General information
A colonoscopy is an examination procedure in which the intestinal mucosa can be viewed with the help of a special tool, the endoscope. The endoscope is a movable tube with a camera at its end. This camera then transmits images of the intestinal mucosa to a screen which the doctor can view.
Colonoscopy is on the one hand a diagnostic procedure, with which changes in the intestinal mucosa, such as inflammation, ulcers or bleeding, can be detected early on, in some cases even before the patient suffers symptoms. On the other hand, it is also a therapeutic procedure, because during a colonoscopy, tumours (the so-called polyps), sacs (the so-called diverticula) or preliminary stages of a colon cancer can be removed in the same session. A colonoscopy can be performed in a practice (outpatient) or in hospital (inpatient).
In principle, a colonoscopy is a less painful procedure. However, pain may occur when the endoscope is pushed forward by pulling or pushing on the intestine. .
Therefore, a colonoscopy can be performed with the administration of various drugs if necessary. On the one hand, sedatives such as benzodiazepines are available. An important representative of this group is midazolam.
These cause the patient to sleep during the examination and thus not even notice the examination and the potential pain. However, since some patients stay awake and also want to look at the screen to which the images of the intestinal mucosa are transmitted, there is also the possibility of injecting a painkiller only in the event of pain. This is usually an opioid, such as tramadol.
Another possibility is to perform a colonoscopy under short anaesthesia. Anaesthesia is generally understood to be the temporary loss of consciousness. With a short anaesthetic this state of unconsciousness is only maintained for a short time.
The condition is often induced with a drug called Propofol. During a short anaesthetic with Propofol, this is administered through an access in a vein in the patient using a syringe pump. The syringe pump ensures that Propofol is continuously injected into the patient’s circulation during the procedure, thus maintaining the short anaesthesia for the duration of the colonoscopy. The effect of Propofol starts to take effect from as little as one minute.
Is anesthesia dangerous during a colonoscopy?
Side effects and risks of a colonoscopy In general, complications in endoscopic procedures such as colonoscopy are very rare nowadays. Overall, short anaesthesia during a colonoscopy is not considered dangerous. Colonoscopy under short anaesthesia with Propofol is generally well tolerated and has several advantages.
Especially for very anxious and pain-sensitive patients, a colonoscopy under short anaesthesia is much more pleasant and less traumatising. However, short anaesthesia also carries risks that must be taken into consideration for every patient who needs a colonoscopy. About half of all side effects occurring during a colonoscopy are caused by the short anaesthesia.
Possible side effects during/after a short anaesthetic with Propofol: The above-mentioned disturbances in the cardiovascular system and respiration affect in particular elderly patients and patients with concomitant diseases such as high blood pressure or cardiac insufficiency, which is why special caution is required in this group of patients. Propofol should not be used at all for short anaesthesia in pregnant women and children under 16 years of age. In addition, some patients may have an allergic reaction to Propofol.
In the worst case, an allergic shock may even occur. Another possible side effect of Propofol is the occurrence of Propofol infusion syndrome. Propofol infusion syndrome is an extremely rare complication that leads to cardiac insufficiency, cardiac arrhythmia, acute kidney failure, hyperacidity of the blood and muscle breakdown.
Propofol infusion syndrome is a life-threatening complication and must be treated immediately, making it very dangerous for the person affected. The most important thing is to stop the administration of Propofol and to supply the patient with fluids and medicines that maintain the patient’s circulation. Due to the risks mentioned above, all patients are continuously monitored during the procedure with the aid of monitors, so that changes such as cardiac arrhythmia, a drop in blood pressure or oxygen saturation can be detected early and countermeasures can be initiated in good time.
The intervention itself also involves risks, both with and without short anaesthesia. For example, during a colonoscopy, injuries to the intestinal mucosa or perforations of the intestinal wall (piercing of the intestinal wall) can occur. If a perforation of the intestinal wall occurs, bacteria from the intestine can enter the abdominal cavity and cause infections.
If the bacteria enter the bloodstream, there is a risk of sepsis (blood poisoning). In case of sepsis, antibiotic therapy and intensive medical monitoring are necessary. Furthermore, bleeding is a possible side effect of a colonoscopy. – Vertigo
- Unrest
- Nausea
- Vomiting
- “Bad Trips” (bad dreams that seem very real)
- Gaps in memory (amnesia)
- Respiratory disorders
- Blood pressure drop
- Cardiac arrhythmia
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