Monday, October 27, 2008

Do you want conscious sedation?

US News and World Report has a story from a few days back asking whether or not you want to be out for your colonoscopy, using Versed or other forms of conscious sedation.

26 comments:

Anonymous said...

Never again will I ever allow anyone put Versed I me for any reason! I was lied to by the Dr about sedation "putting me to sleep" even though I know now it really causes amnesia. Exactly one hour after after the colonoscopy was complete I was put out the door and I found myself at home having never even seen or talked to anyone again at the hospital after the drug was put in me. I delt with panic attacks every day for over a year after that drug was used on me. I was 51 at the time and I had never had a panic attack before that in my life. I know now that anyone allowing Versed to be put in them had better know and fully trust their Dr and hospital, because Versed gives no pain relief and the amnesia it causes is strictly for the Dr and hospitals benefit. It allows them to maintain a schedule and to go as fast as they want even to the point of hurting you. They know you will never remember what was done to you and if you do have a problem or reaction to the drug once they get you out the door it is your problem now not theirs.

Nursing Dude said...

Conscious sedation is a tough to go through. We will be having a vague picture of everything happening around us, but not able to do much. Thats horrible.

Anonymous said...

nursind duse said it all" nevery agree to colonoscopy nder Versed...the amneis is fleeeting, haunting and I still have nightmares about ebing lied to about this drug, I met with m GI doc,he said that the had it and thought that "it was fine"........I asked him if I could verify this (I'm a hospital computer specialst), so I punched up his recent colonoscpy on STENTOR ( a records storeage system) and sure enough, his was with a miimal dose of painkiller (fentanyl)-no verded, no propofol..but it's what e told me tha the had.........I asked him to document tohis deceit in my medical record (he did!) then asked me sheepishl is I would complain/sue..I said no, told him I was disappointed and left. Incredibly, they mailed me the prep and expect me to ge the exam next week. I told him that I wold not trust him to ash my car,

Anonymous said...

Fear not unseated colonoscopy. The discomfort is minimal and is probably comparable or just slightly higer then a dental cleanup. Being awake during the procedure forces the crew to proceed at slower speed and be more accommodative. You can also see the proceedings on the screen and discuss the details with the physician. The total time from getting on the hospital bed to getting off the bed is also reduced to 35-45 minutes.

Nemokat05 said...

Thursday, February 19, 2009
Colonoscopy
I have to have a colonoscopy tomorrow at noon. I am not looking forward to it. I have to drink this shitty stuff that makes me have diarrhea all day long so I am going to be on the toilet today. I have to have it because I've been pooping red and my poops are big and large and they can stop up the toilet easily. I just can't wait for it to be over with because I am just going to come home tomorrow and rest all day long and do nothing.
Posted by Nemokat05 at 12:16:00 AM


i am going to have it done and i dont think i will like it!!!!

Anonymous said...

I'm a nurse who worked in a GI lab for many years and I can tell you that Versed is indeed a horrible drug. It forces the patients to lie there, in pain, unable to move or to communicate while the GI doc treats them roughly and often without compassion, Docs love the drug because most patients are forced to forget the procedure because of Versed; only to remember later and have haunting nightmares. Versed is patient abuse.

Randy said...

There are alternatives to Versed.
Many drugs are available to make this procedure more tolerable, in most countries no drugs are used for routine colonoscopies.
Proper patient education before the procedure, goes a long way in decreasing a patients anxiety and negative experience.
Im a consultant for Conscious Sedation Consulting and we educate physicians, dentists and nurses on the administration of sedation, a great deal of that training is on patient assessment, it is just as important to know how to sedate as it is to know when not to sedate.

Best,

Anonymous said...

I'm a CRNA and I always thought that the horror stories about Versed and amnesia, memory loss, PTST were over the top. Not anymore; one of the CRNA's in our group had a colonoscopy with Versed and her memory loss is so bad that she can't work anymore. It's been 2 months and her memory loss is still terrible. Gastro docs need to start telling patients the truth about conscious sedation and especially Versed. I have been in practice for 25 years and have administered conscious sedation many thousands of time; I have never used Versed nor would I ever consent to receiving it.

Anonymous said...

I'm 54, an airline pilot (so I don't know anything about medical stuff)...The company doctor told me at my 6 month physical that he would not sign off on the exam if I didn't promise to get a colonoscopy; so I reluctantly scheduled one. I did the prep and reported fo rthe exam; Itold the doc that I wanted to skip the Versed (mainly because the the bad press that it had received, and I can't afford memory loss in my profession). I was shocked when she told me that they had a lot of complaints with Versed and did not use it anymore; they had a CRNA who gives propofol (diprivan?). I told her that I have been shot at in wartime, but the idea of amnesia drugs is just too spooky, so I declined the sedation; which she said was o.k. but that she recommended that she have painkiller ready just in case Ineeded it. The exam was easy; she talked me through it and the pain was minimal. After the exam, I had a lot of pain from trapped air, and before I could get the IV out and leave, she had me lie down and told me that it was time for the painkiller that I had not asked for and she injected it. The resulting nap was great and the air was noisily eliminated thru a rectal tube that the doc had gently inserted...Sounds gross, but I would do it againin a heartbeat without sedation. Footnote: the exam showed pre-cancerous polyps, so I get to return yearly for a while which I will gladly do. I would not go back if they had tried to give me Versed; the doc assured me that the "horror stories" about Versed are indeed factual. Why some providers try to push this drug on patients is beyond me; but then again, I'm no doctor.

Anonymous said...

I'm 29, so I'm a little under the recommended age for this procedure. I just had my colonoscopy 2 days ago because I had had two episodes of minor bleeding and the doctor wanted to make sure nothing was really wrong. The prep work was the worst and anxiety was making things move the morning of the procedure that I thought had been finished the night before, but that was the worst of it for me. I I made sure I wasn't being put on Versed before they put the IV in me and the nurse assured me they don't use that, but Propofiol. So I consented to the drug and when they wheeled me into the procedure room and started me on it the only complaint I had was the plastic smell from the breathing apparatus. As soon as the Propofol started I was asleep. When I awoke I was quite happy for the nap since I hadn't slept well the night before and I was just a bit drowsy throughout the day. I haven't had any negative side effects and will gladly receive that sedation again when I have my next colonoscopy.

Anonymous said...

I'm 29, so I'm a little under the recommended age for this procedure. I just had my colonoscopy 2 days ago because I had had two episodes of minor bleeding and the doctor wanted to make sure nothing was really wrong. The prep work was the worst and anxiety was making things move the morning of the procedure that I thought had been finished the night before, but that was the worst of it for me. I I made sure I wasn't being put on Versed before they put the IV in me and the nurse assured me they don't use that, but Propofiol. So I consented to the drug and when they wheeled me into the procedure room and started me on it the only complaint I had was the plastic smell from the breathing apparatus. As soon as the Propofol started I was asleep. When I awoke I was quite happy for the nap since I hadn't slept well the night before and I was just a bit drowsy throughout the day. I haven't had any negative side effects and will gladly receive that sedation again when I have my next colonoscopy.

Anonymous said...

Colonoscopy is a good idea; the sedation with Versed is not. I'm a nurse who assists with dozens of colonoscopies per week (I "drive" that means manipulate the scope from insertion to the cecum); and we have WAY too many problems with Versed. My own doctor (a wonderful young woman) trusted me enough to come to our endo facility for her colonoscopy; long story short: the Versed-induced memory loss and phychic trauma that she experienced were boyond belief). I hope that she sues our facility. If you can't get an unsedated exam (safer and better), bet propofol (it costs a lot); ubt at least you will have less chance of wrecking your memory. I'm so ashamed that I recommended that my friend get this exam with sedation.

Anonymous said...

I prepped yesterday for my first colonoscopy. It wasn't nearly as bad as I thought it might be. The main reason I've put off having one for the past several years, over the recommendations of my docs, was that I had a fear of being awake for the procedure.
Sure enough, I get to the office this AM, everyone is nice and kind and reassuring, telling me that I won't be awake, I'll be blissfully out of it with the versed. I go into the O.R. and get up on the table and they start the versed and fentanyl and I get a little light, dizzy, blissful but wide awake. I tell ask them if I'll be out and they say yes. But I never to under all the way. I didn't feel them begin the procedure (or I don't remember) but mid-way through I start to feel discomfort beneath my left ribcage. I tell them. There is a nurse on my side of the gurney, I hear the doctor say to increase the dose. It doesn't help. They keep going and the discomfort turns to bad cramping. I tell them again. Again they up the dose, all I am is dizzy/high but feeling like I'm in labor, as in having a baby (which I've done). And in a few minutes the doctor tells me that I have a tolerance to versed and they they can't complete the procedure.
Next think I know I'm out of there and in recovery, apologizing because they couldn't finish. I feel disappointed, as though I wasted two days with this. The doctor stops by and says in a month or two we can reschedule with an anesthesiologist.
I'm so disapointed that I have to do this again. I really don't want to do this wide awake. I don't have bad feelings about the versed. I remember almost everything from the day and think I would have had real panic without something. I'm just sorry it didn't do what I thought it would.

Anonymous said...

I had a colonoscopy yesterday. I'm a pharmacist, so I'm familiar with the sedation drugs. They strongly suggested Versed and threatened not to do the exam unless I consented to it. When I told them that I was a pharmacist, they immediately agreed to do the exam without sedation..they said "your a pharmacist, of course you don't want Versed"...This freaked me out. I have had way too many patients complain of long-term memory loss and anxiety attacks from this drug. I can't believe that the FDA hasn't pulled from the market or at least black-boxed Versed. Anyway, the unsedated exam was not bad and I did get some pre-cancerous polyps removed; the only downside is that I no longer trust this GI practice because they tried to foist a bad drug on me when they thought that I was the "average patient". When they found out that I was a pharmacist, they immediately agreed that Versed was a terrible idea. The doc isn't totally wrong by pushing Versed; they are genuinly concerned that an unsedated patient (with memory of the procedure) won't return for another exam if needed. I don't buy that argument; just tell the truth and slow down.

Anonymous said...

HUM? I've worked in GI Labs for years. We've not had complaints about using Versed? I've had it and had no problems with it. Coarse I'm not sure what yall are talking about saying they use it to make the procedure go faster. We take our time, we don't rush the drug or the procedure. And our Doctors are not rough at all. We have a great group of Doctors, they don't force you to have the sedation if you don't want to have it, most folks say they want it, all of our GI Nurses and Surgical Nurses that have had the procedure, want versed. Our Anesthesia folks give versed before taking patients into the OR for a surgical procedure. I had back surgery at another place, ours doesn't do back surgery and they gave me versed prior to going back to the OR..... There may come a time when I change my mind about the drug but as for now, versed has not been a bad drug for me or our patients. Perhaps yall are getting too much of it?

Anonymous said...

Nurses who give versed for procedures don't "see" problems with it's use (or they ignore them to get the patient out the door); the problems occur after the patient gets home. Severe memory loss, PTSD, frank psychotic episodes are common in 10% of patients who get the usual .05mg/kd gastro endo dose. That's a huge percentage. This drug is overusds by many (not all) gastros who just want to do a procedure quickly and get the patient out the door. After all, they probably won;t see the patient again anyway, so they don't care. I work in a university hospital and have NEVER seen any of our doctors consent to endoscopy themselves with versed. NEVER. The last post was probably right; many patients are getting too much drug. There is a world of diference between a few milligrams given preop to induce procedural amnesia (to cover everyone's butt) and doses of 8+mg given by slob gastros. In primary care, I see the carnage casued my careless use of versed, expecially during colonoscopy. Conscious sedation whould be administered by anesthesia personnel only; I won't order one unless the patient can get a CRNA to administer propofol. We have 5 physicians in my group, all are over 50 or 40 with a history of CC and none of us has had a colonoscopy-mainly because of the horror stories that we hear from patients who have experienced sloppy sedation, mainly with midazolam (versed). I list versed as an allergy even though I have never had the drug. Do you think that all of the patients who are posting their terrible versed experiences are doing so for kicks? I doubt it. These people (for the most part) have been hurt by this drug.

j-squared said...

I have had Versed for three colonoscopies, including the one that found my 7.5cm. malignancy, and twice for a cardiac cath - pre-and post-op an aortic valve replacement. Whether or not it was administered prior to "deep" anaesthesia for surgery, I'm not sure. As far as I know, I have not suffered from any ill effects relative to Versed. If it has been found that there are other, better drugs to replace Versed, it is because research continues to improve the efficacy of most medications.
I do not dispute that some people may have an adverse reaction, but having worked in the medical field, I am familiar with the patient who believes everything that "the guy next door" tells him about what he heard about the horrible consequences of taking this or that med, or having this or that procedure. Some people are very suggestible, and they might well benefit from hypnosis as anaesthesia.

It's hard enough to convince people to have a scope done, how many more would refuse if there were no sedation?

Anonymous said...

Colonoscopy is a great procedure, but too many docs are insisting on using Versed (midazolam) sedation for this exam and it's unecessary. Versed does nothng for pain, it's only given to induce amnesia and about 10% of the patients who receive Versed have long-term, terible memory impairment that is often not noticed until days or even weeks after the procedure. Slob gastro's love versed because they can go fast, hurt the patient and get them out the door before they start to remember how badly they were treated. Docs and nurses who treat patients this way: someday you or a family member will have this happen to them and you will have a lifetime of nightmares that you richly deserve.

Touchet said...

This drug is nothing but a amnesia drug. The only reason they would object to NOT giving it to you is if they have a habit of ignoring the patient's pain. If they inject the max amount of pain killers, believe me, you won't be feeling any pain. They can give you valium for sedation if they absolutely feel the need to "relax" you. In any case, it has been my experience that intravenous narcotics pretty much relax you A LOT anyway.

If the doctor refuses to do the operation with out versed, then you refuse the test. Tell him you will find another doctor who is willing to do it. Request a copy of your records and say goodbye.

Anonymous said...

had a colonoscopy in 08. was sedated via twilight using VERSED. would do it again and not change a thing. the procedure was simple, no pain at all during or post-procedure, was fine at home afterwards. it would be great to have VERSED to take at home after a hard day's work that you just want to forget about!

Christy said...

Honestly, with ANY medication, there is a risk of major side effects.

I had a double lung transplant in 2001. I have had multiple bronchoscopies since (also 4 different portacath placements) with the use of Versed for conscious sedation. I have never experienced a side effect from it. Actually, I have never heard of any of my transplant friends having a side effect from it either.. well other than temporary sedation.. what it was meant for.

Anonymous said...

Just had colonoscopy a couple of weeks ago. I had Fentanyl, 2mg Versed and Diprovan. I felt the entire procedure-which was quite painful. I was told before the procedure that I would be able to squeeze my conscious sedation nurse's hand if I needed more pain medication. I felt like the entire time that I was talking to them and telling them I was in pain, but they said I just slept the whole time. There was no amnesic effect and not adequate pain control. My scope came back negative, thankfully. I don't need another procedure for 10 years, but my mom will be having a scope next week and I will encourage her not to get the Versed. I will consider listing it as an allergy, as someone else suggested. I also work at the hospital where I had the procedure and plan on talking with someone in the anesthesia department about the Versed/side effects.

Anonymous said...

I have never had, and will never have, any invasive treatment / procedure nor will I take any drugs such as versed. It is my body and I, and I alone, say what happens to it.

Anonymous said...

Had a colonoscopy ~ 6 months ago with fentanyl and versed. No adverse reactions, no pain, nothing. Came out from the sedation while still in the exam room, left the facility 30 minutes later after reviewing the results with the GI doc. No memory impairment, no pain, no adverse effects. This is not to say that nobody has adverse effects or that there are no risks - with any type of sedation and/anesthesia there are risks. It's a matter of personal choice and personally deciding what is right for you. Nobody should use a drug they aren't comfortable with and informed about, but Versed is not the horror drug that some are making it out to be.

Anonymous said...

I was given Midazolam as a sedative before a Gastroscopy yesterday. It has REALLY put me off any further endoscopy procedures, and I'm due a Colonoscopy in less than 2 weeks too. I have had 5 sedations in the past for other non-endoscopic procedures, all with Propofol and had no problems. This time was different, I felt NO sedative affect and remember the whole event as very invasive and MOST unpleasant - gagging response for whole procedure and was soooo relieved when the scope was finally taken out! Now left dreading my Col' and don't know what to do :-(

Anonymous said...

I made the mistake of trusting the endo doc who did my colonoscopy; she promised "only a tiny dose of Versed" nad only if I asked for it. I signed the consent and: wham...she squirts 4mg into my IV and it was the most horrible experience..I was imobile and in severe pain, then I got very agitated and combative.......My memory was damaged by this drug, but the doctor ended upwith a black eye (from me) and the exam was not finished.....so they won't get paid...later, my wife and I met with this doctor (she had a nice shiner, complete with steri-strips) and she apologized for the Versed (as a patient control drug) which was inappropriate. My wife asked: "my husband has been your patient for 10 years, why did you lie to him about the Versed sedation?"..No answer. My wife said: "I hope that your black eye and broken eye orbit hurts like heck" (I don't remember hitting her)...but she deserved it.