Conscious sedation via IV meds is pretty standard for colonoscopies, in my experience. To thread that scope all the way to the end of the small intestine requires finesse and a LOT of air blown into the large bowel to expand it and open the pathway. And that HURTS, and causes spasms, etc. IV sedation reduces the pain and spasm. And makes the procedure far less torturous.
Now if one is having a sigmoidoscopy, such IV sedation is not so necessary, as one is not advancing nearly as far into the large bowel as with the full procedure. It’s more of a straight shot, and much quicker to do.
I’ve done both procedures, though not in recent decades.
IIRC what I was told when I had my one and only colonoscopy, the gas they use now (this was two years ago) is absorbed instead of needing to be farted out, and does not cause the kind of pain the previous gas caused-- it was never plain “air.” Anyway, yes, it did used to feel like gas pains from hell, which, as someone with IBS (albeit, mild), can say, gas can be EXTREMELY painful.
Anyway, I was totally out for the whole of my upper endoscopy. I woke up during the, no pun, tail end, of my lower endoscopy. They squirted a little more of something into the IV, and I felt a tingle, but didn’t go out again. Definitely wasn’t feeling anything, though.
Pretty glad I was out for the upper. The last thing I remember is having something put in my mouth a little like a ball gag, but with a hole in it for the camera. I was also on an oxygen cannula, in case my nasal breathing was compromised, and I’m assuming the “ball gag” had something-- a second hole, or something. I do know I was on a pulse oximeter.
I think when I was 12, and I had an upper, I had a tube down my trachea, but I don’t remember anything between being asked to get up on the table, to being in the car, on the way home.
I’ve done both upper and lower endoscopies. I hated the sedation enough that I’ve done some upper endoscopies without it, which is unpleasant, as i retch. But the colonoscopy without sedation was fine. A little crampy, but neat to watch. And as soon as they pulled the tube out i was ready to get dressed and go home. No recovery, no need for someone else to drive me.
I think sedation as an option makes sense, but i have no idea why it’s standard in the US. I think doctors just prefer not to have a busy body patient in the room.
For my last colonoscopy, I was told to lay off fish oil capsules for several days prior. They said it leaves a gummy film that messes up the camera lens.
For my first retinal detachment surgery(vitrectomy and gas bubble) they used twilight anesthesia, but not so much that I was out of it. I have vague memories of seeing the probes inside my eye but not caring. I was also apparently pretty chatty, I think at some point they gave me another shot to shut me up. Second surgery (silicone oil) was also under twilight and I don’t remember. Third (scleral buckle) was under general - gas mask over mouth, count backwards, then…recovery room.
So yeah, unless the need you awake (Mrs. Martian had brain surgery that they had to wake her up after the craniotomy so they could do some functional mapping) they’d rather you were asleep and not bothering them.
Honestly, given the cost of the patient (time to recover, someone else needs to take time off to bring you home, some small risk of problems) that doesn’t seem like a compelling reason to do it routinely.
Another thought: If they see something during the colonoscopy, they will usually grab a biopsy or remove a polyp on the spot. How painful would that be without anesthesia?
It’s outpatient here, too. I don’t think I’d care for the anaesthetic spray. Call me a wuss, but I prefer being knocked out. I can’t answer for everyone’s insurance, but Blue Cross covers colonoscopies 100% on my plan.
Not to mention the problems some of these drugs have in some people. I find it hard to justify risking reigniting my benzo problems just for some elective procedure.
I guess I’m glad to know there’s a trend to sedate going the other way, too. But I’m very disappointed, as it seems to make investigating my entire digestive system off-limits without some very compelling cause–more than just the pain I sometimes get.
I didn’t get the direction about no lotions on either of my colonoscopies so far, but I also find that the nurses have no problem wiping with alcohol anyway, where they want things to stick (the IV in my case). This may be the reason for such a request, but it doesn’t seem to me to be a very good one.
They did sedate me - but now that you mention the bag , that’s what I was thinking of when I read IV and what I’m sure I didn’t have. I can’t see why they would attach a bag after I was sedated - the bag wouldn’t be to administer the drugs if it was hung after I was already sedated and I don’t know why I would need fluids during a procedure that took less than an hour. It’s possible that I had the “needle in the hand” part and I just don’t remember it - is just that part with no bag considered an “IV”?
Yikes. I had a swallow study that I had to be awake for, and it was pretty awful, but less invasive than the endoscopy. The spray doesn’t do much. I absolutely would not want to be awake for an endoscopy. Also they took a biopsy of something during the endoscopy – not sure if it would be painful?
When I had my first colonoscopy, in 2005 IIRC, I was told that I would be given a local anesthetic and would be able to watch the camera’s view throughout the procedure. I was very disappointed when they decided to put me completely under.
I remember that afterwards I had to stay in recovery until I had passed gas, and being told that I would probably continue doing so after I got home. However, I did not have to have anyone there to take me home. My insurance did arrange and pay for my transportation to the clinic and back.