Sorry I am a bit late to this discussion, it's been a crazy busy week.

Meds typically given for colonoscopy are either administered by the gastroenterologist (as "conscious sedation") or by an anesthesiologist (MAC or "monitored anesthesia care," not a general anesthestic).  Anything give for this should be fine -- GI's usually give a narcotic such as demerol or fentanyl + midazolam (benzodiazepine with nice side effect of amnesia).  When I did anesthesia for these in training, usually for patients with significant underlying medical conditions where the GIs wanted an anesthesiologist taking care of the sedation part of things, I'd do propofol and usually skip the midazolam.  I would typically give a small amount of narcotic as well, as colonoscopies *are* painful because of the air insufflation used for visualization -- don't underestimate the intensity of stimulating those stretch receptors.  I've done dozen of these cases.  Those of you who forgo meds altogether, um, wow.  Please drug me up for something like that.

Patients respond in spectacularly different ways to the same dosage of medications, and a typical dose of midazolam/fentanyl given for a colonoscopy will be absolutely fine for a breastfeeding baby -- and mom *shouldn't* need an entire day to recover from those meds (but everyone is different).  Doing a straight-up propofol case without midazolam and with a touch of narcotic would result in an even faster recovery from the anesthesia but in most jursidictions an anesthesiologist needs to do that.

Endometrial biopsies are usually done in the office without any anesthesia at all.

And as others have alluded, the typical concoction used to "clean out" the GI tract beforehand is an osmotic solution designed to draw fluids into the colon -- it's not absorbed at all and shouldn't affect the baby although mom may become a bit dry/dehydrated.

Good luck to this mom,
Sarah Reece-Stremtan MD (pediatric anesthesiology fellow in Washington DC)

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