There are two ways to sedate patients for colonoscopy. There is conscious sedation is when the
gastroenterologist administers a ‘twilight sedation’, or moderate sedation when
sedation is administered by an anesthesia professional, usually with propofol,
a drug now known to most of us as a
contributor to the death of pop superstar Michael Jackson.
Most Patients Prefer Propofol over the Twilight Zone
Leaving issues of cost aside, most individuals involved in
the colonoscopy experience prefers the propofol option. Here’s why.
The drug is extremely safe when administered by trained
personnel, who in most cases are Certified Registered Nurse Anesthetists
(CRNAs).
Unlike with twilight anesthesia, the procedure is entirely
painless. Patients can expect to
experience the same level of discomfort as they do with a haircut.
Knowing that they face complete comfort during the
procedure, patients are relieved of anxiety that often precedes the procedure
for several days or longer.
With a CRNA on the team, we have a professional at the
bedside whose sole responsibility is to monitor the patient’s breathing and to
make necessary adjustments in real time.
The endoscopy nurse, a seasoned R.N. professional, can now
devote all of his or her attention to assisting the gastroenterologist and
monitoring the patient knowing that the patient’s respiratory status and
sedation are fully under the CRNA’s authority.
Recovery after the procedure is quicker and cleaner than
with twilight. In fact, patients often
feel so well afterward, that we have to emphasize that they are still under the
influence and are not quite ready to drive a car, fly a plane or command a
nuclear submarine until the next morning.
Using CRNA’s add to the cost of the procedure because these
professionals are entitled to be paid for the work that they do. Is it extra cost worth all of the benefits I
have outlined? As a patient, would you
be willing to pay for the CRNA’s services out of pocket if your insurance
company, who cares only for your health and welfare, only covered conscious
‘twilight’ sedation’? Which option would
insurance company executives or Medicare administrators prefer for
themselves? Perhaps, they would be more
enlightened and empathic if they had to undergo sedation in the ‘Twilight Zone’
before issuing an edict declaring how much your safety and comfort are worth.
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