03-07-2016, 04:33 PM
(This post was last modified: 03-07-2016, 04:34 PM by Aether087.)
When anesthesia for upper endoscopies and colonoscopies is directed/administered by the gastroenterologist, the anesthesia type is "moderate-sedation." This is usually a combination of midazolam (high-test Valium) and fentanyl (synthetic opioid many times more potent than morphine). The amounts used are usually small (less than 5 mg midazolam and less than 200 mcg fentanyl) BUT both of these drugs depress the bodies response to arterial CO2 and thus depress respiration. This respiratory depression can last for up to 24 hours and can exacerbate sleep apnea. Patients who receive midazolam and/or fentanyl should definitely be monitored for at least 3 hours and have their machine with them.
When anesthesia for 'scopes is administered by an anesthesiologist, the anesthesia type is "monitored anesthesia care (MAC). The drug used is almost exclusively propofol (killed Michael Jackson) and results in a deeper level of anesthesia than does moderate sedation. The advantage to propofol is that it is very easy for skilled personnel to titrate the med to the patient's needs and propofol is quickly cleared from the body after administration is stopped. Clinically significant respiratory depression rarely persists for less than 10 minutes and most patients are discharged in about 30 minutes. It is not necessary for patients to have their xPAP with them for MAC anesthesia. I had an inguinal hernia repair done this AM with local anesthesia and MAC sedation. Was awake in the OR at end of case and discharged home in less than 30 minutes.
I will use my APAP for bed tonight.
I too recently had this procedure, which took about half a day. It was as a result that during recovery from a previous procedure at the facility that my original diagnosis was made
The whole process went like this:
G.P. referred me to the Specialist, specifying that CPAP was used;
Specialist books the procedure at a Day Surgery Facility, specifying that I should be first on the list due to being diabetic and used CPAP;
I completed the necessary forms for admission paying particular attention regarding the use of CPAP, and confirmed that the CPAP machine was not required;
I reported to facility reception, confirming that they did not want the CPAP machine;
Admission Nurse read the admission form confirming the information given , and then did BGL and BP readings etc and noted CPAP use;
Anesthetist interviewed me prior to going to theatre and noted CPAP use;
The Procedure was carried out;
In the recovery room particular attention was paid to SpO2 and breathing;
Discharged to go home;
Next day a phone call from the facility was made to ensure that I was OK.
So it can be seen that all concerned paid attention to my use of CPAP, and I was impressed that all concerned approved of its use.
My message is to ensure that everyone in the treatment chain is advised. There is no shame involved!