when he received his colonoscopy and although you would not be awake during the procedure, this choice has a high reported satisfaction rate with patients because they are “out” for the procedure, but awaken quickly and unlike Versed or Midazolam it is not an “incomplete” type of sleep or one in which the paitent still has pain
4. Note, the patient in one of our articles opted to receive pain medication and Valium, so he was awake and able to converse with his physician. He clearly remembered the entire procedure
So once you’ve determined what your goals are, you can “interview” the practice so to speak on the phone by asking questions before you schedule an appointment. It is a good idea to ask to speak directly to one of the physician’s or practice’s nurses and to get the name of the person you talk with as sometimes schedulers will have less than adequate knowledge about medications and will simply say “yes” to all your questions meaning that when you go in for a consult you may have wasted both your time and funds in an appointment with someone who does not offer what you are searching for.
I hope this helps and please let me know if you have more questions. If you find someone in your area who will work with you to find a solution that you are comfortable with, please write back in and share that person’s name so that others may benefit as well.
Good Luck, thanks for writing in, and Stay Well.
How soon will I be able to return to work after a colonoscopy? Will I have discomfort from the procedure?
Hi Linda, thanks for your question. In terms of knowing how quickly you can return to work after a colonoscopy “it depends”. Let me give you some additional info that may help you. Your exact recovery time will depend upon the medications you are given and if your prodedure goes as planned. If there are no complications and you are given propofol for anesthesia during your procedure, then this drug is a very short-acting anesthetic and most patients recover from it’s effects rather quickly, recovering in minutes vs hours compared to some of the other drugs that can be given for anesthesia.
Keep in mind that when former President Bush had his colonoscopy, his doctors used propofol during his procedure. His doctors probably thought it very important that he not be groggy all day and so they chose a medication that would wear off quickly.
Having said that, it depends upon which part of the country usually you live in in terms of whether or not you will be given the option to receive propofol as an anesthesia option. Some practices and doctors don’t like to even offer propofol as it requires that there be a nurse anesthetist or anesthesiologist to administer the medication. Keep in mind that this can add some costs to the procedure which your doctor may then have to “share” in terms of their reimbursement by your insurance company etc. And your insurance company may or may not pay for the extra cost of using propofol.
There are other doctors who may use a pain relieving medication like fentanyl along with something to make you relax like Valium. Recovery is fairly quick using that combination as well. One of the patients who allowed me to videotape his colonoscopy had this combination of medications given to him and he recovered fairly quickly and went home after his procedure to rest, but he was out dancing later that evening about 10 hours later! In terms of “recommended” practices though I would say that for most patients it would be recommended to go home and rest for the remainder of the day…just wanted to share with you that this particular patient whom I followed, was feeling fine and able to dance later that evening.
The majority of doctors generally use a medication called Versed which is a medication which can cause you to “not remember” the procedure along with a medication called Fentanyl which is used to manage pain. Please read some of the articles about possible issues about Versed as although many patients do just fine with it, there have been reports of some patients not being pleased at all with this medication. If you and your doctor choose this option, you may be groggy for most of the day.
Bottom line, with any of the medication/s given is that you will be told that unless you experience some type of complication most patients can return to work the next day. With the shorter acting anesthetic like propofol you will be able to return to productivity sooner, but you may still choose to rest for the remainder of the day and return to work the following day.
As always, ask your physician what his/her recommendations are for you and your individual situation and ask questions about what type of medication you will be given and ask for options if you are not satisfied with the medication that your physician “normally” uses.
In terms of discomfort during the procedure you should not experience any discomfort. The key again, is to find out which medications your provider will use and to have a discussion in advance about any other medication conditions that may affect what medications you will be given and how much of any medication will be safe to administer. And in terms of discomfort, make sure you choose an experienced physician and ask them questions in advance about your comfort during the procedure, what your options are in terms of being either completely asleep (using something like propofol and fentanyl ) or awake and being made comfortable with an option of something like (Valium and fentanyl) and if your doctor is using (Versed and Fentanly), just make sure that you read about this combination and then discuss what options your particular provider will be using in advance (before you actually show up for your procedure) so that you know what to expect and are making the best choice for you and your particular situation.
Hope this helped and thanks again for the question!