Expert: Ronald Levy, M.D. - 3/10/2008

Question
I had a colonoscopy several years ago and it took hours to be aware.  I just had surgery for an umbilical hernia repair and was very anxious regarding the use of versed. Except for 1 mg of versed to help with induction since a lot of Propofol would not drop my blood pressure. I did avoid it.  Does Propofol drop your blood pressure and will the versed stop this?  My other question relates back to the colonoscopy.  I obtained my records and found that I was give 1 mg of versed and 25 mcg of Fentanyl every 2 minutes for 5 doses then another 2 mgs of versed and 50 mcg of Fentanyl five minutes later along with 6.25 mg of Phenergan, the procedure ended 5 minutes later. In the span of 17 minutes I was given 7 mgs of versed and 175 mcg of Fentanyl.  I was then discharged 35 minutes after the end of the procedure. Is this appropriate, I did not remember a thing for hours after the procedure.  Can you clear these medications to safely be at home in less than an hour or did they push me out of the surgical center too soon.  I have a fear of this medication would like some answers to help me understand.  Thank you.

Answer
To answer your first question, Propofol can drop your blood pressure. Versed does not prevent this. The purpose of Versed is to relax you and to give you amnesia for the procedure. This is normal and usually desired. As for the dose, each person is different and we titrate the dose to effect. Ther dose you received is not excessive. With regard to pushing you out of the hospital, again it is hard to say. If you were alert and there was someone to take you home it is not a problem. The amnesia can last up to 24 hours. What would keep you in the surgicenter longer was if you were too sleepy, nauseous, etc. So without any other information I would say that everything was appropriate and I'm sorry that about your anxiety about Versed.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston