For whatever reason, I’ve had many procedures done with this sedative over the years. And one thing that always makes me nervous is that the doctors and/or anesthesiologists have tended to emphasize that I won’t remember anything. They say this as if it’s a positive feature, but I find it concerning in that it suggests that I’m conscious at the time and possibly in considerable pain but just unable to remember any of it afterwards.
From Wikipedia: “Propofol, marketed as Diprivan among others, is a short-acting medication that results in a decreased level of consciousness and lack of memory for events […] Propofol is not a pain medication, so opioids such as morphine may also be used.”
But I can’t get a description of what exactly sedation means in this context. How much pain/discomfort does a person actually feel? (And how might anyone know the answer to this question, if the person being sedated is in a state of reduced consciousness?)
I’ve had procedures with this (or similar). Apparently, I have a fairly high resistance to it, but when they finally juice me up enough, I’m toast. I don’t remember any aspect of the procedures. So… at least to my thinking, no matter what horrific pain/discomfort I may have been in, I was out of it enough to not resist and don’t remember it. So it doesn’t really matter.
I had never had general anesthesia until my knee repair early this month. I think everything about my experience was typical, except that I am disturbed by an unknown period of memory loss. I was taken into the (outpatient) OR, and the nurse did a consciousness check thing (name, why are you here, what day is it)… and the next thing I was opening my eyes in recovery. I know I must have been conscious for a few more minutes, but having that short-term memory erased is one of the most bothersome - unsettling - things I’ve ever had happen.
I am not sure what drugs I was given, but I am pretty sure propofol was one of them.
Had that same thing happen to me, except it was 1989, and it was Versed (Midazolam).
One minute I’m sitting on the OR gurney (not even the operating table), having a conversation with the nurse about how I knew what the amnesic effects of the drug were (read “Cardinal of the Kremlin” by Tom Clancy), and the next thing I knew, I was swaddled up like a baby, was really sleepy, my throat hurt, and my knee was more sore than before. Definitely a surprise.
Interestingly, the last knee surgery (early 2014) was less discontinuous. I was on the table being strapped down when I lost consciousness, and woke up in the post-op recovery room. But I remembered being anesthetized and all that, so it wasn’t really a surprise.
I have been the sober one at at least 100 sedations like this. They are usually referred to these days as procedural sedations.
Depending on what we are going to do, from an I/D on a pylonidal cyst, sort of the least sedation, to putting a dislocated hip back in place, we use some sort of analgesic.
Versed definitely wasn’t as useful as propofol, as it was more dangerous to sedate a person as deeply. But it did have good amnesiac properties.
I can remember a patient not exactly screaming, but moaning with purpose, when we reduced her dislocated hip (using Versed). She was obese and it took awhile. I kinda thought she was going to remember something but, no, all smiles and “when are you going to start” when she woke up.
So, yes, the amnesia part is seen as a positive feature.
I would wager it depends on what order you were given the drugs in. I’ve had three endoscopies and a shoulder surgery.
The three endos were done under twilight sedation. I don’t remember anything at all about them from any point after about 10 seconds after the doc told me I would start getting sleepy. IIRC, they told me they use morphine, benedryl and Versed.
After the first one, my ride showed up when I asked if someone called them, he told me that I had called him. After he said that, I did recall fumbling around with the weird (bedside) hospital phone while waking up and I can kinda sorta remember the nurse telling me to call for my ride. At some point during the second procedure, I had mentioned this and the nurse told me that they’re not supposed to let (recovering) patients use the phone, IOW, whoever told me to call for a ride, was wrong.
Anyways, when I had my shoulder done, nurses and other medical staff were in and out of the room the whole time I was there. At one point, one of them gave me a shot. When I asked what it was, she said ‘versed’ and I replied ‘so, uh, that means I got about 5 more minutes to rememb…’, then I woke up wondering why my shoulder was bugging me.
Makes sense to get something like that for twilight. But I always wondered about it for general. You hear stories about people waking up, but not being able to move. But that seems pretty rare. I’m fairly sure I had to be intubated/extubated while under, I wonder if they did that before being fully under so that I could ‘help’. I suppose between that and all the immediate pre-surgery prep, they may just rather the patient not remember all of it.
My friend woke up during an endoscopy. He called it the worst experience of his life and has refused to go back to the doctor ever since.
The last time I was under general anesthesia was for a tooth extraction. The drugs were given via I.V. so I assume it was propofol, or something similar. The dentist asked me to count backwards from 100, got to 97 or so before lights out. However, I did dream while under, so it wasn’t like most people’s experiences of suddenly going from sedation to recovery.
The dentist said nothing to me about being “awake but unable to remember” which was probably a good thing, or else I would’ve been majorly freaked out.
Look up Versed - a quick acting, short term memory eraser used in ER’s to do quick but nasty things to patients.
I woke up while they were still trying to put in a NG tube. It turns out I can no longer be intubated - the tube runs into a wall and I feel a “Thud” in the back of my skull.
Point being: the use of memory suppressors is a common technique.
Versed doesn’t work on me; that is I am sedated but I am awake and aware. My last colonoscopy was “fun”. They are painful at times, let me tell you.
OP, think of propofol more like short-term general anesthesia. You are knocked out (remember Michael Jackson used this to “sleep”). I understand that some interns and residents use it to get a quick rest. Like general, not fun things may happen to you while you are drugged, including painful things, but you are unconscious and will not remember them when you wake up. It is a good drug for some procedures because it is relatively short lasting and you wake up quickly and are generally alert.
Having been aware during some very painful procedures (not talking about the colonoscopy) and out completely during others, I vote for out completely.
I’m not sure what I was given, but I’ve had three foot surgeries, two that were about four or so hours long and the other, a very short procedure. I was under twilight sedation each time. The first time I woke up and I swear everything was rainbows and sparkles. The other times I woke up in tears, very distraught. After one procedure I was crying inconsolably because I missed the surgeon and was so sad he wasn’t there to see me .
ISTM if you were having significant pain you’d be inclined to flinch or pull away or other things like that. None of which would improve the doc’s ability to do whatever to you.
My vote based only on subjective experience is that
A) not much pain “leaks” through to the level that’d automatically recoil, much less the far higher level of the brain that’d register unhappiness over the experience.
and
B) “You” are your memories. If you don’t remember it, it effectively didn’t happen to you. Current you isn’t affected by the consequences of whatever prior you may have experienced but not recorded.
I distinctly remember saying “ouch” very loudly and trying to pull away from the experience, and them just saying “shhhh, shhhh, it’ll be over it just a minute.” From which I can conclude that many people show a pain reaction and they didn’t realize that I was any different. I am sedated, I’m just different in that I actually do remember it. I need to let them know up front next time.
Robin Williams talked about this a bit on the Graham Norton show once regarding surgery he had to undergo; he likened taking propofol as a sleep aid to undergoing chemotherapy because you were tired of getting your hair cut.
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