Effects of anesthesia (in general) and Versed (in particular)

In My Humble Opinion
1

I had cataract surgery day before yesterday around mid-morning. My friends who have had it have virtually all said, “Piece of cake, in and out in half an hour, no problems at all,” and I was prepared for that and hoping for that. But no.

My after-eye is great–colors bright and shiny, on the computer screen whites are brilliant white and blacks the darkest of black. I had no pain or discomfort in my eye at any time. Left the hospital with no eye patch, only a plastic shield to tape over the eye when I sleep. All that had to do with the eye itself was great.

But as I said in this threadback in 2015, the anesthesia kicked my ass. I learned in that thread that I should make a point of telling anyone and everyone that I’m sensitive to anesthesia. I’ve had a couple of procedures since 2015 and I’ve had no problem. With one of them I was given a Scopolamine patch behind my ear to stave off nausea and it worked fine.

When the anesthesiologist came right before the cataract surgery, I told him about my sensitivity, and he basically blew me off. I told him I had had the patch with another procedure, but he assured me I wouldn’t need it. I guess he figured since he wasn’t doing a general, I’d be okay. What part of “I’m sensitive to anesthesia” did he not get? *All of it. *

He said he was going to use Versed, which I had only had one time before in the ER when they set my broken ankle. That was 11 years ago, point being that I was 11 years younger. I’m 70 now, and technically considered a geriatric patient. Also I was pretty traumatized from the broken ankle and if there were any Versed after effects, they were probably absorbed in my generally shitty mental/physical state. Versed doesn’t put you totally out, of course, but with both times I’ve had it, I do have a memory (possibly an illusion) of a lot of noise and commotion around me.

Anyway, I felt very woozy and sick after the cataract surgery. Right away I noticed the stunning change in my vision and that was great. No complaints there. Also, no pain or discomfort in or around my eye. But after my friend brought me home, I threw up, like I did after the lumpectomy in 2015. Went back to the ophthalmologist yesterday morning for follow-up and we talked about this. He’s a quiet guy, but I could tell he was disturbed, especially when I told him the anesthesiologist “blew me off.” I used those words. I’ve been going to this eye doc for about 13 years. I told him the eye result was great, but I could only describe the whole thing as an ordeal. I’d like to have the other eye done, but not if I have to go through this again. It was not the walk in the park that others have described.

Who else can tell me about their experience with the effects of Versed, both during administration and after? My google research says it usually clears the system in urine or BMs in a few hours, but the effects can last 1-2 days. I’m still feeling it somewhat this morning. It will be a few hours before I reach the 2-day mark. I’ve read and I know that with <gulp> senior citizens, anesthesia effects can linger.

Also, has anyone had cataract surgery with only a local? My doc says he has done that.

2

I am a few years younger than you, but I had cataract surgery on both eyes (also with good results). But I am apparently not as sensitive as you are to Versed. I had no after-effects, although I think I had a larger dose than usual.

They were going to do my eye surgeries with local anesthesia, and with Versed to relax me so I didn’t care. (They also did something to paralyze the eye). But I was there on the table, the surgeon started digging around in my eye, and was chatting with the techs and nurse about the apps on his phone. I growled “Hey - pay attention to what you’re doing!”, he said to the CRNA in attendance “I think he needs a bit more anesthesia!”, and that is the last I remember of the process.

I believe they use Versed in part because it produces retrograde amnesia, which means maybe you were semi-conscious during the event but don’t remember it.

Sorry it was so unpleasant for you. If and when you decide to have the other eye done, make sure everybody knows that you had a bad after-experience from the anesthesia. Having the anesthesiologist blow off your concerns is not good medicine.

One of the disadvantages of being old, as I have found, is people treat you like an idiot. In my case, it might be justified, but not in yours. When you meet with your eye doctor, tell him/her about your bad reaction to the anesthesia. When you are being processed thru intake for the surgery, tell the nurse. When they start getting you set up, tell them again. When the anesthesiologist comes in, tell him/her again.

If you have someone with you for the surgery, make sure that person says it too. Over and over.

Regards,
Shodan

3

I had eye surgery to correct squints in both eyes. Most was done under anesthetic, but the final de-squinting adjustment was done under local (complete with clockwork orange style eyelid hold open clamps). I would recommend doing it under general. Uncomfortable is not the word for it

BTW I am usually fine with modern anesthetics, but the eye op made me really nauseous too. (I threw up and the nausea continued for a few days) My GP suggested that it was due to the fact that they couldn’t use the usual gas method, as the mask would interfere with the surgery.

4

The one time I’ve had Versed that I’ve known about it, it completely wiped out my memory for the next hour or two. As in, I was talking about it with the nurse prior to knee surgery, mentioned that I was aware of that property of Versed (it’s a plot point in “Cardinal of the Kremlin” by Tom Clancy), and we chatted a bit more. She administered the drug into my IV, and <blam!> There I was, swaddled like a baby in the post-op recovery room with no memories in between- it was like someone flipped a switch and I was in a different position, different room and felt very different (sleepy post-anasthesia).

Weird stuff, for sure.

But being nauseated and woozy post general anesthetic isn’t abnormal at all from what I understand, and doesn’t indicate any particular sensitivity. And both are known side effects for a few days after getting Versed as well.

5

Thank you for these helpful replies. I just talked to my ophthalmologist on the phone more to make him aware of the sitch than anything else, and basically he said I just have to wait til it wears off.

I didn’t think Versed was considered a general anesthetic, but it’s kind of a moot point now.

I did not have any amnesia, either this time or the time Versed was administered when my broken ankle was being set. I have very vivid and unpleasant memories of lots of noise and chaos around me (I’m guessing there wasn’t). I remember during the cataract surgery the doc telling me to look up and look down. The feeling was sort of like being put in a container with people pounding on the outside. Same with the ankle setting experience.

I’m drinking lots of water. Made some soup. I hate feeling drugged.

Thanks, y’all.

6

heck with scop patches, ask for zofran … the only thing that it doesn’t keep me from vomiting on smelling is italian sausage/peppers/onions grilling. Just spent 10 months dealing with chemo and radiation with serious nausea issues. lovely dissolve under the tongue or inject into the iv … though the pills come in 2 flavors, vaguely minty and vile mixed berry =)

and i love versed, milk of amnesia … it can be dosed so you don’t remember huge needles being shoved in to numb the neck to play around with the parathyroids because you need to be awake so they don’t screw up your future ability to talk, or to install a power port so you don’t scar up all your blood vessels with IVs going in or it can make you blink out and wake up in recovery =)

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ThelmaLou, I’m sorry you had what sounds like an awful experience.

I hope you get a different and better anesthetic for your other eye, and perhaps some advanced discussions, planning and coordination on that would guarantee that a different one is tried. I would think you’re not the only one to have this type of reaction, but maybe you’re part of a small percentage of people who do, and hopefully they will then know what are the best alternatives to try.

8

Hey! I now remember that this happened to me too — briefly. Knee surgery, about 20 years ago… after surgery I remember talking with the doc and he was reviewing the post-op instructions with me, and he said, “and make sure that you do XYZ”. I said, “What? XYZ?? What is that?” (I’m not remembering what XYZ is, but I vividly recall the conversation) And he told me that we had discussed XYZ earlier, and that I had acknowledged it.

I had no recollection at all of that earlier discussion, which happened about 30-60 minutes before.

Why the hell would docs discuss important matters with someone coming out of anesthesia?? The doc said I’d fully acknowledged his instructions earlier. I didn’t even recall such a conversation.

9

Thanks. I’ve been researching it, and there are some scarier stories than mine. :eek: I should know by now that you have to advocate for yourself in a surgical situation. But I DID tell the anesthesiologist. He knew me better than me, right? :mad:

10

I don’t know about Versed, in particular, but I know I’m sensitive to anesthesia. I will almost always vomit afterward. If they listen to me and give something for the nausea, there’s no problem. How awful the anesthetist blew you off. My younger sister is also very sensitive. Maybe its genetic, or maybe women are more sensitive?

11

Back in 2012 I had brain surgery (SDMB thread here, https://goo.gl/RZhuzU) and had extreme constipation caused by the anesthesia. It was awful, terrible, and painful until things, uhh, cleared up.

I never knew constipation was a side effect of anesthesia.

12

When I had surgery and all of my docs were women, including the anesthesiologist, I was given the patch and I had no problem.

Hmmm…now that you mention it… :dubious:

13

I’ve always heard that surgery on eye muscles has a high risk of N&V, due to some kind of connected reflex.

The reactions that the OP and others had may also have been to other medications they received in the process.

14

I have heard of it done with just a local, but as I mentioned in enipla’s thread, it’s a great deal more challenging, technically, as it’s hard to perform it while chasing the patient down the hall.

I’m sorry to year you had such a wretched time with Versed. Definitely make a written complaint to the hospital - doctors ignoring patient warnings = a good way to cause a very bad outcome. Especially since one of the problems - nausea - is so easily treated. I’ve written letters of complaint several times when meds were screwed up. Hell, after one surgery, where I’d made it QUITE CLEAR - IN WRITING - that only Zofran was to be used for nausea if needed, the doc wrote instructions for Phenergan or something - luckily I didn’t need it.

It’s quite possible you need a different sedation protocol. Versed is a benzo. I had a combination of that and fentanyl (a narcotic) for mine, which might let them use a lower dosage of either.

Have you had successful sedation procedures with other protocols? I’ve had propofol (a.k.a. “milk of amnesia”) for my various endoscopies. Depending on the type of surgery you have, they may need you more conscious: I had to be able to move from one table to another under my own power, and I suspect I could not have done that with propofol. If you’re not doing a laser-assisted version, that might not be an issue. Maybe a different benzo would be a better choice; I think they use Versed because of it’s amnestic properties and relatively short half life. If you’ve ever had anything like Valium without problem, that might be an option even if you’re woozy longer.

Your eye doc should be able to prescribe you something for nausea in advance, if all else fails. Is that patch available at a regular pharmacy?

If you do go back to the same facility, make sure they don’t stick you with the same anesthesiologist. Sadly, it’s “luck of the draw”; I had a nurse anesthetist my second time around, an MD for the first (and he’s the one who refused to sedate me at all for the laser part).

One anecdote I have about benzos: When my dentist wrote me a scrip for Halcion (triazolam, I think) to take for dental anxiety before some major work, I checked with my primary care doc first, and she commented that in older patients, it can cause more problems (I forget what they are). Maybe Versed is similar. As I was in my early 50s at the time, I took it with no problem.

Oh - as far as lingering: After any sedation, I do tend to be unable to focus for a solid 24+ hours afterward. Not any 48-72 hours like you’ve had happen. Not sure why that is, since as you note the stuff has been well metabolized by then, but

15

Nausea is such a common reaction to anesthesia that they bloody well should know how to deal with it. For my gallbladder surgery, and my first eye surgery, in each case the topic of the appropriate med was brought up (I have Restless Legs Syndrome and Zofran is the only one that doesn’t make the legs go wild).

In fact for the gallbladder surgery, I’m pretty sure they gave me a dose routinely (of Zofran; it was the surgeon who wrote orders for a different, contrandicated one afterward).

Now, I don’t tend to be nauseous in any case, and I’ve never had a problem after any kind of surgery even when they didn’t give me anything for it. But I gather I’m luckier than most in that regard.

Constipation, now… I don’t know about it being linked to the anesthesia… but the narcotic pain relievers, on the other hand… :eek::eek::eek:

16

I expect that’s what they gave me initially for my wrist surgery. They were doing a supraclavicular regional block (injecting into the nerve cluster right where the neck and shoulder join up) and I expect it’s fairly unpleasant. I remember NOTHING after the room started tilting until I came to with the mother of all headaches. Dunno if there was any connection; I’ve never had that after surgery before so maybe it was partly a reaction to the regional block.

Which was lovely… until it wore off. Then life really sucked.

BTW, Versed is not a general anesthetic. It’s a sedative / amnestic. You’re alert enough to respond etc., but you just don’t care… and often don’t remember.

17

When I had my lumpectomy I was violently sick after surgery (that’s what precipitated the thread I cited in my OP), but even that time, I was okay by the end of the day. It didn’t take three days.

When I had some uterine polyps removed the anesthesiologist (a woman- I’m only mentioning her gender because she LISTENED TO ME) gave me the scopalomine patch and I had no problem.

I’ve had two colonoscopies and had no problems, but I don’t know what was used. I suspect it was propofol.

I told the opth that I didn’t want this anesthesiologist for the other eye, and he said, “He’s the only one we’ve got. We can’t go get a different one just for you.”

The opth said that HE is sensitive to anesthesia and always asks for a pediatric dose.

I’m going to see the opth this Friday for a followup and to discuss doing the second eye. I want to discuss:

  1. different anesthesia, maybe propofol
  2. pediatric dose
  3. getting the patch (“belt & suspenders”)
  4. what’s the advisability of doing it with local only and without anesthesia

I really don’t want to go somewhere else. I’ve gone to this opth for 14 years. I’m satisfied with him personally. I’ve told him about the anesthesia issues in three conversations since the surgery–I believe he gets it now.

When I got the “how did we do?” survey phone call after the surgery, I told them everything and used the words, “The anesthesiologist blew me off.”

Thanks for weighing in. I appreciate it.

I’d really like to hear from someone who’s had this done with only a local.

ETA: Yeah, I know Versed is not a general anesthetic. And I DO remember what went on while I was under- at least my recollection is dreamlike. I remember lots of talking and noise and flashing lights. I don’t think that’s literally what went on, but how my drugged brain scrambled what was going on around me.

Constipation, YES. FIVE days with no… activity. Ugh. And I was eating homemade vegetable soup every day. Tons of fiber.

18

Update: I had my other eye done three days ago. The ophthalmologist did order the scopolamine patch. Had a fairly long talk with the (same) anesthesiologist right before the surgery. I knew he had used versed and fentanyl the first time. I asked him why fentanyl, and he said <with a little shrug> analgesic. I said don’t use it this time. He said do you think it was the fentanyl that made you sick. I said I didn’t know, but let’s don’t.

After the surgery, my eyeball was quite sore. I guess that’s what the fentanyl was for. I asked the nurse for a cold compress, and the discomfort was mostly gone in about an hour. My friend who took me said my demeanor was night & day different. She said after the surgery back in January, I was out for 40 minutes after they brought me to recovery! And of course, when I woke up, I felt awful, threw up later, and was sick for three more days. Not to mention constipated for five days. :eek:

This time, I was alert immediately and didn’t throw up. I felt okay. However I did have strange heart palpitations and an upset stomach that night. I’m still (3 days later) having a little gastro-intestinal distress. I don’t know if it’s related.

I drove myself to the follow-up visit the next day with no problem. No bandage or cover on the surgery eye either time. I have to tape a plastic shield over the eye for a week when I sleep.

All I can say is that I’m glad we only have two eyes, because I don’t want to go through this again. My eyesight is brilliantly clear. The vivid colors, the clarity-- astounding. Something really startling: looking at my face in the mirror is like looking at high-def TV, and not necessarily in a good way. Was it Robert Browning who said something about “seeing ourselves as others see us”? I’m going to need new make-up.

19

I think it was Robert Burns, not Browning.

20

Yep, Burns, To A Louse.

“O wad some Pow’r the giftie gie us
To see oursels as ithers see us!
It wad frae mony a blunder free us,
An’ foolish notion:
What airs in dress an’ gait wad lea’e us,
An’ ev’n devotion!”