Prior to propifol colonoscopy I had fentanyl/versed and it used to knock me out for the whole day.

when I had my cataracts last year they only gave me versed as a conscious sedation and it still put me to sleep.

i guess I am a lightweight and any anesthesia tends to have an sleep effect on me.

there are a number of folks here who prefer and actually do the pouchoscopies while completely awake. That could be an option. I don’t do it that way because my GI likes to snake it up all the way to the take down site and tells me not to do it awake.

@Jarrett posted:

Has anyone had a Pouchoscopy with conscious sedation (midazolam/fentanyl)? What was the experience like? This is my first pouchoscopy and all my past colonoscopy and flex/sig have been unconscious, so I'm interested in learning from anyone's experiences. Thank you!

I have conscious sedation with the cocktail you describe every year. The alternatives are no sedation, or Propofol. Propofol is 20 times more expensive than Conscious Sedation, although many/most people don't seem to care about that. Propofol is used by most endoscopy centers as their preferred option because it enables them to maximize profits by moving patients in and out more efficiently. Conscious sedation means a groggy patient who has to be kept in the recovery area a bit longer. I don't believe in allowing endoscopy centers to profit at the patient's expense, and build up the patient's total expense and insurance costs, but many people here are totally fine with being charged 20 times more. And the endoscopy centers train their staff to convince patients to choose Propofol and most patients blindly follow that recommendation.

The main advantage of propofol over conscious sedation is you wake up quickly and aren't groggy.  With either method you aren't allowed to drive or take Uber. Someone (live human body) must accompany you. The main advantage of conscious sedation is that it's dramatically cheaper and reduces what is billed to your insurers snd what your total cost is, meaning it keeps your health insurance premiums down. Others like to pay high or very high insurance premiums which, of course, is their prerogative.

Up until a few years ago, it was legal in Connecticut for conscious sedation to be administered by someone other than an anesthesiologist, e.g. a nurse. Or anyone. This is no longer the law. Both propofol and conscious sedation must be administered by an anesthesiologist. This means that conscious sedation, at least in CT, isn't quite as dramatically cheaper than Propofol as it used to be.

The fentanyl/versed combo does make me drowsy/ a bit groggy, although not excessively so. But since I always take off the day I am scoped from work, and am required to get a ride that is not Uber either way, it doesn't matter.

Around 3 years ago the Chief Anesthesiologist of my local endoscopy mistakenly chose to engage me in debate regarding Propofol vs. Conscious Sedation. He was unable to rebut anything I have stated above. He is someone I rather like, as he has rescued me from becoming a pincushion at the mercy of Remicade nurses many times, and is a witty guy. But that day he sounded like the head of marketing for the pharmacy that produces Propofol, and I actually told him as much and asked him if he was invested in that company. He no longer debates me, because he knows my opinion, knows I have the background to refute his position authoritatively, and most importantly knows that I get to decide what is put in my body by his minions, not him. You get to decide too.

I have had the pouch scope with no sedation. It's doable, but not comfortable, mainly because you are pumped with air like a helium balloon and feel that pressure. I don't need to deal with that. It's better than an unsedated colonoscopy, which I had every year in the 1970s as a child. But I don't need to deal with it and I don't.

I had almost all of my pouchoscopies without sedation. Except those rare occasions when a gastroscopy was done right before. I didn't feel too uncomfortable and the advantages are that I can see the whole process live on the screen and that I can walk home alone or drive afterwards.

I have never had a pouchoscopy with sedation.  Lots of scopes (upper and lower) with Fentanyl and Midazolam. I like that cocktail and it doesn't leave me too drowsy afterwards.  I soak up the meds, am out for 20 minutes then wake fresh as a daisy.  I'm going for a non-sedated pouchoscopy next week....let's see how this one goes.