Colonoscopy: To sedate or not to sedate?

Dear Dr. Roach: After reading your recent column on sedation during colonoscopy, I wanted to mention that I have asked for no sedation during two colonoscopies in the past several years. I did this after reading an article in the newspaper. People commented with replies, many of which were of the “don’t bother with sedation” approach.  Posters included doctors, nurses and patients.

I felt fine without any discomfort. Yes, I had moments that indeed felt somewhat like gas, but no pain, just some “pressure.” Benefits to no sedation included no aftereffect from drugs. I drove home from the procedure both times myself. I also had no anesthesiologist fees, which can cost more than the procedure in some cases. Finally, I am an interested patient, and I was able to view the procedure on the monitor while my doctor gladly commented and answered questions. I was offered a set of headphones and dark glasses if I wanted, but again, I was interested in knowing the medical details.

As a side note, I saw a study that determined that the longer the time taken during the inspection for polyps, the more that were found (fairly obvious, I guess).  But I believe that when the patient is conscious, the doctor may tend to take more time, especially around turns, and may in fact take more time inspecting folds and creases. — D.S.