Expert: Ronald Levy, M.D. - 7/23/2008

Question
I'm 53 and have an awful family history of colon cancer. I wznt to habe this exam without drugs  or any IV;s (which I was promised until I reported for the test then they tried to "hook me up" im case I changed my mind.  I have lost too many family members to colon cancer; I understand that the test is painfu; if I diecide no drugs and my doc agrees, why do I have to argue with everyone in the endo center about the dubious "conscious sedation"?    My symptoms  are distressing.   thanks.

Answer
First of all I'd comment on the "dubious" term. Conscious sedation works, and it works well. Some patients would prefer to have pain and remember everything and that certainly is their right. If your doctor agrees to that, then there is no problem. As for the IV, it is not safe to do the procedure without having IV access. Should something go wrong during the procedure (hypotension, chest pain, etc), this is not the time to start looking for IV access. They will not give you drugs if you specifically agreed not to have any, but it gives them an access port for emergency drugs should they be needed. I also would not participate in this procedure if I didn't have IV access in my patient. It goes against the standard of care, might be considered negligent and medicolegally is indefensible.

I hope that answers your question,

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston