Today you have you’ve passed through colonoscopy. The majority of colonoscopies are done under sedation and analgesia that you have also experienced. It allows the doctor to examine large bowel(colon) carefully and take samples of tissue (the lining of the bowel is insensitive to pain) and so they can be examined under a microscope. The most appropriate option for you was neuroleptanalgesia. What is neuroleptanalgesia? It’s the state produced by the combination of algesic and neuroleptic drugs when anxiety, motor activity, and sensitivity to painful stimuli are reduced for the time needed to conduct colonoscopy(Bryant.B, Knights.K 2010). You were given propofol for induction, midazolam as a sedative drug and fentanyl as analgesic agents. The drugs were delivered intraveousely(IV) through an intravenous cannula (small tube put into your vein).
Induction of anesthesia : Propofol blocks ionotropic receptor and ion channel in your CNS(brain) that leads to sedation and hypnotic state(you felt drowsy and relaxed after injection). Propofol is a safe drug nevertheless there is a little chance(less than 10%) to have adverse(undesirable) effects like: hypotension, bradycardia, transient apnea (breathing or heart rate to slow down).That’s why you’ll be under monitoring during colonoscopy. Propofol emulsion contains particles of egg protein and soy(it’s normal),so if you have egg or soy allergy you should inform your doctor. (Propofol medscape references, 2011)
Sedation: Midazolam is also a short-acting drug in the affecting special receptors in your CNS(benzodiazepine class).Midazolam induce sedation and amnesia(partial transient loss of memory) that alleviate intolerable memories before medical procedures. The most frequent adverse effect of midazolam are bradypnea(decreased breathing rate) and drowsiness(Midazolam medscape references, 2010).
Analgesia: Fentanyl is a synthetic narcotic agonist analgesic, it stimulates the same receptors that opioids (morphine,heroin) do. But it doesn’t mean that you’ve become a drug-addict. Frequent adverse effects of fentanyl are constipation, dry mouth, nausea, they are usually transient and unhazardous.( Fentanyl medscape references, 2011)
Special interaction of these three drugs creates the effect of general quiescence and psychic indifference to environmental stimuli without loss of consciousness that is called neuroleptanalgesia. It helped you to pass through colonoscopy in the best way, but the medications that you have been given can remain in your body for up to 24 hours after their administration. You should cooperative with your nurse and physician to avoid interaction of anesthetics and substances you can take in after colonoscopy (like alcohol or other drugs). You shouldn’t drive car, operate complex equipment, sign important legal documents within 24 hours after the procedure, because state of confusion, anxiety, nervousness can accompany you for several hours after medical procedure. Communication and cooperation are essential to the anesthesia process(After Anesthesia, 2011). Active participation in your care helps ensure your safety and comfort before, during and after surgery.
1. Propofol medscape references<http://reference.medscape.com/drug/diprivan-propofol-343100#4 >
2. Midazolam medscape references <http://reference.medscape.com/drug/versed-midazolam-342907>
3. Fentanyl medscape references <http://reference.medscape.com/drug/sublimaze-fentanyl-343311#4>
4. After Anesthesia: Your Active Rolehttp://www.aana.com/ForPatients.aspx?id=290>
5. Toxicity, Neuroleptic Agentshttp://emedicine.medscape.com/article/815881-overview
6. Bryant.B, Knights.K 2010 Pharmacology for health professionals 3rd ed, Mosby, Elsevier p261, 264, 294