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Thursday, May 23, 2013
Having Colonoscopy without Sedation
I noted two questions where patients asked about colonoscopy without sedation. It is possible - I had it done that way. I had a small dose of Demarol. I was fully awake and watched the entire procedure, which was very interesting.
I do wish to state that there is discomfort - particularly as the scope followed the last corner of the colon and also from inflation used to open up the colon. The worst discomfort was somewhat intense, but brief.
I would agree that there should be an IV so that if you say `Uncle` sedation can be quickly administered.
Why did I do this? 1. I am a total techie and simply found the process and the technology very interesting. 2. I have never reacted well (mentally) to sedation. Two weeks after my colonoscopy I was having laparoscopic hernia repair which required general anesthesia. I did not want to have to deal with my own severe mental reaction from two back to back anesthesias - I could write a lot about that but that would be a separate question.
My doctor was very understanding and worked with me the way a physician should. He said he does about 3 colonoscopies per month this way. He has also done upper GI endoscopies without sedation.
I might add that assuming I am still healthy I am perfectly willing to go through this again although without sedation, although I might ask for a slightly higher dose of demarol.
Thanks for your interesting comments which I think will be useful to other readers. I believe your desire to experience the colonoscopy while awake probably puts you in a small minority. But it's nice to know it can be done! The most pain comes when the bowel is inflated with gas and at the point where the scope must navigate around the "bend" - the splenic flexure. You described this well.
Having an IV in place is like having a lifeline. If things are not going well with your chosen approach of minimal or no sedation then you can be "rescued" with pain-killing or sedative medication. As I've said before, it is important that you have a comfortable experience. It's also important not to lose sight of why you are having the procedure in the first place. The gastroenterologist is most likely to do a good job of examining your insides if you are quiet, immobile, and pain free!
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University