Crohn's Disease Forum » Tests for IBD » Anesthetics for colonoscopy, and their effects on the brain


09-28-2018, 08:24 AM   #1
Crohn2357
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Anesthetics for colonoscopy, and their effects on the brain

I have been getting a colonoscopy every year due to high risk of cancer. Because of the inflammation and pain, I get anesthesia for the procedure, and I wonder if these agents are harmful for the brain.

Could you share your opinion?

Here's an article on the sedation agents for the colonoscopy:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973564/

I think they give me propofol, an anxiolytic, and something else. A trio cocktail for the procedure.
09-28-2018, 09:32 AM   #2
Crohn2357
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Functional imaging methods, including positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), have become important tools for studying how anesthetic drugs act in the human brain to induce the state of general anesthesia. Recent imaging studies using fMRI and PET techniques have demonstrated the regional effects of propofol on the brain. However, the pharmacological mechanism of the action of propofol in the intact human central nervous system is unclear. To explore the possible action targets of propofol in the human brain, a systematic review of the literature was performed. The literature search was performed with limiting factors of "propofol," "functional imaging," "positron emission tomography", and "functional magnetic resonance imaging" from 1966 to July 2013 (using Medline, EMBASE, CINAHL and hand searches of references). Studies meeting the inclusion criteria were reviewed and critiqued for the purpose of this literature research. Eighteen researches meeting the inclusion criteria were reviewed in terms of the appropriateness of valuation technique. In the unconscious state, propofol sharply reduces the regional glucose metabolism rate (rGMR) and regional cerebral blood flow (rCBF) in all brain regions, particularly in the thalamus. However, GMR, such as in the occipital, temporal, and frontal lobes, was obviously decreased at a sedative dosage of propofol, whereas, changes in the thalamus were not obvious. Using fMRI, several studies observed a decrease of connectivity of the thalamus versus an increase of connectivity within the pons of the brainstem during propofol-induced mild sedation. During deep sedation, propofol preserves cortical sensory reactivity, the specific thalamocortical network is moderately affected, whereas the nonspecific thalamocortical network is severely suppressed. In contrast, several recent fMRI studies are consistent on the systemic decreased effects of propofol in the frontoparietal network. Accumulating evidence suggest that propofol-induced unconsciousness is associated with a global metabolic and vascular depression in the human brain and especially with a significant reduction in the thalamocortical network and the frontoparietal network.
Anesthetic effects of propofol in the healthy human brain: functional imaging evidence.
https://www.ncbi.nlm.nih.gov/pubmed/25056258

This Is What Happens To Your Brain During Anesthesia
https://tonic.vice.com/en_us/article...ing-anesthesia

How general anesthetics affect the brain
https://www.medicalnewstoday.com/articles/320564.php

Anesthesia, brain changes, and behavior: Insights from neural systems biology.
https://www.ncbi.nlm.nih.gov/pubmed/28189740

Expert opinion: Exposure to general anesthetics is potentially harmful to the human brain, and the consequent long-term cognitive deficits should be classified as an iatrogenic pathology, and considered a public health problem. The fact that in laboratory and clinical research only certain anesthetic agents and techniques, but not others, appear to be involved, raises the problem on what is the safest and the least safe anesthetic to maximize anesthesia efficiency, avoid occurrence of adverse events, and ensure patient safety. New trends in research are moving toward the theory that neuroinflammation could be the hallmark of, or could have a pivotal role in, several neurological disorders.
An update on anesthetics and impact on the brain.
https://www.ncbi.nlm.nih.gov/pubmed/28697315

Brain Effects of General Anesthesia
https://psychcentral.com/lib/brain-e...al-anesthesia/
09-29-2018, 11:44 PM   #3
Lynda Lynda
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Thanks for the information.
Years ago I received Versed as anesthesia for my scopes, now I receive propofol.

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10-03-2018, 08:41 AM   #4
Tuff
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My gastroenterologist uses conscious sedation. He refuses to put anyone out. I remember watching the procedure on the screen, but I wasn't really "there". I did respond when he asked me to move a bit.
10-03-2018, 12:00 PM   #5
Crohn2357
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The research points out that the anesthetic propofol, for example, significantly reduces cerebral glucose metabolism rate, and cerebral blood flow. This is a recipe for disaster. It's like your brain is dead for as long as the drug is in your veins to keep you unconscious. This is an invitation for alzheimer's (whose pathogenesis mainly consists of reduced cerebral glucose metabolism rate, reduced cerebral energy, reduced cerebral blood flow etc.).

The mechanism of the other drugs that have been used for anesthesia are not better than propofol if you look for them.

My first colonoscopy was done without anesthesia, and it hurt like hell. From then on, for all the colonoscopies and sigmoidoscopies I have had, I got anesthesia. My GI also said it would be better for me to get anesthesia, because of the inflammation and the sensitivity, especially around my rectal area.

I don't know how it would feel to get a colonoscopy without getting general anesthesia. How does it feel to get a colonoscopy with moderate to severe rectal inflammation and getting only light sedation (or nothing at all) for the procedure; could someone post his/her experience?

Last edited by Crohn2357; 10-03-2018 at 08:35 PM.
10-03-2018, 01:02 PM   #6
Tuff
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The last colonoscopy I had in March using conscious sedation. At the time, my large intestine and rectum were toast, covered in ulcers. I also have a stricture in the rectum. That was the only spot where I felt some pain, when he pushed the scope through the stricture. It also felt uncomfortable when he turned the camera around. We're all different, I think I have a high tolerance for pain. The competency of the doctor could be an issue too. The nurses told me not to worry, that my doctor is just excellent. I agree.
10-03-2018, 01:12 PM   #7
Crohn2357
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Tuff, thank you for sharing.
10-03-2018, 04:29 PM   #8
D Bergy
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I donít recall any noticeable effects from colonoscopy sedation nor do I know the agents used. However, I did notice a loss of memory from my two surgical procedures later on. One of them was fourteen to sixteen hours according to my wife. Until I just asked her now, I had no idea it was that long.

I guess you could expect that given the time under anesthesia but again, I donít know what type of anesthesia used.

Anyway, I had decided I am not getting any more colonoscopies unless there is some compelling reason to do so.
None of the prior ones showed anything of any value as my Crohnís inflammation was not in a region accessible by a scope.

Dan
10-03-2018, 08:42 PM   #9
Crohn2357
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I donít recall any noticeable effects from colonoscopy sedation nor do I know the agents used. However, I did notice a loss of memory from my two surgical procedures later on. One of them was fourteen to sixteen hours according to my wife. Until I just asked her now, I had no idea it was that long.

I guess you could expect that given the time under anesthesia but again, I donít know what type of anesthesia used.
Do you think the loss of memory still continues, to some extent?

Someone shared his/her suspicions regarding his/her experience with anesthetics and deterioration of cognitive function: https://www.healingwell.com/communit...f=17&m=4069112

I read in articles that the anesthetics' negative effects on the brain and cognition are more pronounced in children and the elderly people.

Anyway, I had decided I am not getting any more colonoscopies unless there is some compelling reason to do so.
None of the prior ones showed anything of any value as my Crohnís inflammation was not in a region accessible by a scope.

Dan
I agree, I will be much more cautious about anesthetics, sedative agents from now on. Thanks for sharing.

Last edited by Crohn2357; 10-03-2018 at 09:04 PM.
10-03-2018, 09:04 PM   #10
Trysha
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September this year I had upper endoscopy and colonoscopy and was sedated with fentanyi
and versed...recovered quickly and no after effects.
The same was done last year...no after effects.
I find I have reactions to a number of meds so I am fortunate this was used...without problems.
That may not be true for everyone due to biological variation.
One mans meat can be anotherís poison.
I have had this year a severe anaphylactic reaction to morphine which was swiftly treated with epinephrine....a complete surprise since I had it before with no problems.
Now I have been told to carry an epi pen......I was in the ER being treated for a broken and a dislocated shoulder with chipped bone after a bad fall.
I made a swift recovery after the procedure under general anesthetic.
It happened so suddenly while I was talking to a relative and we were expecting to be able to go home...suddenly I was unconscious due to the bad reaction after the injection of morphine.The recovery was swift after the epinephrine but then I was not allowed home and spent the next thirty days in hospital.
10-03-2018, 10:22 PM   #11
Crohn2357
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I think, in regards to the anesthetic usage, it is clear that every time you are given the anesthetics, your brain gets a negative effect from it.

How we feel after the procedure does not reliably reflect what has happened to our brains.

The harmful effect is there, and the brain gets harmed from exposure to anesthetics; that much is certain. The questions are: how are we affected, how much are we affected, and how much of the effects are permanent?

The anesthetics we receive (i.e. which ones), the duration of the anesthesia, the dosage, the individual's state etc. are some of the parameters for the harmful affect; but harm necessarily happens to all people (every human brain) with these agents.

That's my understanding.
10-03-2018, 10:25 PM   #12
D Bergy
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Do you think the loss of memory still continues, to some extent?
Yes, I don't think what I lost will come back and really as time goes by I am not really able to tell what I forgot. Can't remember what I forgot. Ha ha. The most obvious thing to me is I have always been good at identifying songs on the radio with the group or person who sang them. Not so much after all the surgeries. I still recall a lot of them but I know of some songs that I draw a blank on that I do remember knowing before. I rarely forget that stuff once I know it.

I was driving down a road I had been down a thousand time or so and came to a T in the road. I had no idea which way was the right way or where I was even though I knew what road I was on. That was a bit scary, as my father has dementia and that is the first thing I thought of.

I do not recall this personally but I was discussing this memory loss thing with my wife and asked if she recalls anything related to that since my surgery. I still have a hard time believing this but she certainly isn't one to make up things. She said one of my grand daughters was standing next to me and I asked her who it was. She doesn't recall the exact time frame so it is possible I was on the various painkillers post surgery at that time but even so, that is a pretty big memory loss although its not like I forgot who the grand daughter was or didn't know her. I did not recognize her though.

I still have my ability to solve complex problems which is kind of the thing I excel at. So I do not appear to have lost any of that, or at least as far as I can tell. Also I am older every day and age doesn't improve a darn thing that I am aware of so how much is attributed to that I don't know. But, definitely some memory is gone and it was gone right after my surgical ordeals. I do recall telling my wife that I lost some memory right after.

Trysha. Since you mentioned the Epi Pen you should be aware of the possible consequences of epinephrine use. If you need it, you need it, and in an emergency its certainly worth using, but it appears that it may not be without its own effects on the brain.

https://www.naturalnews.com/2018-10-...in-damage.html

Dan
10-03-2018, 10:31 PM   #13
Crohn2357
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That was a bit scary, as my father has dementia and that is the first thing I thought of.

Dan
I think Steve Fowkes is worth listening for prevention and reversal of Alzheimer's - dementia:

https://www.youtube.com/results?sear...+alzheimer%27s

https://www.youtube.com/watch?v=Cbew309VhQg
10-04-2018, 10:19 AM   #14
Tuff
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One comment at the Healing Well link got my attention. Someone mentioned ICU and oxygen having the same reaction. Seven years ago I was in ICU for five days following a pulmonary embolism. For a year afterwards, my handwriting was chicken scratch and I could not concentrate enough to read a book. My beautiful handwriting is back, but I still have trouble finishing a book.

On second thought, that could be oxygen deprivation due to the embolism. I also had five units of blood administered during my stay.
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