Suggest Treatment For Sleep Apnea When On Fentanyl Patch

Brief Answer:
MAC-better option

Detailed Answer:
Hi,

Thanks for using HCM.

I am Dr. Sabiha Banu, anaesthetist. Can understand your problem & feel greatly concerned about your condition.

As such colonoscopy can be done in very smooth way, with good pregelled local anaesthetic scope under the hands of good expertised surgeon, if patient is tolerant and co-operation as the procedure requires minimun time. Many endoscopist at my centre perform colonoscopy with just this pregelled local anaesthetic agents. However most of the patients with history of sleep apnea have high chances for apnea and bronchospasm during painful insertion or dilation of the sphincter (during scopy). Therefore use of anaesthetic agents are right.

From your history I see you already have history of sleep apnea, (opiod induced with central respiratory suppression), stage 3 CKD, GERD, and all these medical problems are clinically very risky condition to allow use of General anesthesia. Therefore MAC (Monitored anaesthesia care) is the best option in your case due to the required dose adjustments & titrated doses with necessary oxygen support. During MAC, you will be on conscious sedation which in simple words mean you will be asleep during the procedure. So I think you should be considering general anesthesia.

Most of the drugs used during MAC are opioids, benzodiapines, anticholinergics, oxygen & rarely inhalational anaesthetics.

In other words, use of anesthesia is acceptable in your case. You can without issue go with MAC where you will be asleep during the procedure. I will not recommend total general anaesthesia because considering the medical condition, GA is extremely risky.

Can you let me know if you are on CPAP support for sleep apnea.
Hoping that i could help you at least in some extent.

Hoping that your procedure runs smoothly, uneventfully, with positive outcome.
Please get back to me if you have any related doubts.

All the best , take care

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Brief Answer:
MAC--safe, no complications

Detailed Answer:
Hi

thanks for following up with HCM.

Sleep studies will really decide the requirement for CPAP, or the need of OXYGEN during MAC, also safer for both (patient and anaesthetist), to prevent complications for smooth and uneventful procedure.

When you have already undergone with GA (for knee surgery) & IV sedation ( for Colonoscopy) recently, then this episode of colonoscopy should not produce any problem.

Do not worry MAC/Concious sedation under monitoring, as such will keep you more comfortable with keen anaesthetic observation.

I hope that my information will help you in the best.

wishing you good health once again.

All the best, take care.

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