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Tuesday, January 27, 2015
IV drugs without amnesiac properties
I`m scheduled for a colonoscopy but would prefer not to have versed as it has no benefit to relieve pain and takes away one`s memory for the entire day. What can I request instead and what is customary? Thank you.
Versed (midazolam) and fentanyl are customary. Propofol is popular. You are correct that midazolam does not relieve pain but your statement that this drug takes away one's memory for the entire day is not true. Millions of patients have received midazolam for various medical and surgical procedures and appear to have been satisfied with the experience. A pain-killing drug and/or local anesthetics are usually used together with midazolam. The amnestic (memory suppression) effects of propofol and other sedative drugs, including midazolam, thiopental and dexmedetomidine are approximately the same. However, the amnesia begins when the drug is given. Memory preceding the administration of the drug is not lost. There are a number of analgesic (pain-killing) drugs that can be given for a procedure like colonoscopy. These include meperidine (Demerol), fentanyl, alfentanil and remifentanil. These drugs do not produce amnesia.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University