Difference between revisions of "Colonoscopy"
From WikiAnesthesia
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{{Infobox surgical procedure | {{Infobox surgical procedure | ||
| anesthesia_type = | | anesthesia_type = MAC | ||
| airway = | | airway = Natural airway | ||
| lines_access = | | lines_access = 1 PIV | ||
| monitors = | | monitors = Standard ASA monitors | ||
| considerations_preoperative = | | considerations_preoperative = Watch for symptomatic anemia from GI bleed | ||
| considerations_intraoperative = | | considerations_intraoperative = | ||
| considerations_postoperative = | | considerations_postoperative = | ||
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* Bright red blood per rectum (BRBPR) | * Bright red blood per rectum (BRBPR) | ||
* Melena | * Melena | ||
* | * Unexplained constipation/diarrhea | ||
* Routine follow-up for patients with known polyps, IBD, other chronic bowel disease | |||
* Colon cancer screening (in US, every 10 years after age 45) | * Colon cancer screening (in US, every 10 years after age 45) | ||
| Line 37: | Line 38: | ||
|- | |- | ||
|Hematologic | |Hematologic | ||
| | |Anemia is common with lower GI bleed | ||
|- | |- | ||
|Renal | |Renal | ||
| Line 50: | Line 51: | ||
=== Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. --> === | === Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. --> === | ||
* CBC w/ Hgb | |||
=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> === | === Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> === | ||
* Nasal cannula for oxygenation | |||
=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> === | === Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> === | ||
* Bowel prep based on GI physicians | |||
=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> === | === Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> === | ||
* N/A | |||
== Intraoperative management == | == Intraoperative management == | ||
=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> === | === Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> === | ||
* Standard ASA monitors | |||
* 1 PIV | |||
=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> === | === Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> === | ||
* Small amount of propofol and lidocaine (for MAC) | |||
=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> === | === Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> === | ||
* Left lateral decubitus | |||
=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> === | === Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> === | ||
* Propofol drip (TIVA) | |||
=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> === | === Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> === | ||
| Line 72: | Line 90: | ||
=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> === | === Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> === | ||
* PACU and home unless unstable anemia | |||
=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> === | === Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> === | ||
Revision as of 18:12, 22 November 2021
Colonoscopy
| Anesthesia type |
MAC |
|---|---|
| Airway |
Natural airway |
| Lines and access |
1 PIV |
| Monitors |
Standard ASA monitors |
| Primary anesthetic considerations | |
| Preoperative |
Watch for symptomatic anemia from GI bleed |
| Intraoperative | |
| Postoperative | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
A colonoscopy is a flexible scope that is inserted through the rectum to diagnose and treat problems with the lower GI tract (rectum, colon). It is commonly used to further work up patients with:
- Bright red blood per rectum (BRBPR)
- Melena
- Unexplained constipation/diarrhea
- Routine follow-up for patients with known polyps, IBD, other chronic bowel disease
- Colon cancer screening (in US, every 10 years after age 45)
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Neurologic | |
| Cardiovascular | |
| Respiratory | |
| Gastrointestinal | |
| Hematologic | Anemia is common with lower GI bleed |
| Renal | |
| Endocrine | |
| Other |
Labs and studies
- CBC w/ Hgb
Operating room setup
- Nasal cannula for oxygenation
Patient preparation and premedication
- Bowel prep based on GI physicians
Regional and neuraxial techniques
- N/A
Intraoperative management
Monitoring and access
- Standard ASA monitors
- 1 PIV
Induction and airway management
- Small amount of propofol and lidocaine (for MAC)
Positioning
- Left lateral decubitus
Maintenance and surgical considerations
- Propofol drip (TIVA)
Emergence
Postoperative management
Disposition
- PACU and home unless unstable anemia
Pain management
Potential complications
Procedure variants
| Variant 1 | Variant 2 | |
|---|---|---|
| Unique considerations | ||
| Position | ||
| Surgical time | ||
| EBL | ||
| Postoperative disposition | ||
| Pain management | ||
| Potential complications |
References
Top contributors: Tony Wang, Charles Campana and Chris Rishel