Wednesday, November 15, 2006

On Conscious Sedation

I don't know if "conscious sedation" is universally used for colonoscopies, but I've had it (for an upper endoscopy) in the past, and I found it interesting.

The really odd thing about conscious sedation, for me, was the amnesia. Most of us have seen television shows or read books about people experiencing a loss or lack of memory of events, but it's another thing entirely to experience it, and my upper endoscopy some years back was my first such experience.

I do remember being wheeled into the room for the procedure, the IV starting, and then....

...I was asking "did they find anything?"

"No," the nurse replied kindly, "did you know this was the fourth time you've asked?"

I didn't. I noticed I was lying in bed in the recovery room, and ... hey, how did I get dressed?

It is a curious thing, and it's difficult for me to know how much of this feature of conscious sedation is keeping the patient from the memory of the pain or discomfort of the procedure, and how much of it is just a side-effect of an otherwise effective medication. I don't know the answer, I'm curious to know the answer, anyone know?

105 comments:

kightp said...

I'm pretty sure the amnesia is a feature, not a bug. I have a very vague, dreamlike memory of having surfaced briefly during my own colonoscopy, saying something about discomfort and having my position adjusted by the attendants. It's not a memory of pain, but a memory of having been in pain, if that makes any sense.

And coming out of it, for me, was a bit of a fade-in, fade-out process. I remember a nurse helping me get dressed ... the nothing ... I remember the doctor coming in to show me pictures and his beginning to explain them to me, but nothing of the explanation. I remember walking up my front steps and into the house and checking the note I'd left myself on the dining table ("feed the cat") ... nothing ... and going back to check it again later to see that I'd written "the cat has been fed" on it. It took a couple of hours after the procedure before my short-term memory really kicked back in.

Mary said...

and going back to check it again later to see that I'd written "the cat has been fed" on it . . .

Then later, a fuzzy memory of the cat erasing that bit . . .

Lisa said...

This semi-sedation procedure scares me. I know it's irrational, but I'm afraid that if I had it during surgery, the surgery would hurt and I'd be awake for that. The fact that I'd later forget all of it doesn't really comfort me. So, reading of your experiences is fabulous comfort for me.

My mom claims that during her skin cancer surgery, where she had this sort of semi-sedation, she woke up and started bossing the doctors around.

Anonymous said...

Versed sounds like a scary, scary drug. Take a look at the experiences near the bottom of the Versed page on askapatient.com or the versed busters blog.

I'm going to be having a colonoscopy and endoscopy soon, and am going to demand that they do not administer Versed or any drug like it.

Joe said...

The premise of the second blog seems strange to me, I was fully informed both times I've been given Versed of it's amnesic side-effects.

Anonymous said...

Colonoscopies are uncomfortable for sure, however, bone marrow tests are much worse. Having had bone marrow tests with and without versed I insist on versed now. The amnesia is the blessing and it doesn't make you forget anything before the procedure or after the the drug wears off. It makes you relax during the procedure and tensing up causes more pain. So heed my advice! Use the versed!

Anonymous said...

The use of VERSED opens the door for the Dr and nurses to do things and inflict pain that you would never allow to be done if you were aware it was going on. VERSED is NOT a pain relever. This drug is messing with your mind. I guess some people are ok with that. If your Dr does not explain this drug in this way to you I wouldn't trust anything else he(or she) tells you either.

Anonymous said...

I just recently had a colonoscopy and yes I have had those same fuzzy memories. Actually, most of my family members have had one recently because one my brothers died of colon cancer a few months ago at age 35. So I have had the opportunity to talk to my family members about it aswell. I do have a very fuzzy memory of the precedure hurting or at least I said it was hurting and then I woke up in recovery.

I asked my dad about that and he said that he works with a guy who also had a colonoscopy but he was not sedated for it. He said that it hurt. Apparently it was bad enough that he was telling the doctor that he had better stop hurting him or me would kill him.

So, if someone demands that they have the procedure done without Versed then be my guest. I hope you enjoy your total consciousness of what happens. But as for me I am a fan of Versed.

steven's mom said...

When I was scheduled for a colonoscopy the person who set up my appointment told me that I would have conscious sedation, a twilight drug. I mistakenly thought that I would be aware but just not care. No mention was made to me by any medical personnel what the name of the drug was or that it would cause amnesia or that is has absolutely no pain killing properties.

For months after the procedure I had a creepy, weird feeling of trying to remember something but I just couldn't. After procuring a copy of my medical report, I found out that they had given me Versed. I looked it up on the internet and found out that it produces amnesia. That's when I realized why I was feeling so creepy. I was really mad that no one had told me that they were going to induce amnesia. When I was 13, I had general anesthesia and it did not produce the same negative effect. With general anesthesia you are truly "knocked out". I found out from an OR nurse that under the influence of Versed a patient can still talk and move and follow directions and feel pain.

I also found out that Versed is routinely used prior to surgery now even if you're going to have general anesthesia.

You probably will not be told or asked about the Versed. They will just give it to you.

Joe said...

Steven's Mon,

My experiences with being advised about Versed were quite different, I had my procedure done at the Palo Alto Medical Foundation, and they were quite clear (maybe even put into writing) information about the drug and the accompanying amnesia. I would be deeply disturbed by being "surprised" by Versed.

--Joe

bryniebin said...

I had a transesophageal echocardiogram and they gave me versed and valium before the procedure. It was clearly explained to me what the reasons were for administering these drugs and the effects they would have on me. The trouble is that not all people react the same way and unfortunately I remember the entire procedure. The Versed had no effect on my memory and the Valium only did what it has done before and turn me into a complete witch. Has anyone else had a lack of effects from Versed?

Joe said...

Yep, I know of a couple folks who've had no amnesia after being given Versed.

Anonymous said...

For those preparing to undergo a colonoscopy, there's a great deal of helpful medical information about colonoscopies here.

Anonymous said...

I just had a colonoscopy and was put out with Versed and no told about possilbe amenesia. i last recall them injecting me with it and the next thing i recall was being in my home 3 hours later! i do not recall the procedure, dressing afterwrard, being in the recovery room or getting home in my friend's car. I realized afte ri was home i had no memories of all of this and it scared the hell out of me. what did i say during the proecdure? What did i do? I wish i was told about the side effects prior to the procedure. i still might have used Versed but at least I wouldn't find myself in my home wondering where my morning went.

Anonymous said...

I just had my 4th colonoscopy. For my first one I had a choice of how much sedation I would be given. I opted for the minimum 1 milligram of Versed and 50 milligrams of Demoral. Versed creates the sedation and Demoral (a narcotic) is for pain relief. This is often times is considered a pediatric dose. I was quite satisfied since I could remember the entire event but I was not very uncomfortable.

For number 2 I was not given a choice I was just knocked out. I was not happy.

For number 3 I requested a light dose and the doctor proceeded to give me 3 milligrams of Versed and 100 micrograms of Fentanyl. Needless to say I was out. Latter on I have a vague memory of telling the Doctor that I did not agree with his suggestion of waiting 5 years for my next colonoscopy. (I have a family history of colon cancer) I did not appreciate appearing to be in control of my faculties when I really wasn't.

For number 4 I changed doctors, and stuck by my 2 year cycle. I had 2 polyps removed. But what is important is that I the procedure done without any sedation or painkiller. I really felt great after it was done. Yes the last curve was painful and I learned deep breathing fast but it was not anything that I could not endure. BTW I am a 63 year old man. Not everyone can handle the procedure without drugs but my proctologist says that I have the anatomy for it. Also I felt so good that the next day I ran a mile in 4 min and 36 sec. This was on an elliptical machine. I have not done that time in the last couple of years!

Consider your options and talk to the doctor before you see him/her on the day of your procedure.

agdsquirrel6 said...

There seems to be much speculation about the drug Versed in the discussion. First, this drug is used strictly for anesthesia, NOT for analgesia. The whole point is for you to be comfortable enough so that you will be cooperative and calm during the procedure. Since it has none, it is often used in conjunction with a drug like Fentanyl that has analgesic effects. I don't think our medical professionals are trying to pull a fast one on us by giving us Versed. As a patient, it is also your responsibility to be asking questions if you don't understand. Who wants to be completely aware and remember everything about having a scope inside you anyway?

Joe said...

agdsquirrel6:

It's fine to say "you should be asking questions", but it's odd to hear you suggest that a patient should think to ask every possible strange side-effect of what they'll be given for a procedure. Now, I *was* completely informed, so I'm not complaining for myself. You wouldn't say "you didn't think to ask if this drug would cause your skin to be permanently turned green, so it's your own fault", I think this is analogous.

Why would anyone want to remember? Perhaps one way to think about it is this--many people find the "lack of memory" distinctly uncomfortable. (I did not, but that's me.) To pick an extreme example, one friend is a rape survivor who'd been raped under a "date rape drug", she'd find the amnesia a source for panic and anxiety. Many people who don't feel particularly trusting of the medical system in general or their doctors in particular may also have some good reason to not like the amnesic side-effects.

Proactive communication of side effects is a requirement of ethical medicine, and the folks complaining here appear to have been treated unethically, and given that, I understand their anger entirely.

Susan said...

my daughter just had a colonoscopy and ednoscopy with conscience sedation and she felt everything and cried on the table and nothing was done to help her. As far as I am concerned she was abused. She is not willing to pursue any legal action or anything, she just wants to put the whole horrible experience behind her. Me I want to show a Louisville slugger into the doctor where the sun doesn't shine.

Anonymous said...

I have a lot of professional experience with IV drugs and used to think that Versed was O.K. It is not. Too many patitnts experience severe trauma under it's influence, get pushed out the door in a semi-amnesic state, then gradually recover memories of a very traumatic event, often done with little or no effective anangesia. I have been a physician for 25 years and would never subject a patient to this drug. In my experience, about 2% of the women who undergo colonoscopy with versed/fentanyl develop moderate and sometimes debilitating mental problems from getting this drug. Colonoscopy can be done with nthing if one is slow and careful or with just fentanyl (painkiller)...and it works great. I have done moe than I care to count and NEVER use Versed.

Anonymous said...

I just had a colonoscopy under "moderate sedation" - fentanyl and versed. I remember everything including the discomfort. It wasn't that the pain was that bad, it was that I was excpecting to be a little "out of it" and I wasn't. I dressed myself 15 minutes after the procedure and was out the door after another 10 minutes and only because my ride was late. I was a little dizzy but not zonked like I have heard some people are. Next time I think I will ask for more fentanyl and no versed since I read that the two togther are more powerful and fentanyl dose has to be cut back.

Anonymous said...

colonsopies if sone dy a skilled doc require no drugs and nly strong IV painkiller (if you ask for it-fentanyl)..hey don't like to do to them this way; they promise something to relax you, give yo a dose of versed and hope that you will have amnesia of the rough, painful procedure. you will lie there imobile and in agony. The amoujnf of painkiller given is a joke. Insiston painkiller only, write it on the consent "no sedation" avoid a lifetime of nightmares and have a great exam..........why do you need "amnesia" drugs like versed if they conrtol the minimal pain with fentanyl? answer: your doc wants to make a lot off money doing the exam fast, have you amnesic as you are wheeled out and the "nurses" will suggets that the procedure was wonderful..until the lifetime of anxiety/nightmares start. I have had 4-only with fentanyl

Anonymous said...

Versed is a "patient control drug"; many, many people have a horrible colonoscopy experience with it....it should be banned..I am supposed to have the exam yearly, but will never have another one due to the haunting nightmares, feelings of helplessness while experiencing extreme pain (they like the drug because you have "amnesia"-at least until you get home)....WRITE ON EVERY PIECE OF PAPER THAT YOU SIGN "I DO NOT CONSENT TO VERSED"

Anonymous said...

You people who are saying that Versed makes you "relaxed" and "calm" and "cooperative" are full of it. I had this drug and it did NOT give me amnesia. Let me tell you from personal experience I WAS NOT RELAXED AND CALM!!!!! I remember how I felt, which is what you don't want me to do! I was horrified, anxious ANGRY AS HELL, panic stricken, but what could I do? The muscle relaxant part and the unnatural obedience to your commands rendered me HELPLESS! Just because you are so "relaxed" that you can't move or object, doesn't mean it was a good experience. Every single person that I have ever heard of who has recall is not a happy camper. Get it?

Bill said...

Two days ago I had my first colonoscopy and removal of three little polyps, at age 70.

Having been warned by blogs like this one, thanks, I insisted on NO versed. The language I used was the same as the wording of the Lahey Clinic's patient rights document: "advance directive", something the entire medical staff is sworn to obey. It worked! My only sedation was 50 micrograms of fentanyl, which I hardly noticed until I felt sleepy at home that evening.

I don't know how much the fentanyl took the edge off the pain, but I didn't really have the courage to omit it entirely. My doctor called 50 micrograms "a whiff".

There was momentary pain in a couple of places when the scope was snaked around the sharp bends, though nothing I couldn't handle. I trust that by experiencing that bit of pain in real time I will be free now of flashbacks.

But I may go for 100 micrograms of fentanyl next time! (I think the usual dosage is 100 to 150 for my weight when it is combined with versed; that number is hard to track down.)

By the next day all discomfort was gone. I only took one Tylenol for a brief headache.

As a bonus, I was able to watch the whole procedure on a video screen, and can recall all of it. It wasn't recorded on a DVD, but the doctor gave me a printout of several frames grabbed along the way. Not all procedure rooms offer such a screen in view of the patient, so ask about it, and be sure to wear your glasses.

Thanks again for pointing out the potential hazards of versed. I will never let them use that stuff on me!

Anonymous said...

I just had a colonoscopy and was given Versed along with Demerol. I felt no pain , have had no memory losses or any other adverse side effects. I felt great once the sleepiness wore off. It was in fact the most restful sleep I have had in ages !! I have had several scopes using these drugs over the past few years . I highly recommend these drugs for a pain free procedure unless you have some kind of allergy or etc. to them.

Tom said...

I had a routine colonoscopy yesterday and was under unconscious sedation. This was new for me who have been getting these periodically since 1990. I was surprised to be out and never saw the 'scope' on the monitor. I have to ask my MD about it. I did notice that I was shaky once I was dressed. That was new. No other side effects.

Anonymous said...

I just had a colonoscopy today with the combination of Versed with Demerol. This must be the magic combo. They said here come the drugs. I looked down and was fully dressed with a Ginger Ale in my hand. If it was a nightmare procedure I can’t believe I was in any way aware as it was going on. The only experience I recall is an instant flash forward about an hour.

DonnaLinkmeyer PA-C said...

I'm a PA with 20 years experience, and I have recommended colonoscopy with conscious sedation to thousands of patients in the past. Not anymore, if the drug Versed is going to be used. Fully 10% of our patients who get this drug have haunting amnesia, flashbacks and a PTSD-type reaction to the rocedure; 10% is totally unacceptable. Patients are often tricked into accepting this amnesia drug as "something to relax you and keep you comfortable". This is a lie; Versed has no painkilling properties and it's given to render the patient imobile, docile and semi-amnesic; the problem is, the amnesia is quite temporary and many patients end up with nightmares for a very long time. I have witnessed amny colonoscopies; there is no excuse for 3 nurses to restrain a patient in agony, begging for the doctor to stop the procedure, smug in the fact that the patient "won't remember any of this". Rather than use proper sedation (propofol) of adequate doses of narcotic (fentanyl), many docs just do the exam quickly and roughly and kick the stunned patient out the door and let them deal with the consequences as their memory slowly returns. The use of Versed makes me ashamed to have ever recommended any procedure where it was used. I tell every patient to write on the consent "no Versed"; also, no physician that I have ever known would consent to receiving Versed.

Anonymous said...

I am surprised and somewhat relieved that so many other people have had similiar reactions to mine. I received versed and demerol before my colonoscopy 5 years ago. When I got home I took a nap. When I woke up I thought I had had a bad reaction to the sedative. I could not remember things. I started to panic. I remember no pain, but I remembered feeling helpless. When the nurse called me later and I told her how I felt she said the amnesia was normal. I had read every pamplet they had sent me and their explanation of the sedative before the proceedure was that it would make me sleepy. I felt very misled and angry that I was not informed. In 3 weeks I go back for another one and don't know what to do. Do I go without versed and maybe have pain? Last time I cried for almost a month over my experience. It was very haunting and causes me great anxiety even to this day when I think about it.

Anonymous said...

Anonymous 5/15/09
Please tell us what you did and how you did with your colonoscopy. What did you do in regards to using VERSED again? I also was never told about the amnesia and I spent a year getting help to stop the panic attacks which started after VERSED was used on me for a colonoscopy. Next year I am due for my 5 year repeat colonoscopy and and not a day goes by that I don't worry about what I am going to do. I have a very deep distrust now of medical people that use this type of drug in patients. If I can' get it done in some way without the drugs I don't think I will go back.

Tom said...

I posted in March '09 my surprise in having the procedure done under general anesthesia. I met with my MD and asked her about it. She said that this form of anesthesia was being used to prevent colon spasms. She said that just as I was sedated, so was my colon. I think this will be the method from now on. I did not get the name of the anesthetic used.

Anonymous said...

I knew I was going to have sedation for my colonoscopy, but I assumed that meant I would be relaxed, and if not aware of the whole procedure, at least be aware that I was having the procedure and have some knowledge/memory of it afterwards. I remember the injection, then nothing.... waking up with a start in recovery.... no memory whatsoever. It has totally freaked me out. I keep trying to fill in the gaps in my memory, but nothing comes. I was misled, no-one ever explained this awful feeling of complete helplessness.

Tom said...

My recommendation to you 'anonymous' is to take your concerns to the MD who did the procedure. If you are still not satisfied, then interview another MD until you find one that is for you.

The last thing I remember from the procedure that I had was the voices of the anesthesiologist and the MD, the visual of the anesthesiologist and the syringe; nothing more. When I came to I was surprised to see that no one was there. I was slightly disoriented for a short time, then walked out of the room on my own.

Anonymous said...

I had a "twilight" too for my second colonoscopy.

I don't care what the name of the medications were that prevented me from discomfort during the procedure, as I have complete trust in my doctor. He has my medical history, is a trained/experiencedd professional and has done 2 colonosocopys on me.

When he removed 2 precancerous polyps from my colon (one pedunculated) likely saved me from cancer of the colon (which my grandfather had and had to have some colon removed).

Anonymous said...

I'm a clinical pharmacist with 30 years of experience as well as a Ph.D. in pharmacology and I always thought that the negative comments about Versed (midazolam) were exaggerated. I always told the nurses who consent the patient getting Versed that the drug is "to make you forget" not "sign this so the doc can give you something to keep you comfy", thinking that proper informed consent would prevent most Versed problems. Wrong! There ARE a huge number of patients who experience PTSD and lingering creepy amnesia/memory loss from even low doses of midazolam! I have talked to many, many of them and their stories are all credible. I recently had an outpatient colonoscopy that could have been done with CRNA and propofol but I was too cheap to pay the additional copay and at the last minute agreed to Versed. Huge mistake. Going in, I knew all about the procedural amnesia and was certian that this would not bother me. I trust the doc completely, we have seen each others naked backsides before, so I'm certianly not embarassed by colonoscopy. The exam was easy but the Versed experience was a nightmare: it caused severe anxiety, inability to communicate, sweating and paranoia...so bad that the doc had to abort the exam; what she did see looked really bad, but the exam was incomplete because of the Versed-induced paranoia. I'm not kidding. Now, I'm terrified f another exam and if I do it I will not consent to any sedation at all.

richlin60 said...

Having been through numerous surgeries the past 10 years. I have to say Versed is some good stuff. the last three were an UGI, bone graft and last,a colonsoscopy. The amnesiaac state produced along with the analgesic definitely makes one under the influence. After my UGI my daughter said I conversed with the physician and I told her I felt'loopy'for an hour in recovery with no memory of it. Saw double vision for 20min on the way home. After my colonoscopy today, I have a very vague memory of someone dressing me.Vaguely remember my daughter walked me into the house. She told me I said several times I feel 'stoned'. Next thing I remember was waking up an hour later. Had to call her back and find out what the Dr. said.
I rtecieved 5mg Versed and 100mcg Fentanyl about 3 hrs ago. Smart to say you MUST have a disignated driver. Wonder if CIA uses this stuff during interigations?

Anonymous said...

I'm a retired nurse, had a colonoscopy with Versed, was talking in the procedure room when given the drug and talking when I woke, saw the screen and a benign lipoma, was awake when instrument removed, dressed self, listened to doctor tell me I would remember nothing of our conversation about results, walked to ride, forty miles home, fixed dinner, slept as usual, no bad effects. I don't care that I was not awake for the majority of the procedure. I was grateful that I was not.

Grandma said...

I had a colonscopy last week. I was given (this is what is written on discharge) 10 mg midazolam (versed) and 300 mcg fentanyl. Now I am depressed...nothing sounds like fun, I feel very emotionless and uneasy. This happened before.
Only last time I thought it was steriod injections that cause me to have a complete psychotic break. I had 4 back procedures over a 2 month period and each time was given Versed. Not once did it work for me. I had a neurotomy done and felt the pain of the nerves being burned from my back, remember asking when they would be done etc. Most of all I remember the debilitating depression I faced.
Now that this has happened again and the only factor that is not a part of the colonoscopy is the steriod, I know the versed is what is making life so hard to deal with right now.
IT REALLY SUCKS! I have never felt so mentally miserable as I do after versed.
I am a 33 year old woman if that gives you any more info.

Anonymous said...

Summary: 50 Year Old Male, first colonoscopy, used versed and fentanyl, no problem!

This morning I had a colonscopy, recommended because I am 50 years old. They gave me versed and fentanyl. After about 2 minutes of receiving the versed, the next thing I knew I was in the recovery room. I was groggy, had a bit of cranberry juice and and graham cracker, and went home (my wife drove me). No problems, no pain. I slept for about 5 hours afterwards. After reading "scary story" blog entries such as those above I have to wonder how many people are "fine" after this, and wonder if the postings are the "extreme edge" ...

I had read "scary stories" before this procedure, and asked several doctors I know about going "unsedated". Not surprisingly, the reaction was "you have to be kidding". Other than having to take a day off (not a bad idea anyway), I'm not sure of the downside.

If there is scientific literature that discusses these types of issues, it would be great. On the internet, it's hard to tell somtimes, so I guess the best advice is to check with your own doctor and maybe a few others if you can.

It's boring to say that "nothing happened" using these drugs, but I hope that this post puts a counterpoint to the scary stuff.

rw said...

I had a colonoscopy two days ago, as a follow up on possible inflammation discovered on a CT scan. I was quite nervous - I probably read too much on the internet and watched too many youtube videos of the procedure. My pulse was 140+ beforehand, and there was talk of getting an EKG; probably dehydration was part of this, but no doubt there was plenty of adrenaline in my system.

I was given 2mg of Versed and 100 ug of Fentanyl. I barely noticed any effect from them, but I expect the Fentanyl helped with pain. I didn't feel sleepy at all; the Versed may have helped a bit with the anxiety - my pulse dropped to around 120 during the procedure.

I watched the whole thing on the monitor, and was asking questions about what I was seeing on the monitor. I was able to recognize where the small intestine joins the colon, at which time my doctor showed me my appendix.

The good news is that this was not nearly as bad as I expected, even though I was fully awake. The only painful part was the last bend, and I had to move around a bit to help the doctor make the turn. I guess that may have been been trickier if I had been knocked out.

From the monitor, it looked like some of the delicious polyethylene glycol cocktail I had drunk earlier was still inside in a few places - they just suction this out - apparently this is normal.

They pump an enormous amount of air into you - so much that some of it makes its way into your stomach, and you have to burp it out - I guess its like farting from your mouth.

Afterwards, they wheeled me to the recovery room, told me to continue to lie on my side, and fart. I have never farted so much or so violently in my life - my only regret was that they had taken away my iPhone - it would have been worth recording.

My doctor told me that there was no inflammation, no cancer (this was my biggest concern), and no polyps. I'm glad I got this done, and this news was a huge relief.

Many people say that the preparation is much worse than the colonoscopy. I agree with this. The actual procedure isn't that bad at all - even if you are awake.

Anonymous said...

I had a colonoscopy this morning without sedation; after reading the Versed horror stories on the net, I cornered my doc before the exam and insisted that she address the Versed problem. Surprizingly, she admitted that about 10% of patients who receive Versed in doses above 2mg have long-term memory impairment and generally horrible experiences with the drug. She only uses it because it's cheaper than propofol,but would not consent to getting it herself. And that's what you wanted to give me? What crap. As I was storming out, she offered propofol (no charge) but I refused. She told me that she could do the exam unsedated, no IV at all and would stop if it hurt. O.k., we did it, 2 polyps, biopsies no drugs and it was easy. Seeing the patient's in recovery zombified with Versed was awful. The doc told me that about 1/2 of the nurses had their colonoscopies unsedated, but "don't tell anyone"..Having Versed mess with your mind is way too dangerous for me.

Anonymous said...

I just finished my first colonoscopy a few hours ago. I had 2 mg of Versed and Fentanyl (I didn't catch how much). They asked me to roll onto my side and then I opened my eyes in the recovery room and got dressed. My ride and I went and had breakfast and I feel perfectly normal (the hardest part is obeying the "don't drive" order). Aside from being out during the procedure no memory problems - no disorientation - no nothing. At least in my case I wouldn't hesitate to do it all over again.

Anonymous said...

My doc has been pestering me to get a colonoscopy fo the past year; I was afraid of the sedation because of the many stories of memory loss and long-term nightmares that Versed (midazolam) can often cause. She told me that I was being a control freak. Two weeks ago, she had the exam herself with Versed, and she has been a self-described "basket case" ever since. Long term (2 weeks so far) memory loss, panic attacks and nightmares. She called me last night and told me to NEVER get this exam with Versed. I'm a pharmacist and I have heard from too many patients that midazolam is a horrible drug. It's great until you get home and the amnesia wears off and then your mind is obviously screwed up. I don't understand a scientific reason for this, as it's a benzodiazepine, but 10% of patients who get Versed tell me that it was a HUGE mistake. Now my primary-care doc agrees with the "No Versed" minority. The FDA needs to take a look at Versed and Black-box it's use. This is no joke.

Jim NY said...

I had a transesophageal echocardiogram (TEE) on November 5th. I was told I would be given fentanyl and a sedative - conscious sedation. There was no mention of midazolam (Versed) or its amnesic effect. The cardiologist said that I probably wouldn't remember the procedure even though I would be awake. I didn't think much about it other than the possibility that he meant that the memories would be hazy. As they began the procedure, the doctor asked for 1mg of Versed. That was the last thing I remembered until some point in the procedure when the Versed started to wear off. I could feel myself choking on the cable for TEE transducer and felt terrible pain in my throat. The next thing I can remember, I was being wheeled out of the procedure room.

I thought it was strange that my discharge instructions indicated no driving, equipment operation or alcohol for 12 hours, and not to return to work. I have had general anesthesia before and never had all of those restrictions afterward. It wasn't until the next day that I found out what Versed was, why it is used, and why I could drive or go to work for at least twelve hours.

I am livid. Versed didn't stop any pain or choking. Its only purpose was to make me forget the torture I was being put through. This is barbaric! And it didn't work because it wore off and I am haunted by that memory of choking. I want to scream every time that memory comes back. I start reflexively swallowing uncontrollably as I was doing during the procedure and go into a near panic.

They chemically short-circuited my mind by causing amnesia with Versed. No one told me this was going to happen. No one asked me if that was OK. No one said I would be choking and gagging and in pain. I was lied to and I am outraged.

NEVER again will I let anyone use midazolam or propofol or any other amnesic on me. I will NEVER again agree to "conscious sadism". The use of amnesics like versed and propofol needs to be banned.

Anonymous said...

I had a colonoscopy yesterday. This was my first; I am a female age 51 and just went for a baseline scan. The doctor told me I would be sedated and an anesthesiologist would be attending since I am a "bigger" woman-200 pounds. I was never told what they used but I had a fantastic experience. I had an IV and oxygen thru the nose. All I remember is the anesthesiologist telling me to take two deep breaths and I would feel sleepy and then I awoke in recovery and felt just like waking up from an ordinary sleep. Passed gas for 5 minutes, put on my clothes, drank a juice and left to eat a large lunch at Boston Market. Then I drove back to my office and worked the rest of the afternoon. Never felt tired or weird. The scan was perfect. I should call and ask the surgery center where I went what was used. I think they may have used Etomidate because I felt the same ease in falling asleep and waking up as I did when I had my broken arm set early this year in the emergency room.

Michel said...

I have had this procedure (colonoscopy) done on me a year and a half ago, and as far as I remember it was quick and painless. Then I started thinking, I don't know if they used versed, but I have to assume that it could've been. 15 secondes after they gave me three injections the doctor started the exam. All I remember was the doctor letting me know that she was at the end of the colon when she reached it, and me answering back...that's it. And then I remember being wheeled out of the exam room and into recovery. I remember nothing else of the procedure. No pain...just a blank.

Mina said...

I had to have a colonoscopy when I turned 34, due to a positive stool test and family history.
I went there thinking I would be sedated, but when I realised I was not sure if I was pregnant or not, I told the doctors and they advised me against sedation, just in case I was. 4 days after that I found out that I was not, so I could have taken the darn drugs, but all is water under the bridge now.

I had the colonoscopy without sedation. It is not comfortable, but one can surely do it without sedation, this is certain. There is no great pain, there is discomfort, as I have said, and once or twice a half of second of pain, but no more than that.

Next time I do not know what I will do, because the entire procedure feels a bit like robbing you of your last shreds of intimacy. But who knows. A lot can happen in 5 years. And I haven't died (not even of shame) now, perhaps I can survive next time as well.

Best of luck to all.

Jo said...

I had a Colonoscopy 3 years ago and had midazolam (I think it was 3mg). I felt a bit uncomfortable but no great pain. The most surprising was the pain of the air pumped in (although that wasnt too painful) as I thought the painful part would be inserting the scope!

I had no side effects from the midazolam and I felt quite chilled actually! My short term memory isnt brilliant but I think that is my blonde character!!

I'm about to have another Colonoscopy in 5 days time and it didnt particularly help reading this blog as it sounds like a load of horror stories!

Lets hope that this time I wont have any horrible side effects!

Tom said...

Best to check with the doctor doing the procedure and the Anesthesiologist. The last procedure I had, I was totally out. It took a few minutes to clear my head afterwards and then I was back to normal. Seems that as we are all different, the effect will be different for each person.

Anonymous said...

I had a colonoscopy yesterday under conscious sedation and it was pure torture and I remember everything. When I was getting into my gown I could hear the screams of a woman who had gone in before me and had to wait through 10 minutes of this before going in. I had the sedation and one shot of pethidine. It is not painless, it is agony. This is the second time this has been done to me, and today I feel like I've been something like tortured or raped. I cannot believe that they get away with this in the UK. Next time I will insist on a general anesthetic and total unconsciousness, if not through the NHS then I'll pay for it myself.

Anonymous said...

No medical practitioner has been honest with me about the use of Versed.

Asked a for Valium - anesthesiologist - he does not use Valium because it is too "caustic". I surrendered to what I did not want. Without questioning it again.

After tonight's review of the problems with Versed, I concur with kightp. The amnesia is a feature not a bug.

I had the medication most recently for a surgery around the eyes (muscles and skin were removed to improve field of vision). I was panicked, able to say this throughout, but I believe had what they would consider the max for this drug. I did not feel pain. I had to lie still for a couple of hours while they trimmed tissue, stitched about 100 sutures. Now I am reading that +5.0 mg is on the dangerous side. I had 5. Good.

Guess what? I already had a full spectrum PTSD. Over the eyes? I thank God for the surgeon talking me through. I did not move, I had to when she said. Told her with every surge of panic I needed more medicine. She was very good. I was obedient. She held it back.

If your patient has to open your eyes and shut them, that needs to happen. What other drug? I heard she is the best surgeon. I ratify that. I had the procedure at Tufts in Boston. She consults in my city.

I will not allow that medication in my system again. I am fine with benzos-true lifesavers.

Many surgeries where Versed was used. I don't function as well at all as I have in the past.

I had a frank discussion about this drug with my pharmacist and friend of 20+ years. WE both realize it's good to sedate before you intubate. I wake up fighting, and have not done that since propofol came on the market.

So when do you have a voice? Anesthesiology is has always been a no choice deal, we mix a cocktail based on your pre-op/bmi/medical record. I've noticed some defensive reactions, "Oh, you'll be find, don't worry", when I ask "which drugs?".

I was with a patient of mine, waiting for the Dr.(psychiatrist). Was tutoring neural pathways - chronic pain, when up came the Versed topic. We couldn't remember the name. ;-0 We asked the doc. He said propofol, we knew that wasn't it.

24 hours later, I remembered the trade name. Found all of your comments. As somewhat of a neuropsych/chemist hobby type, I can't for the life of me grasp the difference between this med, others of it's class - side effect of amnesia, expected effect, response variation - barbaric infliction of PTSD!

Used to hasten a procedure? That is rape. It is the med and the Dr. - us/them fully bleeped up by this med. Why does it act as hypnotic, amnestic, anxiolytic - cheaper? Who the hell invented it?

Please don't drive, go back to work, etc. You are impaired. You don't know it. Any anesthesia!

My duty is to warn you!

Anonymous said...

I had a colonoscopy on 5/28/10, with only analgesic (fentanyl 150 mcg) used. The nurses and doctor tried to convince me that I should agree to the Versed-fentanyl combination, but I refused and made sure that I had written "no conscious sedation with Versed; analgesic for pain only" on the informed consent sheet.
Two things bothered me about the push to consent to conscious sedation:
1. The informed consent sheet has language that removes the surgical center from all liability in the event of any adverse effects from the procedure or sedation; and
2. The OR nurse tried to tell me how painful and traumatic the procedure would be without the sedation.
With respect to #1., there is no way that I will consent to a procedure that uses a drug with well-documented risks and that also requires me to let the facility off the hook should there be any adverse effects from the sedative.
Regarding #2, colonoscopies are routinely performed in Europe and Asia without sedation, and I fail to see why it is necessary to be sedated for the procedure here in the US. After all, Katie Couric had a colonoscopy without sedation. When I told the nurse that, she shut up.

As for the procedure itself, although it was pretty uncomfortable at times (like really, really bad gas), the pain was transient and I could work through it okay.

The one thing I would like to know is WHY and WHEN the Versed-fentanyl combination became the "standard" for colonoscopies. Versed was originally marketed as a pediatric sedative, and I'm very curious to learn more about how it came to be used for this procedure.
Please feel free to e-mail me at mt.state@juno.com if you have any information about this.

Anonymous said...

I remember bits and pieces of the colonoscopy, being yelled at to breath,relax and hold still.I remember feeling mis handled and agitated when I was coming around and crying uncontrollably. I would try to sit up and felt dread and panic as a nurse would press me back down onto the gurney.Then my first really vivid memory was the nurse telling me that she had to give me 3 times the amount of medicine and that She has ever given and said a lot of rude things that left me feeling paniced,agitated angry and sobbing she also said I was so high I would not remember what she was saying...well I do.I left there without being given anything to drink just to spend the next fews days without sleep and becoming more and more overwhelmed and feeling unstable. I went to see my family Dr. told him what happened and he prescribed xanax. The Dr. who did the procedure was distant and said my emotions are not related to the meds they gave.I am really finding the medical professionals to be sorely lacking in assistance for what has happened to me and resistant in helping me.I feel like this is just the tip of the iceburg and that is a very scary feeling.

Tom said...

Very wild story report. Makes one feel like the hospitals are not much into patient care. My advice is to get a MD you can trust to do the scope. My MD told me that the reason they knock you out is so that you are relaxed during the procedure and don't tense up making it easier to complete the exam.

Tom said...
This comment has been removed by the author.
Anonymous said...

Not "wild" at all. My colonoscopy experience two years ago with midazolam was almost identical to that poster's experience. And yes, after my nightmare experience with this truly horrible drug, and the uncaring medical staff I dealt with, I now most definitely do believe some doctors/nurses are "not much into patient care."
















not all doctors/nurses are sympathet

Ann Theresa said...

I want to thank everyone for their comments. I am a former surgical tech and have assisted on many colonoscopies. I am afraid to go under anesthesia. I know what to expect for the procedure, but the comments about the drugs are very informative. I will use the advise to write No Versed on the directives and just go with a pain killer. I figure, I had a D&S done with no sedation(even when they clamped the cervix with the teneculum) I think I can certainly do a colonoscopy with nothreing or light analgesic. Thanks for the warning about the amnesia....I CRS as it is, I don't need anything to add to that. I'll be having it done in a few days...I'll be back to comment.

mand said...

I had my first colonoscopy yesterday morning.I was terrified of having it done,so i requested sedation.It was explained that i would be alert and feel like i had had a few glasses of wine(light sedation then?)
I was given midazolam,not sure what dose along with something else.It relaxed me but DIDN'T make me sleepy at all.I watched my colonoscopy in technicolour,and even saw my biopsies taken.
I didn't feel much pain except for near my right side,and all those breathing exercises i learnt during childbirth came in useful!
Very woozy afterwards,my blood pressure had lowered somewhat,and fast forward to now..still breaking wind!

Anonymous said...

i had the colonoscopy and it was horrible. i awoke and felt the horrible pain and i heard the nurse saying her bllod pressur is dropping and the doctor kept telling her to give me more versed and she refused and he said the blood pressure machine must be broken. i was crying and screaming but they ignored me . the doctor did not complete the procedure and met and told me to never have another procedure i had to wait until the next day when i went in for another colonoscopy without sedation when i called the doctor and he informed me that i had an allergic rection to versed. he was not going to tell me until i told him i remembered the procedure then he fessed up. what if i had not have remembered he never would have told me about this and i may have had to use versed again and i may have died. the least he could have done was tell me so i couuld tell future physicians that i was allergic to versed. this procedure was awful with nightmares and recurring memory of the procedure.

Bill R. said...

My wifes doctor has been trying to get my wife to have a colonoscopy for seven years. A routine (there is nothing routine about it) procedure that she does not want. On her last visit for a physical this month, he told her because she has not scheduled one, he is going to schedule it for her. I feel he is out of line doing this and this raises a red flag to me. He has givin her no information or pamplets on the procedure. No information on Versed (Conscious Sedation) either. What is most irritating is that there no information being givin to her on the risks of colonoscopy and the drugs used for conscious sedation, primarily the use of Versed. I know the standard answer is "routine procedure - minimal risk" which is a big line of BS. Colonoscopy is not routine and there are some pretty serious risks associated with a colonoscopy and the use of Versed, up to and including death.

She has no history of any problems that would signal the need for a colonoscopy. Nor has her mother or father had any history or issues of this type. I beleive the doctor is out of line in trying coerce into having a procedure that she does not want.

I have done a lot of research on colonoscopy and Conscious Sedation and I am not posting this comment just based information that I have read. Seven years ago, when the doctor started trying to get my wife to schedule a colonoscopy, I scheduled one because we needed to know what it was all about. After having that colonoscopy with Conscious Sedation, I will not have another due to my experience.

packerbearfan said...

I had Versed (midazolam) during five separate heart stent placement surgeries over 2 years and colonoscopies and gastroscopes before that. I received 2 mg of Versed at a time several times through the 5 stent surgeries. My short term memory is very bad now, and I have had to give up my full-time position as a Certified Substance Abuse Counselor and apply for disability. I am 63 and neuropsychological testing ruled out Alzheimer's or dementia. Radiologic tests ruled out structural abnormalities. I could not remember what I heard 2 minutes earlier or even which client was in my room right after they left. New names or stories I hear are impossible to recall. I did not connect the Versed with my obvious short term memory loss until the nurse before my most recent colonoscopy said they quit using Versed due to problems with memory loss. I did have severe problems with memories of the @#&^%$@ doctor jamming a gastroscope down my throat many more years ago, but later found that was undermedication. I then warned my doctors/dentists to use at least 2 mg of Versed. Boy, was that a mistake. Has anyone sued the company over this ongoing short term memory loss situation?

Anonymous said...

I've had a colonoscopy with no sedation what so ever, and it was among one of the most painful things I had experienced.

I think it's important to keep in mind why it's painful though. It isn't that you are being put in any physically damaging or life threatening situation. It's just that the colon is trying to get the scope and gas they use out of it, and does what it normally does when it's having a hard time ridding itself of something. It cramps. In this case, the cramping is severe.

It's just an amplification of how it naturally acts.

You are generally not in any actual danger, and you actually can't feel any biopsies they do.

Perhaps why so many people who claim that the versed didn't work at all seem to be traumatized by this experience is because the versed actually did work somewhat, and they recorded a painful chunk of memory in which they did not remember the reason for the pain at the time and so could not reason with themselves that they weren't in any danger.

For those who claim they weren't told of or didn't consent to versed at all, I'd like to remind you that this may not be the case.

I just had a procedure using versed and while I remember the anesthesiologist telling me he was going to give me versed during the procedure, I didn't remember him talking about it before hand, however my relatives were there and assured me that he did and even told me how much he was going to give me.

I have no complaints about the experience btw.

I think that if you are going in for a colonoscopy you just need to keep in mind that your body will experience pain from it that pain killers can't actually numb without a spinal or epidural, and so the only way to manage it without such drastic means is to impair your consciousness or memory.

Anonymous said...

Sounds barbaric to me. In my case, the doctor definitely did not explain sedation to me, even though I had requested to be awake for the procedure. (He later said he "took full responsibility" for that, but the damage to my trust had already been done.) Informed consent means that the doctor should explain enough to the patient to actually be able to make a choice in whether or not a procedure is to be done. I will never agree to conscious sedation again for any procedure, not because of what I went through (which was bad enough), but because I was deceived about the drugs I was given. Lies of omission (deliberately withholding information from a patient) are still lies. Shame on those doctors who do what's best for them and not what's best for the patient.

Anonymous said...

Let me rephrase Anonymous's (2/12) last paragraph:
"...you just need to keep in mind that you will most likely experience excruciating pain during the procedure that may not even be numbed by pain killers, but the drugs will cause amnesia of the traumatic experience."
Your subconscious may indeed remember it, and you may be left with anxiety, depression, and PTSD anyway, what they (medical people) claim they're trying to avoid....

Anonymous said...

I had a colonoscopy 2 days ago (Friday 8th April 2011).
I did a fair amount of research prior to the procedure, and decided that I didn't want to be administered the drug Versed (it's called Midazolam at our hospital).
This is simply a personal choice for me, I'm not saying it's best this way, but I think it's important to make your own choice.
I phoned the hospital to tell them of my prefernce several days before, and they were OK with this.
I also decided not to take the pain killer Demerol (we call it Pethidine) either, so I had absolutely no drugs administered.
The nurses were fantastic, a bit surprised at my choice but very supportive.
The pre-op interview nurse told me she would have the procedure performed "drug free" also, if she needed it done, so that took the edge off my apprehension a bit, because she has seen hundreds of these procedures done.
So what was it like ? - Yes it was uncomfortable, and a couple of cramp type pains lasting a few seconds, but on the whole it wasn't too bad, and if I ever need it done again, I'll definately opt for "no drugs" choice.
I was lucky that the hospital (Inverclyde Royal on the west coast of Scotland) has a separate endoscopy/colonoscopy suite (don't know if this is normally the case) and they are a tight knit team with huge amount of experience, and also the nurses were so brilliant to the point where I was so impressed by their compassion and care for a complete stranger (OK, that's their job, but you don't always get nurses that are as good), and of course the specialist who carried out the procedure was very skilled and willing to accomodate my preferences.
I hope some of this information is helpful, and I do understand that the procedure can be more difficult and painful depending on an individuals physiology, but for me it worked out fine.

Anonymous said...

I just had a colonoscopy on friday. I'm 56 and have avoided doctors and tests until recently; I retired and finally got a PCP who did my first real annual physical since I was in the Air Force (long ago). When she noticed that the slide from my rectal exam showed occult blood, she scheduled me for a colonoscopy immediately. I resisted the idea because of the Versed sedation; I don't want memory loss and all of the crap that goes with an amnesia drug. Surprizingly, she agreed with me and told me that many patients had bad experiences with Versed. She told me to get propofol is I wanted sedation or just fentanyl for pain. She's yonug and smart and admitted that Versed is used for compliance and is being phased out by the endo center that she refers patients to. The endo doc (another young woman) was totally supportive of my wishes; she doesn't recommed Versed and says that they use propofol for most people only because many patients are so distressed by the idea of colonoscopy. She opined that I was more afraid of the sedation than the test (she was right) and agreed to to an unsedated exam (that's how hers was done and most of the nurses in the office too)..beautiful, I felt much better. She did add one thing: consider letting us give you painkiller only (fentanyl) if we can't finish the exam without drugs......no amnesia or creepy sedation effects. BUT, I won't give you anything unless I ask you first. The unsedated exam was easy and a nurse was standing by with painkiller and reminded me that all I had to do was ask if I wanted it, but it wasn't necessary. The doctor kept asking me if I was comfortable, and aside from a few minor cramps from not releasing the air that she had to inject, I was fine. At one point, a nurse was rubbing my shoulders and encouraging me to fart; once I did I felt great. I need yearly exams and the will be unsedated.

Anonymous said...

I had my first (and now possibly my last) colonoscopy day before yesterday. Friends who've had the procedure said it was nothing. That doesn't describe my experience. I "awoke" or "became aware" during the procedure and experienced excruciating pain that I quite well remember.

I was given (as I learned later when reading the report at home) Versed, Fentanyl and Benadryl. Obviously, the Versed didn't fully work on me. I feel traumatized, victimized and lied to. The medical industry is scamming the public into believing that is a painless procedure. It is NOT. And they just give you Versed so they can attempt to rush you through and you won't remember how barbarically you were treated.

IF I ever have another colonoscopy, I will insist on pain meds and no Versed. And at this point, that's a big IF.

Anonymous said...

After reading so many of the negative stories about Versed, today I had my first colonoscopy with just a small dose of Demerol. The doctor's mouth dropped open when I told him I wasn't having Versed. I have to say that I probably didn't really even need the Demerol, except for it's very mild relaxing quality perhaps. The only "pain" from the colonoscopy was from the scope going around those few corners and it was very short-lived. The remainder of the procedure had varying degrees of discomfort (NOT pain) from the air in the colon but nothing even close to intolerable. The whole procedure took about 20 minutes, including removal of one polyp (no pain there either). If anyone is thinking of having a colonoscopy without Versed, by all means, do it, you won't be sorry!

Anonymous said...

Wow. I just had my 5th colonoscopy done (first in 2000, 6 mo later 2001, 2004, 2006, and now 2011. Had other tests in 2009 that used versed as well. Always had versed, but been on xanex and welbutrin for depression last couple years so Dr. office said would use more versed. 5-10 mg used previously, this time 15 mg and I am still headachy, tired and yucky feeling a full day later. Came online to see how long effects would be and say this posting! What a wake up call - I have noticed my short term memory has continually been going down hill for past several years - versed may be the reason why!! I am only 50 and have no dementia/alzheimers in my family. i will be doing some serious research on this!

Anonymous said...

Thank you for your blog and making people aware of their choice with sedation. I was very nervous about conscious sedation, and I appreciate how my doctor's office handled the issue. The day of my procedure, I talked with the anesthesiologist from the practice, who asked if I wanted sedation and whether I wanted total or partial. I appreciated that the option to go without sedation was offered. I said that I didn't want Versed/midazolam, and I also wrote this on the consent forms. I was given propofol and was put completely out per my request. I woke up after the procedure and felt okay. I rested in the procedure room for about 20 minutes after the procedure. Then a nurse helped me up from the bed, I dressed myself, and I was given water and a cookie. I headed home accompanied by a friend (this was required) and felt fine.

Leo said...

After one year I still have short term memory loss after 2 years of 5 Versed anesthetic type heart angiogram/stent treatments. I also more recently had a colonoscopy where the doctors just stopped using Versed "because of ongoing short term memory loss issues.l"

Leo said...

I wrote before that I blame Versed for ongoing short term memory loss because I had so many overdoses getting 14 stents in 5 separate procedures, plus colonoscopy and teeth pulled. I had to have another angiogram, and this time I said no Versed. It was so easy I could not believe it. All I felt was some minor pain when they cut into my artery in my groin, and felt nothing else at all, with no sedation, no recovery time and went home 3 hours later. By the way, my memory loss is improving very slowly due to either time alone or Aricept.

Gill said...

I was given this drug June 2010 without my consent or knowledge in the UK for an angiogram.
I only agreed to the angiogram after being assured that no needles were involved ! or x rays !
Having my memories wiped out has had a devistating effect on my life,it was not just for the procedure,during which I experienced excrusiating pain but I suffered from long blanks in my memories for months,I just went from place to place without any idea of how I was getting there.No one helped me ,I am still struggling with this 14 months later

Anonymous said...

I lost almost seven hours. I had the procedure about 10 AM and woke up on my couch at home at 4:41 PM, with no memory of the procdure, getting dressed afterwards, having a large warm cinnamon roll in recovery, driving home with my cousin, giving him directions,...... Very disconcerting.

Anonymous said...

Colonoscopy is a good idea; coloncopy sedation drugs are bit tired and missing loved ones.for hours (Versed)..This is unecessful; patients would consent to propofol in some cases. The patient had a history but found out that running a lunch truck would provider income. I do not consent to Versed of other benzos. No way do I want a nurse (CRNA or not) doing my anesthesia.

Leo said...

I continue to have short term memory problems 2 yrs after having colonoscopies and angiogram/stent procedures using large doses of versed. I have had some doctors/nurses say it could be from the versed, others say they quit using it for procedures due to complaints. Use versed at your own risk!

Amsim said...

Hi!

In May 2011 I had a colonoscopy and I was not sedated properly when I was told I would be. I was conscious during the procedure and I was buckling, fighting against the doctors and screaming in pain.

My muscles were not relaxed because I wasn't sedated so I was in severe pain. Instead of comforting me the staff held my arms down and continued with the procedure - they even talked to me and asked if the seed on the screen was a grape seed and I replied that it was a kiwi fruit seed. I don't know how to describe the pain, I've had bad muscle injuries, bad UTI's and I get period pains that make me faint (they are hereditary and my mother used to get injections because her periods were so bad)but the procedure was the single most painful experience in my life. I wanted to faint but I couldn't. My muscles hurt so much at the time and for weeks following they were still in so much pain that I couldn't even put pressure to go to the toilet. Six months later and I am still terribly mentally scared - I felt like dirt that day and that feeling of helplessness has never left me.

I am considering to sue the Australian hospital.

Amsim said...

This is Amsim continued.

Also, I would liken the experience to being anal raped - I felt the insertion of the camera 100%, the moving of it etc and all the pain associated with it. I called out for them to "TAKE IT OUT TAKE IT OUT!" constantly and they ignored me.

Sometimes I feel like killing myself. I feel so helpless and disgusting.

Richard Rathbone said...

I had a colonoscopy three days ago and was given conscious sedation. I was terrified of the procedure because so much InterNet commentary suggested that it was agonising medieval torture. I remember lying on a gurney and then waking up, snuggled up in my towelling robe and being talked to by an angel-nurse. If I hadn't consulted my watch I would have thought that nothing had happened. No residual pain, no lasting wooziness. Thank you conscious sedation, thank you, thank you.

Leo said...

Well, Mr. Rathbone, Versed was my favorite anesthesia too, until a year later I found out I had permanent short term memory loss from it!

SUGAR AIN'T SWEET said...

I've had colonoscopies before - with NO drugs (AGONY), with total knockout anesthesia (A-OK with me) and the most recent one with "twilight sedation." I will NEVER do THAT again.

I was totally awake throughout the whole thing (and didn't want to be.) I could and did feel pain, and when I cried out in pain, I was told to be quiet by a very nasty-sounding nurse to be quiet. Without even thinking, I reached up raked the side of her face with my fingernails. I don't expect she will forget THAT in a hurry.

As it happens, I have PTSD - usually under pretty good control, but the combination of Versed and whatever else they gave me set off a world-class PTSD flashback and I felt ice-cold. Since then, I've had nightmares about it, and in every nightmare, I get chilled all over again.

I can't imagine ever agreeing to go through this in the future, but you can believe, I will demand to be completely "under." I don't want to remember ANY of it. That works a lot better for me.

Anonymous said...

I could not believe that the GI doc who was scheduled to do my colonoscopy was ready to give me midazolam (Versed) without informing me that it was an amnesia drug and that many patients have horrible experiences with it. Just before the procedure she checked out askapatient.com for the many Versed horror stories and told me that she didn't realize that the drug was so bad. Two of the nurses in the GI suite informed her that their phones ring daily with calls from colonoscopy patients who complain of long-term problems from Versed...such as not being able to remember their kid's birthday's weeks after getting Versed. I wasn't feeling great after the prep and basically told the doctor off for not knowing about the Versed that she was going to give me; she seemed upset that I wasn't going to get the colonoscopy, but she did say: "I understand why you don't trust me; our sedation consent for Versed is misleading and incomplete, but it's all than most insurance companies will pay for". As I was dressing to leave, the GI doc introduced me to the nurse anesthetist that she had called in to do my case with propofol after the Versed debacle; I was polite enough to listen to her 30 min spiel on propofol and how great it was; the GI doc sat their the entire time apologizing about not being honest about the Versed. Needless to say, I didn't consent to the propofol either; once I was lied to about the Versed I couldn't consent to any sedation drugs at all.

glenn said...

My experience is a detailed memory of what I thought at the time was being tortured to death, for no reason I could possibly think of. My wisdom teeth were removed under Versed, drilled out. I remember it, and what I was thinking at the time. Details have been left on this blog:

http://nomidazolam.blogspot.com/2012/02/e-mail-from-glenn-part-one.html

If you read the third part, 'Versed - a recollection', be warned - it is not a pretty tale.

Anonymous said...

Had an endoscopy today. They used versed on me. No problems!

glenn said...

" Had an endoscopy today. They used versed on me. No problems!"

Dude, there were problems. Primarily being, you don't remember what those problems were.

Ever been told that you'd been an idiot at some party because you were drunk? OK, even if you haven't, would you consider it irrelevant to your life just because you didn't remember it? How about if someone beat the hell out of you and humiliated you, would that be ok if you didn't remember it?

Would you opt to have that sort of treatment? It doesn't matter - right?

Leo said...

Anonymous, it took me years to figure out Versed caused short-term memory loss that has lasted several more years. You took a big chance with your only brain, hope you have good luck down the road remembering why!

LeeApp said...

Hi,

I am scheduled to see a gastroenterologist very shortly, who, I suspect, at the recommendation of my GP will be performing a colonoscopy (as well as an endoscopy). I am absolutely petrified of the test, and simply don't want to know to the point that I asked my GP to request in her urgent, fast-track letter to state that I want a general anaesthesia. In the past, I have reacted badly to mild sedatives and become combative. I don't know if I will be able to receive this, but having read through this blog, has just made me even more freaked out because of the many bad experiences people have had. I've already had one melt-down over this the day before last, and yesterday asked my GP to prescribe some diazepam for me to take as needed. She did, but handed it out with an eye-dropper, giving only a 14-day supply. Fortunately, I have a few left over from a surgery I had last year that I experienced more massively high anxiety over, and I also have buspirone that I take for anxiety but is not working now.

I just want to go to sleep and wake up when it's over and know nothing in between except to ask a nurse if they've started, to find that they're done. My surgery last year went brilliantly. I had whatever anaesthetic with an anti-emetic that knocked me out in seconds (it was 1.37pm) and woke up afterwards (at around 3pm) with everything done and dusted and felt quite good, despite the fact they kept me in overnight.

Please HELP!!! I am totally freaked out over this!!!! It's to the point that I don't think I can go through with it!!!!

John said...

Hi LeeApp,

I went through a sigmoiscopy before and all you feel is some discomfort mostly due to the air they push in you to help making space with the probe really not a big thing at all (not real pain but I can see why some people would describe this as pain especially if they are sedated and they don't really understand what's happening to them - and on top of that people are not responsive to them cause they think you're sort of dreaming or not really connected with reality - this will reinforce their notion that there is some "pain" in my opinion)
I would take one of 3 options:
1)Take the pain killer injection (analgesic) but no sedation (no Versed). In reality there no real pain going on (I think that part of our body does not have a lot of pain sensitivity) but this will relax you and if there was a little discomfort ("pain") here and there it will be even more easy for you.
2)Do option 1) but ask that they be ready to put you under completely if you feel/decide so during the procedure (if you tell them to stop the procedure and you're not sedated they'll work with you and accommodate you, at that point just ask to be put under - I'm pretty sure you won't ask for it when you see how not truly painful this is but it will make you relax to know this option is available).
3)Just asked to be put under completely, complete anestesia worked with you before so if you're too nervous about this that might be the way to go.

laura said...

I just had a colonoscopy yesterday using the Versed and Fentanyl. This is the third colonoscopy I've had and I "woke up" during the procedure and was in a great deal of pain that I can only liken to labor pains in that I had to try to "breathe" through it. I don't know what people are talking about who say that it is not a painful procedure and I feel like I have a high tolerance for pain. After doing some investigating, it seems that my insurance company doesn't cover Propofol which will knock you out completely. The doctor said I had anxiety, which I did not have at all prior to the procedure since the last time I didn't remember it. I just felt "anxious" when I woke up and had pain that could not be controlled by the meds (they said they gave me a high dose). Next time, I will ask for the Propofol as this is the second time I was conscious under the so called conscious sedation drugs.

Anonymous said...

"Conscious sedation" as usually given for colonoscopy with Versed/fentanyl can be a terrifying nightmare. The small dose of narcotic (fentanyl) is often inadequate and the Versed is given to cause amnesia-it has no pain-relieving properties at all. Most patients are awake, many are in pain an fighting the procedure, in very obvious distress. Only because Versed blurs their memory, do these patients ever get out the door. Versed experiences are often brutal and the patient knows something really terrible happened, but the Versed makes memory retrieval difficult. The amnesia can last a very long time and induce PTSD. checkout askapatient.com for Versed horror stories.

Anonymous said...

Had colonoscopy with versed and demerol last week. I was terrified of both the procedure and losing my memory, but I guess I was lucky because it was all so easy, after all. I have completely forgotten the procedure and apparently I had a chat with the doc afterwards (everything was OK, whew!) that I have also forgotten, according to my friend who was there.
But reading this blog makes me aware that I was lucky and I agree that if this many people have had such terrible experiences with these drugs, then the drugs should not be used.
What's worse, though, is the apparent insensitivity and even downright cruelty of the doctors who let this happen, ignore the patient's pain and terror, and don't keep this from happening in the first place. Drug reactions are unpredictable but doctor's reactions should be intelligent and compassionate.
FINALLY -- it turns out that colonoscopy is not really required for asymptomatic people. You can do an home stool sample that is pretty good or have a sigmoidoscopy -- half the trouble, half the price -- that is virtually as good as a full colonoscopy because the stats show that the benefits of colonoscopy are almost entirely for bad stuff found in the sigmoid part of the colon, anyway.
So I question the necessity of the whole procedure for most people -- and that's coming from someone whose experience was OK.
Finally, what an interesting philosophical question -- if you don't remember something, did it really happen? LIke the tree that falls in the forest but no one hears it. Does it really matter that you had pain if you don't remember it?

Anonymous said...

This is a really useful blog, especially the comments.

I've just been referred for a colonoscopy at a London hospital. I was planning to refuse sedation anyway. After reading the comments here, I am definitely going to refuse sedation!!

Let me try to make sense of the various comments:

Firstly, people who have bad experiences are more likely to report them. For every negative comment here, there's probably many more people who were happy.

However, whilst the risk of a bad experience may be lower than it appears, you may still consider the consequences so undesirable that you want to avoid them.

Everyone is different, both in body and mind.

Body-wise, some people's colons will take the scope easily and for some it will be harder. Harder = potentially painful.

Mind-wise (1), some people will not mind having a camera stuck up their bum, others will feel humiliated and violated. This also depends on the attitude of the medics.

Mind-wise (2), some people may have adverse reactions if given versed / midazolam.

My view is that I'd rather run the risk of a potentially painful procedure than be given a drug that can potentially affect your mind. Traumatic memories of a colonoscopy are much better than a fried brain.

In the end, I'd say empower yourselves - do the research and make your own decision. Don't be forced into a mould by the system.

Anonymous said...

Update from previous commentor.

My appointment came through, so I used this as an opportunity to ask about the sedation. They do use the dreaded midazolam (versed) with either fentanyl or pethidine. I said I wasn't keen on it. They said no problem, it's quite possible to do the colonoscopy without sedation and that I would be by no means the first. They didn't say that what I wanted was not possible or try to get me to change my mind. They just said it's for your comfort but not essential, and I didn't feel under any pressure whatsoever (they said this after they'd said no sedation would be fine).

Wow! I was expecting to have an argument about this, as the information booklet they gave me previously didn't mention no sedation as an option and basically said "we do all colonoscopies with sedation". But that's obviously not the case in reality.

So it's all good so far. I'll do another update, probably when it's all over.

Anonymous said...

I'm shocked about how patients are lied to about the Versed "sedation"..they say it's to "relax you and to make you sleep" this s a lie. it's given to induce (sometimes) temporary amnesia and to force patient compliance. It's not a drug that you doctor would ever consent to for themselves, but they "insist" that YOU have it. Write on the consent: "I'm nt consenting to Versed"and ask the doctor (not a nurse or CRNA-a nurse) to sign it before you sign. I'm an endo nurse and this deception makes me sick.

Anonymous said...

I had my first colonoscopy last week and, like many others, was completely unprepared for the amnesia. I may have had it worse than others. The last thing I remember was turning on my left side before the exam, I have no memory of the exam, no memory of the recovery room, no memory of getting dressed, no memory of being walked to the car (as my husband later told me) with him on one side and a nurse on the other. I was completely freaked out when I realized the extent of amnesia I experienced--I simply could not imagine functioning well enough to dress myself and yet not remembering anything. It also was (and is) extremely upsetting and disconcerting that I do not know what happened during the procedure, yet I was conscious. I checked my husband's phone and it was an hour and 15 minutes between the time I knew the exam was about to start and the time they called him to say I was in recovery--this is much longer than the average time of a colonoscopy so it's very possible I had a "difficult" exam. Perhaps I am upset about what happened during the exam, yet I don't remember--so it feels as though I am upset about the amnesia.

I am convinced the amnesia is a feature of versed, not a "side effect". Afterwards I did some research and found a survey of experienced endoscopists in Germany (van Dellus et al. 2007): Results included, "Ninety-eight percent of the questioned physicians felt that patients have pain during endoscopy with midazolam+/-opioid, but do not remember later. Ninety-two percent reported that it happens that patients moan aloud because of pain and almost half of the endoscopists (48%) reported of screaming. The majority of the endoscopists (91%) reported fierce defense movements with midazolam or the need to hold the patient down on the examination couch because of fierce movements, respectively (75%). "

I find the consenting process outrageous. As others have mentioned, the "A" word was never mentioned. Does anyone know if something can be done to require more complete and accurate consent forms?

Anonymous said...

Thanks to all for posting. I had a colonoscopy earlier this week. Although my PCP (GP) had referred me to a certain G.I. practice, a specialist with whom I have a very good relationship recommended a different practice instead, one he regards highly. The practice clearly states that they use sedation for most colonoscopy patients. I thought little of this, as I had had deep sedation and an analgesic for a urologic procedure performed a few years ago, which went very well. The colonoscopy would be done at the same hospital as that procedure and I felt very comfortable with their staff from the previous experience.

The nurse who got consent clearly mentioned and explained sedation, but nothing of amnesia. She explained the 24-hour "no driving/no alcohol" prohibitions. Although I had researched colonoscopy procedure and risks, I read nothing about sedation.

While talking with the examining doctor just before the procedure (reviewing my history, etc.), I asked if the sedative would be similar to that used for the urologic procedure. His answer was that the latter was probably a bit heavier than this; that this would give me a "twilight" effect in which I would be able to hear him and the assistants, but "you won't care." I trusted in him and his decades of experience.

After rolling on my side and hearing the physician order "Start sedation," I recall seeing the NA inject two syringes into my IV feed. The next thing I recall was a very brief period of consciousness in which I briefly watched the video screen. I could also sense that my body was being repositioned. However, there was no pain at any time. Never did I hear the doctor or other staff.

I later recall the doctor speaking with my wife and me about has having removed one polyp, and my asking if he was going to have it biopsied. (Yes, of course.) I do not recall, as my wife told me later, that he also said, "And it looks benign. See you in five years!"

At lunch at home with my wife, I felt fine and remarked to her how surprisingly comfortable the whole procedure had been. Not until after lunch did it occur to me to ask her, "How did we get home?" "Did you walk with me from the hospital to the car?" "Was I conversing with you?" (Yes, she said, quite normally.) "Did you help me get dressed at the hospital?" (No.) I then realized and told her that everything between the conversation with the physician until lunch was missing from my conscious memory. I found that very disconcerting, never mind that the procedure had apparently gone well. My wife took it for granted, likening the effect of anesthesia to being in a drunken stupor (something neither one of us would do to ourselves). I feel that my mind had been "toyed with."

Had I been given Versed/midazolam? After reading of the many bad experiences here, I immediately self-tested by writing down the birth dates of our children, my wife and my parents. So far, so good. However, I now intend to get a copy of my medical report, being sure it includes the names of the sedative/amnestic and analgesic used and the dosages given of each.

Maybe I received something else. Or maybe I'm one of the lucky "90%" who did get Versed but who will not experience negative after affects. I will now be vigilant, though. This much is certain: now that I have read this blog, I will be sure never to consent to Versed for any future procedure. Maybe its use will be outlawed by then, anyway. Thanks again, everyone.

Anonymous said...

Beware! Be wary. The medical literature refers to Versed (midazolam) as a "sedative-hypnotic drug." In other words, it's both a sedative and an amnesic, causing lack of memory. In recent years, a "street version" of this drug has been used by thieves in South America - and perhaps elsewhere by now. Controlled studies (search online) confirm that the sedative and amnesic effects of Versed are independent of each other. Probably, then, the amount of the drug a thief sips into an unwary victim's drink is very low. After the hypnotic effect begins, the thief simply asks the victim to hand over items of value. Afterwards, victims report only the memory of a stranger offering them a drink (accepting such an offer is stupid!) or chatting with them at a cafe or bar. There is typically no recollection of having given away their valuables to a stranger. Granted, Versed / midazolam are administered clinically under medical supervision, but do you really want to take a drug that causes short-term amnesia, or possibly worse? Do your homework, and talk it over carefully with your medical practitioner before the day of the procedure.

Anonymous said...

The use of amnesia drugs (aka Versed) for colonoscopy is very common, but is veryscary. I would not get a colonoscopy unless the doctor (nor a crna-they are only nurses) signs the consent which I modify to state: "noVersed or other amnesia drugs). Furthermose I do NOT consent to any anesthesia care unless it is personally administered by an anesthesiologist (DO/MD)

Anonymous said...

My husband just had one this morning. He was conscious. He asked them to wait or give him something else. He is a vet who was referred by the VA. He has severe PTSD. They ignored him, pinned him down, crammed the tube down his throat and began the procedure. He was in pain and when the tube was out said so. The doctor told him it was due to hemroids. After reading these comments I am appalled at the medical community. I can guarantee that versed is not the choice of endoscopists getting their own exams. They use it because it is cheap and they don't care about their patients. Hope his doc has good malpractice insurance. If someone asks you to stop you should. Guess he never heard "no means no". So now we have no rights to our bodies??? This was equivalent to be waterboarded and raped for him.

Anonymous said...

I recently had a colonoscopy with Versed and Demerol. Reading this blog has really helped me understand what I'm experiencing -- the horrible feelings of anger and fear and sleeplessnes along with obsessing about it, almost as if I had been abused or tortured. This was my 5th or 6th time for this procedure, so I'm not new to it, but the last few times have been progressively worse. I will never do this again with "conscious sedation". I am inclined to go with the small amount of pain reliever only next time, or full sedation (which insurance will probably not cover). When I asked my doctor about all these effects I am experiencing he said, "anything can happen". Can you believe that?

Clark Family said...

Anesthesiologist

It is quite unfortunate about the bad experiences shared on this site. However, I'm not surprised. Non anesthesiologist usually don't know the difference between sedation for anxiety and sedation for pain.

I'm responsible for testing and educating non anesthesiologist physicians at my hospital for certification in "moderate sedation", sedation used for procedures when the patient remains awake. Some of the procedures are painful and some are not. Colonoscopies and EGDs are considered uncomfortable enough to be classified as painful.

Try as a might, gastroenterologist are persistent in using high doses of Versed for their procedures and use very little if any Fentanyl. The former treats only anxiety, the latter pain. I think these GI docs are scared of narcotics like Fentanyl since too much can cause apnea (stop your breathing). Instead they use mega doses of Versed which makes you not care about the pain and hopefully not remember it without the risk of apnea. These docs are initially trained to know how much Fentanyl to use but as time goes by they rely on Versed as the Holy Grail of GI anesthesia. When Versed doesn't work they ask anesthesiologists to consult on the case and we treat the pain. Example: A GI doc may commonly use 1-2 ml of Fentanyl (100 micrograms) and 5-8 mg of Versed. I never use more than 1mg of Versed for 99.9% of my non open heart cases (for awake sedation or general anesthesia cases). When I consult on moderate sedation - awake cases, I routinely administer 1mg of Versed with 3-4 ml (150-200 mcg) of Fentanyl. Some cases require more but as others have said, colonoscopies are uncomfortable, not extremely painful.

I recommend those of you who have had bad experiences or are just concerned about an upcoming procedure to recommend (demand) that you receive only 0.5-1 mg of Versed and more Fentanyl. Ask them to wait the 5-10 minutes to let the Fentanyl kick in and I can almost guarantee a 95% or more success rate. Adequate amnesia can be had with minimal Versed and Fentanyl will treat the real issue, pain.

Good luck!

P.S.: Propofol is neither an anxiety or pain medication, it only makes you sleep. If you get enough it can be great but you need an MD/DO or CRNA. If you don't get enough you just lie there uncomfortable until someone figures out that you're really awake.

Anonymous said...

If you want propofol, make sure that you have an anesthesiologist administer it; an anesthesiologist is a physiciann not a nurse...CRNA are nurses, not physicians..and God help you if anything goes even slightly wrong with a CRNA doing your case...do you want to risk your life with a nurse (CRNA)...? npoe..

Leo said...

I agree 100 percent on having a real doctor.

Anonymous said...

Just had a colonoscopy and I was worried about the sedation; I have had family members describe the "conscious sedation" (Versed/fentanyl) as a horrible experience..and some of these people are urses or physicians. Propofol can be better, but only is administered by an anesthesiologist MD NOT a nurse (CRNA) CRNA follow a standard plan for sedation without understanding that every patient is unique and needs titration or a custom set of drugs/doses. Nurses and nurse anes (CRNA) can't do this and having a CRNA do your sedation is risky and dangerous. CRNA and nurses rely on Versed-induced amnesia to cover up the fact that the patient actually experienced severe pain and was in a chemical straightjacket..awake and aware but unable to communicate...wonderful drug Versed..it invites patient abuse. When I found out that an anesthesiologist was not administering my sedation ( a CRNA was scheduled), I cancelled the colonoscopy upon the advice of my PCP. 1 hour later an anesthesiologist was summoned and I put on the consent that she would personally be administering any and all anesthesia care, not supervising other cases. Overkill? Maybe, but I wasn't going to risk my life with a CRNA. The anesthesiolgist agreed to my terms, but hesitated to co-sign my modified consent..which was BS..after a lengthly discussion, I told this less than honest anesthesiologist that I was goin too get the coloscopy without drugs and that I would not sign a consent for sedation. She initally got mad about this (I assume that without my signiture she would not get paid for anything including the 1/2 hour discussion with me). She then became apologetic for being less than honest and said that she would keep me comfortable no matter what. She was extremely upset that I didn't consent to her prescence during the colonoscopy; which was tolerable without any drugs.

Anonymous said...

Versed is just a way for doctors to control you while you are awake and will not remember a thing. I had a hip replacement with just a spinal and no Vesed or anything else. I have read studies that may link Versed or drugs like it to memory loss or dementia as one gets older. No more Versed for me. I hate when I go into a pre op surgery and here the nurses say everyone gets Versed. Beware and don't buy everything they tell you. Amnesia is not fun and can be dangerous