Re: Colonoscopy report-Tina

From: Christine M. Smith (
Fri Oct 22 19:46:00 1999

At Fri, 22 Oct 1999, Tina Shelby wrote: >
>Hi Chris -
>The amount of demerol/versed for your colonoscopy is about how much is
>normally given. His report should reflect the total amount given - not just
>the inital dose. He should have done a biopsy regardless of the normal
>appearing colon. Some things can "look" normal but will show up
>microscopically on biopsy.
>It is curious that the nurse made that comment about not being able to find
>your left ovary. Yes - anesthesiologists usually do look at previous
>aneshesia reports - they give him an idea what you had the previous times
>and if you had any trouble with the meds they used. Tell me - what was the
>1st lap for - and what was done in the 2nd one? If the surgeon didn't
>document the findings at the time of the surgery - he most likely did not
>remember what problems were encountered. The anesthologist should have noted
>if you had problems such as your BP or pusle dropping. Get a medical friend
>to look at it for you - or - if you like - you can seen me a copy and I will
>look for you.
>Let me know about the other surgeries as well.

Hi tina:

This is great! Thank you. I found the endoscopy procedure report for the colonoscopy. I guess its not exactly an anesthesia report because it wasn't in the OR, it was in one of the procedures rooms. Anyway, at 1600 50 mg meperidine and 2 mg midazolam was given. Then at 1605 another 2 mg of midazolam and and 1610 another 25 mg meperidine. The notes at the botton says normal study, uncomplicated exam. Yet he told me that I was "letting him know" it was painful so I guess he thought that was an indication of my pain tolerance and not an abnormality! Well, next time I will keep this in mind. The two laps were done by different surgeons-the first by a gyn and the second by a general surgeon. Both were for adhesiolysis. The gyn (at the first lap) left all the adhesions around the sigmoid colon and just released the one tying the small bowel to the abdominal wall around the area of the appendix. The general surgeon (at the second lap) repeated the procedure with the intention of releasing the same bowel adhesion as the gyn did (because we thought it had reformed)But when he got in there he saw that the adhesion the gyn had worked on had not returned so he (the general surgeon) decided to tackle the adhesions around the sigmoid colon. Looking at my anesthesia notes again, for the first lap the initial meds were 50 lido, 100 mg propotol, 75 and 75 fentanyl, 12 mumbex, forane (I guess this is the anesthesia) at various percentages, toradol at the end, 30mg. At 1005 (induction) blood pressure was 162/90. At 1010 90/60. At this point 5 mg epedrine given. At 1015 98/58, 1020 98/50, 1025 90/42, 1030 80/38. At this point another 5 mg epedrine given. At 1035 98/42, 1040 98/42, 1045 100/48, 1055 118/58, 1100 110/38, then by 1115 120/60. The only thing I could see is that my diastolic blood pressure got a little low. Is that why ephedrine was given or is that routine? There were no comments, other than 1122 10cc 1/4 % marcerine ? (hard to read) locally, 3 mg __/__ robinol and 1130 something about skin closure and something I can't read, rate to 33-, .4 atropine given w return to SR. There are other notations next to SpO2, etc. but they all look stable (100, 99, etc.) FIO2/PIP .32/22, .36/27, .35/33, .3e5/30, .35/25 The notes for the second lap were basically the same, bp at one pt 85/40 but no notation for drug given. At the beginning lido/propolol 30/?, fentanyl 100, rocuromium 40, then at the end ketorolac 30, neostigmine 2.5, glycopyrolate 0.4 No notes were made on the second anesthesia report about the first, so I would say whatever the nurse after the first lap was referring to was not important. I've heard/read that sometimes the left ovary is hard to find because it is hidden behind the large bowel. In my case, the notes for the second lap say that could not find it until they took down adhesions enabling them to move the bowel.

Chris S.

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