Expert: Ronald Levy, M.D. - 2/10/2008

Question
QUESTION: I recently had a colonoscopy and upper endoscopy.  I am not sure what was used for anesthesia, other than it was IV - I understand it was probably pain medication, and a sedative.

I don't know if I was out or just don't remember what happened, but I am now experiencing anxiety about having been sedated.  Are their options that I could choose next time that would allow me to have the procedure but be concious and remember what happened?  I.e. can I ask to have less or no sedative, or some other sedative that wouldn't have an amnesiac response?

Also, I have read that Doctor's consider the amnesiac part a good thing - can you explain why?

ANSWER: Amnesia is good because most people are scared of surgical procedures so the less they remember about them, the better. Also, should they need further procedures, they will have had a pleasant experience in the OR so they won't be so apprehensive. As for you, if you don't like the amnestic part of the procedure, you can certainly request no amnestics although my feeling is that you would regret it later. Unfortunately most sedatives have some amnestic properties.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: I can understand patients not wanting to remember an unpleasent/painful procedure.  I imagine a lot of folk prefer not to remember a colonoscopy because of the emabaressment of being examined in such a private area.  And having an unpleasant experience might cause them to not want to have future procedures.

With pain medication, I would assume that there might be discomfort, but no real pain.  Back when I had a vasectomy, I just had a local, no sedatives.  I didn't have much pain, and I prefered being awake.

Is it possible to have a mild sedative, just to relax?  One that would leave me concious, and be unlikely to cause amnesia?  

If I found that the discomfort was too much, could I ask that the increase the sedation?








I think as long as I had medication for the pain, I wouldn't mind

Answer
Again they can give you a mild sedative but it may still cause amnesia. Of course you could always ask for more (understanding that it will also increase the amnestic effects). If all you need is pain meds, that's OK too.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston