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ERCP Medication Question

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My ERCP scheduled for today has now been pushed back to Friday; my

doctor called me yesterday and advised me that he wants to use general

anesthesia instead of demerol for the procedure. Hence, the need to

reschedule. I've had 3 prior ERCPs and each of the 3 doctors involved

reported the same concern.

I've always been nervous about general anesthesia, but appreciate his

perspective. I have a history of needing a great deal of medication

(last time it was 100 mg demerol along with versed) to keep me

from " fighting back " during the procedure, and he said he wants to

focus on doing the procedure, not on keeping my body under control.

Has anyone else needed general anesthesia for an ERCP? I was so

excited about going in before, but with the general anesthesia plan,

I'm getting nervous.

Debbie in Seattle

UC 1972, J Pouch 1991

Chronic Pouchitis, DX 2005, Stage 2

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No, but I agree (from personal experience) that waking up in the middle of an

ERCP is an experience to be avoided!

I don't do well with Demerol (nausea), and always ask for fentanyl. I

personally don't have any reservations about general anesthesia. If you're

uneasy about it, you may want to ask about alternative sedatives - maybe it's

the Demerol?

Arne

---- Debbie Foley wrote:

=============

Has anyone else needed general anesthesia for an ERCP? I was so

excited about going in before, but with the general anesthesia plan,

I'm getting nervous.

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My doctors have started giving benadryl before administering sedatives

(don't know what kind) for their ERCPS. The nurse said there is a

better result with the combo of benadryl and sedative. It certainly

worked for me. I have woken up during an ERCP and it is not

pleasant.

Corrie

>

> Has anyone else needed general anesthesia for an ERCP? I was so

> excited about going in before, but with the general anesthesia plan,

> I'm getting nervous.

>

> Debbie in Seattle

> UC 1972, J Pouch 1991

> Chronic Pouchitis, DX 2005, Stage 2

>

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Yes, my last 5 were under general anesthesia. I have

a history of fighting back and waking up.

Cindy Baudoux-Northrup

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Looking for earth-friendly autos?

Browse Top Cars by " Green Rating " at Yahoo! Autos' Green Center.

http://autos.yahoo.com/green_center/

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To be honest I didn't know that there is an option not to have general

aneastesia. So far, all my ERCPs have been done under general

aneastesia. I did not have problems with this apart from the nausea

after the procedure.

Chaim Boermeester, Israel

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..i used to get very nauseated after an ercp from something they were

giving me to put me to sleep. it sure hurts to heave after you have

just had your insides probed. what i started doing was reminding the

nurses about the nausea and they put something in the i.v. that would

prevent it. it worked. i would tell you what it is, but of course i

can't remember anything. good luck.

pam

p.s. i am having an ercp/egd friday

everyone pray for no varices and no

banding again.

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I wonder if there are different levels of general anesthesia? I had

versed and fentanyl for my first ERCP in 2000 and for my only

colonoscopy in 2002. They had to give me a lot and I took forever to

wake up and had terrible withdrawal and anxiety/dispair feelings for

days afterwards so on the last ERCP in 2005, I persuaded them to try

something else. They rescheduled for another day and had two people

from Anesthesiology (not sure if they needed both, but it's a teaching

hospital, s Hopkins) They gave me propofol and it was a million

times better than the versed and fentanyl. I do remember them saying

they were giving less than they would be using if I were having surgery

if that matters. Anyway, afterwards, I woke up in a couple seconds and

could focus and concentrate within a few minutes. No side effects AND

the dreams while I was asleep were totally awesome (dude).

MikeZ ..............[i am doing well, I am on the TX list, but with a

MELD of 6 and currently having more problems with knee pain than PSC

which is negatively affecting my cycling mileage, but small problems in

the big picture]

Mike Z, 35, PSC 99,

Severna Park, MD -About

Me-

Debbie Foley wrote:

>

> My ERCP scheduled for today has now been pushed back to Friday; my

> doctor called me yesterday and advised me that he wants to use

general

> anesthesia instead of demerol for the procedure.

> Has anyone else needed general anesthesia for an ERCP? I was so

> excited about going in before, but with the general anesthesia

plan,

> I'm getting nervous.

Mike Z

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From Wikipedia:

Anesthesia or anaesthesia (see spelling differences; from Greek αν- an-

“without†+ αἲσθησις aisthesis “perceptionâ€) has traditionally

meant the condition of having the perception of pain and other sensations

blocked. This allows patients to undergo surgery and other procedures without

the distress and pain they would otherwise experience. The word was coined by

Oliver Wendell Holmes, Sr. in 1846. Another definition is a " reversible lack of

awareness " , whether this is a total lack of awareness (e.g. a general

anaesthestic) or a lack of awareness of a part of a the body such as a spinal

anaesthetic or another nerve block would cause.

There are several forms of anesthesia. The following forms refer to states

achieved by anesthetics working on the brain:

General anesthesia: " [D]rug-induced loss of consciousness during which patients

are not arousable, even by painful stimulation. " Patients undergoing general

anesthesia often cannot maintain their own airway and breathe on their own.

While usually administered with inhalational agents, general anesthesia can be

achieved with intravenous agents, such as propofol.[1]

Deep sedation/analgesia: " [D]rug-induced depression of consciousness during

which patients cannot be easily aroused but respond purposefully following

repeated or painful stimulation. " Patients may sometimes be unable to maintain

their airway and breathe on their own.[1]

Moderate sedation/analgesia or conscious sedation: " [D]rug-induced depression of

consciousness during which patients respond purposefully to verbal commands,

either alone or accompanied by light tactile stimulation. " In this state,

patients can breathe on their own and need no help maintaining an airway.[1]

Minimal sedation or anxiolysis: " [D]rug-induced state during which patients

respond normally to verbal commands. " Though concentration, memory, and

coordination may be impaired, patients need no help breathing or maintaining an

airway.[1]

The level of anesthesia achieved ranges on a continuum of depth of consciousness

from minimal sedation to general anesthesia. The depth of consciousness of a

patient may change from one minute to the next.

-----------------

I think what is usually attempted for ERCPs is deep sedation, avoiding having to

" breathe " for the patient " . Like everything else, there are tradeoffs of risk.

Arne

---- Mike Z wrote:

=============

I wonder if there are different levels of general anesthesia?

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Good to see you post, Mike. I have been wondering how you are.I hope your knee feels better soon so that you can get some summer cycling in.LeeMikeZ ..............[i am doing well, I am on the TX list, but with a MELD of 6 and currently having more problems with knee pain than PSC which is negatively affecting my cycling mileage, but small problems in the big picture]Mike Z, 35, PSC 99, Severna Park, MD  -About Me- 

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My son has needed to be intubated and given general anesthesia for all his procedures, even simple EGDs for years due to him wanting to stop breathing after procedures. It works well for him. MartiDebbie Foley wrote: My ERCP scheduled for today has now been pushed back to Friday; my doctor called me yesterday and advised me that he wants to use general anesthesia instead of demerol for the procedure. Hence, the need to reschedule. I've had 3 prior ERCPs and each

of the 3 doctors involved reported the same concern.I've always been nervous about general anesthesia, but appreciate his perspective. I have a history of needing a great deal of medication (last time it was 100 mg demerol along with versed) to keep me from "fighting back" during the procedure, and he said he wants to focus on doing the procedure, not on keeping my body under control.Has anyone else needed general anesthesia for an ERCP? I was so excited about going in before, but with the general anesthesia plan, I'm getting nervous. Debbie in SeattleUC 1972, J Pouch 1991Chronic Pouchitis, DX 2005, Stage 2

TV dinner still cooling?Check out "Tonight's Picks" on Yahoo! TV.

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Thanks to all who responded to my original posting with encouragement

and wisdom. The anesthesiologist opted to use propofol IV for the

general. (My favorite registered nurse, my daughter, says they use it

often in her trauma center hospital, especially in ICU, as it works

primrily as a paralytic.) No demerol, but several doses of versed,

helped to minimize my anxiety, along with the propofol to keep me

still, thereby enabling the hepatologist to focus on what he needed to

do inside my liver. The dilation done two years ago has held well, and

my doctor said the ERCP actually looked much better than the MRCP had

indicated.

This was my fourth hospital, fourth ERCP attempt and by far the most

respectful and least traumatic. Keep looking until you find the right

physician and the right hospital; it's worth it!

I don't know how I could have survived the last few years without the

support of this group. Thanks again!

Debbie in Seattle

UC 1972, J Pouch 1991

Chronic Pouchitis, DX 2005, Stage 2

>

> My ERCP scheduled for today has now been pushed back to Friday; my

> doctor called me yesterday and advised me that he wants to use

general

> anesthesia instead of demerol

>

> Debbie in Seattle

> UC 1972, J Pouch 1991

> Chronic Pouchitis, DX 2005, Stage 2

>

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