General Anaesthesia vs Sedation

Had to have a gastroscopy today. I was going to tough it out without sedation (and be able to go home within 20 minutes of the procedure), but they sprayed my throat with some Xylocaine (lidocaine in the US) and it made me retch so hard I was doubled up (I think it was the bitterness of the spray).

So they dosed me with midazolam (versed). Needle went in and I woke up after about 30 minutes. Which is a bit weird, because when they going through the options beforehand they said that the sedation wouldn’t be like a general anaesthesia, I would be aware the whole time. I’ve had lots of general anaesthesias, with various agents (halothane, propofol etc), and on reflection it (the memory loss) feels very similar.

So my questions are:

Was I awake and aware during the procedure, and just failed to form memories or was I out?

Is this a typical experience with midozolam?

If I was out, what then is the difference between “sedation” and “general anaesthesia”?

When I went through it I was definitely awake the whole time. The way I would describe it is that I was aware of everything going on, but I just didn’t care. It wasn’t anything like general anesthesia or “twilight sleep.” I’ve had both.

One of Versed’s effects is a very short-term amnesia. You were awake but don’t remember it. I had it for a gastroscopy as well, and felt like I’d woken up from a nap.

In comparison, when I had a laparoscopy I was under general anesthesia. Waking up from that was like waking up after a night of drinking or something similar, with me struggling back into consciousness and feeling very groggy.

One of verseds Treasured effects, along with it’s short duration, is it’s short term memory loss. You might well have been awake enough to protect your airway and answer questions, except for the scope in your throat, and not remember it.

Hmmm versed

Would “protecting one’s own airway” be a good distinction between GA and sedation then?

No need for life support if sedated, but under GA you require intubation and ventilation?


Pointless anecdote warning:

I had dental surgery with Versed last Friday. I was most definitely NOT awake and aware of anything during the procedure.

When the drip (?? I had an IV & a nasal canula, so I assume, but it is merely an assumption, that Versed is administered by IV based on the nose-thingy not smelling funny) started, I panicked. Sudden, unreasonable, and very intense conviction that I was having a stroke.

I have low blood-pressure, no medical or family history of high blood pressure, clotting problems and very little knowledge of what a stroke actually is.

Then, I had absolutely no idea why I was in an exam room with cotton in my mouth. I was calm enough to mime writing to the woman in scrubs who was watching me. Immediately after she asked “you want something to write with?” I knew what had happened.

A little less than two hours had passed between the having a stroke nonsense and coming to.

YMMV, but if I have to do anything like this again, Versed will be my choice of anesthetic. 1/8th of a second of fright, and a few seconds of amnesia is better than the stoned-out-of-my-gourd, power-puking dizziness that comes with the older anesthesias.