I am scheduled for a colon exam soon. I am currently taking Lortab and Soma for back pain. Will this affect me when given anesthesia? 

The short answer to your question is no. The Lortab and Soma you are taking for back pain will not affect your anesthesia. Lortab (acetaminophen plus hydrocodone) and Soma (carisoprodol) are commonly prescribed medicines for pain. Lortab is a moderately strong narcotic. Soma is a muscle relaxant. If you are not currently having any side-effects or other problems you could safely continue to take these medicines up to the time of your procedure. You should check with your doctor on the rules for eating, drinking, and medications before your particular procedure. In most cases, pain medicines can be continued, including the day of the procedure itself, when they may be taken with sips of water. 

I recently had to have an endoscopy; I was told that it would be done under conscious sedation. Despite receiving fentanyl 100mcg and midazolam (sorry, I don`t know the dose) I was wide awake through the entire procedure; it was very distressing, not to mention frustrating because the gastroenterologist got exasperated with me because I couldn`t stop gagging. The same thing happened to me about 15y ago when I had the same procedure. I am not taking any medications that would have interacted with the sedation. There was no anesthesia provider present during the procedure; the meds were given by an RN. Any suggestions for the future if I have to have a repeat endoscopy? I really would rather not go through that again. 

I'm sorry you had such an unpleasant experience with your endoscopy.ﾠ If you need another endoscopyﾠyou should have a good talk ahead of time with the doctor performing the procedure,ﾠso that you canﾠexplain what happened to you. ﾠIdeally, you will get a copy of the records of your recent procedure, including the doses of sedative medication that you received, and share those records with the doctor. There is a lot of variation in the amount of sedation that different people need for endoscopies and similar procedures. ﾠFor example, a skinny, teetotal, 80 year-old woman with heart problems will usually need a tiny dose of a drug such as midazolam to tolerate an endoscopy.ﾠ A robust, healthyﾠ20 year-oldﾠmanﾠwill probablyﾠneed several multiples of that, plus a drug such as fentanyl.ﾠ You are perhaps someone with a higher tolerance for these medicines, needing a larger dose to adequately sedate you thanﾠthe "standard" dose of, say, midazolam 2 milligrams, which you mention. Another anesthetic drug, propofol, can provide excellent sedation for endoscopy, and rapid recovery afterwards, but is best given by an expertﾠin the use of such drugs -ﾠan anesthesiologist. Propofol-based sedation is probably the "gold standard" for sedation for minor procedures. The great thing about well-performed sedation is that its a win-win - the patient has a comfortable experience, and the doctor has ideal operating conditions and can concentrate on the task at hand, instead of trying to complete the procedure as quickly as possible on a squirmy, anxious patient.ﾠ It has even been shown that the rate of detection of abnormalities during endoscopy is higher in patients who receive this kind of sedation/anesthesia. Of course the reason why you may have received only a standard dose of sedative medication is that these drugs can produce an over-sedated, even unconscious patient who then requires resuscitation.ﾠ This is the reason why hospitals are require to "credential" non-anesthesiologists to provide sedation - making sure that they have the skills necessary to "rescue" patients who become inadvertently sedated to excess.ﾠ The RN providing you with sedation may have been concerned about giving you too much. One option for your next endoscopy is to have it in a facility that uses an anesthesia professional, who will tailor the sedation to your needs, and do it safely. ﾠIf this is not available to you, you could simply explain to the doctor what happened, and suggest that additional sedation beyond "standard" doses be used.ﾠ At the end of the day however, your doctors, who understand your medical condition,ﾠare the ones that must be trusted to make appropriate medical decisions with your input and your assent. 

I am having eye lid surgery in two weeks. Is it OK to take a 2mg of diazepam at 7:30AM and surgery then will be at 9AM. I have been told that I will be in twilight state, and that it was makes me nervous. they say I need to be somewhat awake to aid in the surgery. 

ﾠDiazepam, also known as Valium, is a medication that decreases anxiety. In larger doses (generally more than the 2 mg that you intend to take) diazepam causes sleepiness. If you are accustomed to taking diazepam for nervousness or anxiety it is unlikely that this will be a problem during your surgery. Hopefully it will help you get in a more relaxed frame of mind beforehand. During the procedure you will be given intravenous sedation (ﾓtwilight stateﾔ) to keep you nice and calm. This is usually very successful and safe, and allows a rapid recovery and return to daily life. The surgeon does not want you to be too sleepy however because you must be able to cooperate - for example by blinking - during the operation. You should always check with your doctor before taking any medication on the day of a surgical procedure. In most cases you will be advised to continue taking your usual medicines, but there are exceptions. In your particular case it is likely that your doctor will agree to letting you take the diazepam, but you should definitely check with him/her or the office to make sure. 

I am having lacrimal duct surgery performed for a blocked tear duct. The surgeon is using monitored care anesthesia with sedatives. He said I would be very drowsy and possibly asleep. This is unclear to me. I would like to be prepared to ask the anesthesiologist a few questions regarding this type of anesthesia. Any light you can shed on the topic would be helpful. Will I need to be intubated? Will I be monitored? Is this type of anesthesia suitable for this surgery? What is the recovery like? Will I remember the procedure? How is the anesthesia administered? 

ﾠThe following detailed definition of "monitored anesthesia care" (MAC) is from the American Society of Anesthesiologists: "Monitored anesthesia care is a specific anesthesia service in which an anesthesiologist has been requested to participate in the care of a patient undergoing a diagnostic or therapeutic procedure. Monitored anesthesia care includes all aspects of anesthesia care - a preprocedure visit, intraprocedure care and postprocedure anesthesia management. During monitored anesthesia care, the anesthesiologist or a member of the anesthesia care team provides a number of specific services, including but not limited to: monitoring of vital signs; maintenance of the patient`s airway and continual evaluation of vital functions; diagnosis and treatment of clinical problems which occur during the procedure; administration of sedatives, analgesics, hypnotics, anesthetic agents or other medications as necessary to ensure patient safety and comfort; provision of other medical services as needed to accomplish the safe completion of the procedure. Monitored anesthesia care often includes the administration of doses of medications for which the loss of normal protective reflexes or loss of consciousness is likely. Monitored anesthesia care refers to those clinical situations in which the patient remains able to protect the airway for the majority of the procedure. If, for an extended period of time, the patient is rendered unconscious and/or loses normal protective reflexes, then anesthesia care shall be considered a general anesthetic." The choice of a particular anesthetic technique (MAC, general anesthesia, regional anesthesia) is normally a decision made by the anesthesiologist, taking into account the type of surgery as well as the needs and preferences of both the patient and the surgeon. A monitored anesthesia care technique usually involves the administration of intravenous anesthetic drugs, oxygen (given with a nasal cannula or face mask), and standard patient monitoring procedures similar to those used during a general anesthetic. MAC implies that the trachea (windpipe) is not intubated. Because MAC usually entails the administration of lower doses of anesthetic drugs than with a general anesthetic, the recovery period tends to be shorter. The drugs that are used definitely affect one`s ability to remember the procedure, but periods of awareness can occur. Please consult your anesthesiologist before your surgery to establish what is planned for you and to answer any other specific questions. 

I am going to have a cyst removed from my flexor tendon sheath. They are going to use MAC sedation. I am extremely terrified of this. After reading several reviews on this type of sedation, I am now worried that I will be aware of what is going on, and if this happens, I know I will freak out. I want to tell the anestiageoligist (sp?) that I want him to knock me out before the surgeon even touches my hand. I am so scared. Can you tell me if he will do that. I just don`t think I can go through with this if he doesn`t. The cyst is so painful and restricting that I need to get it removed though. Any advice on this MAC would greatly be appreciated. If you could tell me around about way I will feel when I am on it. I know everyone is different. 

Clearly you are very frightened about your upcoming surgery. It's natural to be somewhat anxious but I do wonder what you've been reading and why you are so scared. I'm sure you realize that a cyst removal from your tendon sheath is a pretty minor procedure. If it's pain you are worried about you can be sure that the combined efforts of a competent surgeon and anesthesiologist together will ensure you are pain free during the procedure. If it's done under "MAC" - that is moderate or deep sedation - you may be "aware of what is going on" in that you may feel the surgeon touching, moving or applying pressure to your hand. You might be correct about that alone being enough to freak you out, but I doubt it because in my experience even the most anxious of patients manage just fine, given lots of reassurance and the correct amount of sedative medication. After discussing your anxiety with the anesthesiologist I'm sure he or she will give you some anxiety-relieving sedation - such as midazolam - before you reach the operating room. That will probably be enough to calm you down. During the procedure itself you will probably receive additional midazolam together with intravenous sedation - e.g. propofol. These drugs in high enough doses can produce general anesthesia - unconsciousness - but the aim is usually a state of sedation short of general anesthesia. If you are absolutely unwilling to have the procedure in the way it has been planned you should speak with your surgeon and anesthesiologist, preferably ahead of time. It is likely that they will be rather understanding of your fears, reassure you that all will go well, but offer you the option of general anesthesia if that is what you desire. A necessary condition however is that facility in which you are to have the procedure done must have the capability of providing general anesthesia including the appropriate after-care. There might be additional out-of-pocket cost to you. 

I recently had a colonoscopy. I was given a white milky medication via IV to sedate me for the proceedure. When I awoke a short time later in the recovery room, I felt GREAT. No side effects. I would like to know the name of the medication used. 

That's an easy one! The milky white medication is propofol (trade name Diprivan in its original formulation). Propofol has become, worldwide, the intravenous anesthetic agent of choice. When used for sedation, propofol often produces the experience you describe. A few individuals even have pleasant dreams.