Expert: Ronald Levy, M.D. - 5/23/2011

Question
QUESTION: Hi,wondering if having fentanyl alone(no versed) can, in general,provide enough sedation in addition to pain/discomfort relief for colonoscopy? Have you ever seen this in practice? thank you ahead of time.

ANSWER: Fentanyl does not provide any sedation, it is a pain medicine. Enough Fentanyl can make you stop breathing and put you to sleep but this is not sedation. At that level it is dangerous and might require intubation. Yes, I have seen it in practice but the Fentanyl was used for pain relief (in proper doses) in patients who did not want Versed and were willing to be awake during the procedure. I generally don't recommend it.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston

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

QUESTION: Dear Dr. Levy, did that patient tolerate the procedure well without any versed(ie.. just fentanyl)? thanks once again.

ANSWER: Yes they did but I think the next time he has the procedure, he will probably request the Versed. While he did not have pain, he was still uncomfortable and anxious.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston



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

QUESTION: thanks once again!!:)(small "teeny weeny" question:)I will probably have the IV and start w/Valium if they'll let me. Also of course fentanyl. How does that compare with your thoughts of the sedation?

Answer
Versed is better than Valium. Valium has active metabolites and hangs around a lot longer. If you are elderly, Valium could hang around for several days. The other effects of the two drugs are basically the same so I would still recommend Versed.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston