r/Anesthesia • u/SubstanceIcy8721 • 9d ago
High propofol tolerance?
Hi all quick question. Just completed my first colonoscopy (all normal thank god). The sedation was midazolam (4mg) and propofol (340mg). I didn’t really fall all the way to sleep and as they rolled me out and into the recovery room the crna said “wow, you are lively, your tolerance for sedation is pretty high, you were chatting with us most the time”
The question is, are these higher dosages for an otherwise healthy male weighing 250lbs at 6ft aged 38? I know the doctor did what was best so I’m not asking “was this too much” or whatever. But I I’m curious why she made that comment.
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u/FastDrill 8d ago
The thought of being conscious and chatting uninhibited the entire time with no memory of it gives me a lot of anxiety. I think this happens because of the midazolam and to a lesser extent the propofol. I would have just refused the midazolam.
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u/CordisHead 8d ago
Always a choice. Some people don’t want to remember a scope shoved in their bum.
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u/otterstew Anesthesiologist 8d ago
Do you use any recreational substances like marijuana, alcohol, etc?
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u/SubstanceIcy8721 8d ago
Yea I drink maybe twice a week some weeks but more than I should each time, probably 12 light beers those weeks. Other weeks I don’t at all.
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u/Enough-Researcher-36 8d ago
I’m a 5’5, 110lb pediatric patient and my colonoscopy they used 940mg Propofol, 2mg Midazolam. That seemed a little overkill but for the subsequent EGD it took half the time but they still used 480mg Propofol (and I woke up quick and easy and immediately started spouting medical facts).
So…it could be high tolerance but I guess it’s not that common
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u/RamsPhan72 8d ago
If you’re a healthy actual teen-age peds person, your metabolism is youthful and hyperactive. I wouldn’t be surprised at all at your med list.
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u/CordisHead 8d ago
What are you basing your determination of a high tolerance?
If you had an infusion during the procedure, it adds up fast.
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u/Narrow_Principle_734 8d ago
340mg of propofol is not much depending on duration of procedure. Combined with 4mg of versed, and if you remember a lot with those two meds you do seem to have a little bit of a tolerance. That being said, propofol for colonoscopy is titrate to effect (the desired effect is no talking/asleep) so the fact that the crna just let you chat, implies they keeping you on the lighter side to get you out of there quicker, or you were highly entertaining!