Expert: Dr Ian Jackson - please note UK based - 3/6/2011

Question
Hi Doctor:  I'm a healthy 50 year old guy, good shape with no medical problems. I recently had a colonoscopy and was given 500mg of propofol which seems like a high dose to me.  The CRNA wanted to use fentanyl with the propofol (so as to use less propofol) but the anesthesiologist said it wasn't necessary.  The procedure was incomplete and they were evasive about why, saying only that I had difficulty with the sedation.  The endoscopist said that she had to stop because they were having difficulty keeping me breathing; the anesthesia people seemed to think that this was somehow my fault.  I'm not trying to blame anyone, I was told that I won't be charged for the test, but that I need to have it repeated.  A nurse who has assisted with many of these said that she has never seen a healthy patient get 500mg of propofol for a colonoscopy; I know that exact doses don't exist, but does this seem high?  My jaw of bruised ( them keeping my airway open, I guess).  Does 500mg seem high?  thanks

Answer
Hi Joe
There is huge variation in requirements between people so it is not always easy to be absolutely certain if it was a high dose for what you needed. From experience colonoscopy can be extremely uncomfortable for some patients and they tend to need more propofol or some analgesia such as fentanyl to help. However 500mg is 50mls of 1% propofol and this is a lot for what should have been sedation rather than general anaesthesia.
Can't say much more than that except that I'm glad you are OK!
Kind regards
Dr Ian Jackson.