Question on sedation during gastroscope

[toooldforbrat]

i need to have scopes every few months at the moment & have throat spray and sedation.

Normally I don’t recall anything but during one before Xmas I became vaguely aware of things going on around me. In one last week I became very aware , was gaging violently, trying to pull it out etc . Was a hideous experience and my face still has lots of burst blood vessel marks. Can’t have been much fun for the staff either.

i still need to have these, what could I ask for next time? Can they give more sedative to keep me out?

I’ve never had the experience of truly going under or not remembering anything under sedation. Unfortunately, all my experiences have been like your most recent one. You can ask to have the max dose possible, though I am sure you were probably given that last time if you were having issues. I know they told me when they’d given me as much as they could give me.

Personally, I would ask for light GA next time. I had this recently for a procedure where I could have opted to be awake with local and sedation. You are properly out, but not with the same drugs as if you are having heart surgery, for example. I think you have to be comfortable, especially if you have to have these often.

@mindutopia thankyou for the reply, is the endoscope clinic able to administer light GA or does that need an anaesthetist and different staff?

A GA requires an anaesthetist (and an ODP and a recovery nurse and specialist equipment) and there are barely enough of us to do all the lists that definitely need an anaesthetist so wait times for a GA scope are often longer. Contrary to PP's suggestion, there's also really no such thing as a 'light GA' (it's just that most people recover quickly because it's a short procedure therefore a low cumulative dose of anaesthetic) and the drugs used would very likely be the same drugs used for heart surgery.

The aim with sedation is not usually oblivion but t'is to make a procedure tolerable (most anaesthetists tell patients that they may be aware of what's going on when they're having sedation). For fairly obvious reasons most non-anaesthetist sedation lists are quite protocolised...it may be that they can give you more of whatever drugs they normally use (often fentanyl & midazolam), but they will usually have a pre-defined max dose and the options when you reach that max are either proceed with it being uncomfortable/abandon the procedure. It's a procedure that can often be done with just local anaesthetic so perhaps there's room for improving how/where they deliver the local too.

thank you @Greybeardy , that's very helpful. Sounds like best option is a discussion with the consultant at next appointment and nurses at next booking in.