Expert: Ronald Levy, M.D. - 5/3/2009

Question
I have a wonderful gastro doctor and am scheduled for a colonoscopy soon. I have no problem with the procedure or prep, except that I am so anxious about the sedation. I am afraid of an adverse reaction or the need to be rescued. My doctor uses propofol. I have had one other one hour surgery under general and in the recovery room they said that they had a little trouble bringing me around. My gastro guy has promied he will use light sedation. I would like to be awake, but he does not advise this. I am really worried about needing to be rescued.  I know that propofol has a quick recovery and short life, what exactly does that mean. I am overweight, but in good healt, no meds, no problems. Female age 45. High incidence of colon cancer in family.  Thank you.

Answer
Propofol, if administered correctly is an excellent sedative. As you mention, it has a short half life, wears off quickly, is amnestic and also is an anti-nauseant. When they say they had trouble bringing you around, that could means a thousand things. It DOES NOT mean they had to rescue you and you shouldn't worry about that. While sedation can cause you to stop breathing, you are still arousable and if they arouse you, you breathe. Also, they will give you just enough to get the procedure done. So don't worry. I am sure they are experienced with the effects of Propofol and will manage the dose accordingly.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston