I thought sedation would be actually unconscious?

[Soubriquet]

I just had my endoscopy. I had the throat spray and the sedation and I was completely aware throughout the whole thing.

Gagging a lot, and it was so uncomfortable. It was horrible and not something I wanna repeat in a hurry

Are you a red head by any chance? It's well evidenced that analgesia and sedatives are not as effective in redheads. I've got a friend who took a single cocodamol 8/500 tablet and she's hallucinating but I could easily take the same and not have any effect.

Not a red head but I have heard of the red head dose.

Endoscopy is done under conscious sedation (or with no sedation at all). The aim is for the patient to remain awake and able to follow instructions throughout. Midazolam does have some amnesic properties but these are variable. Some patients will have no recollection of the procedure despite being awake throughout, others will remember everything. The only way to ensure you don't remember is to be under general anaesthetic.

I am hypermobile and am a bugger to anaesthetise at the best of times, and first time I had endoscopy they tried pethidine and midazolam and no dice.

Second I was given an anaesthetist who listened when I told him and he gave me a whacking great bolus dose of fentanyl plus propofol - felt amazing when I came to. Had spine injections done using the same and again no recollection.

Recently had surgery to remove melanoma and they used midazolam and not only was I fully conscious but they had to stop to give me more local 5 times too - they did not listen when I told them I'm tricky.

I really wished that a) more anaesthetists understood about hypermobility and resistance to anaesthesia, and b)they listened when patients explained they've had experience in the past and know what does/doesn't work.

The last was really horrid and I'm due more procedures soon and it's really make me nervous as was made to feel like I was a pain to keep stopping them.

I really wish they could just put me under with a GA and get all the surgeons for the different things I need done in the same room and do it all at once - would make life easier for everyone and far more pleasant for me

This! Endoscopy I was aware but wasn't overly bothered, recent tooth extraction didn't have a clue and first thing I remember was being helped OUT of the wheelchair I had obviously got in myself.

I had a gastroscopy with sedation and remember it with a bit of a shudder. Recently had a colonoscopy with sedation and don't remember a thing apart from having a lovely sleep

Some people are resistant to sedation and anaesthetia. For some reason apparently redheads can be more resistant due to a gene, I forget what it's called. I'm very resistant to every local anaesthetic and sedation I have come across. Even diazepam.

You need to make sure it's noted in your medical records so they know to give you more next time. I had the same issue with midazalam for an endoscopy, didn't touch me, and dentists have a big problem numbing me for anything.

It looks like the nurse used Elastoplast on me despite asking me about my allergies and me wearing a red allergy bracelet. I have a lovely perfect red square where the Elastoplast touched my skin. Lucky I don’t get any other side affects really.

Oh that sounds hellish maybe once the sedation wears off you won't remember. I know my husband didn't remember anything after his.

Sedation worked well for me. I remember asking when they were going to do the endoscopy, and someone saying, 'we've done it.'
I had been massively anxious beforehand, it was a waste of worry.
I did say, before the procedure, that I would need to be as heavily sedated as possible.

You poor thing, that must have been really traumatic.

I had sedation for a colonoscopy and was fully awake and aware all the way through… except as the day went on it was like I could recall less and less?

Colonoscopy is way easier than endoscopy though I’m sure.

I remember taking my sister home after a dental sedation she was telling me what happened but the next day she can only remember going in then being at home she can't remember anything else. Dh remembered nothing.

that’s a shame, do you know what drugs you had?
I’ve had two endoscopies and was pretty much asleep for both. I had midazolam and pethedine.
I did have a colonoscopy which I was sedated, but awake for - was uncomfortable but no worse than a smear.

@Mrsjayy the same happened to my DS. He had sedation for a dental procedure and was talking in the car on the way home but afterwards only remembered waking up in bed!

I had a similar experience to you OP. I was very aware of everything that happened. I just didn't have the ability to do anything about it. It was akin to being assaulted.

It Is very strange my sister was all there chatting away next day she drew a blank.

I was asleep when sedated

I had a total knee replacement a few months ago with sedation and epidural. It was fabulous even though I did wake up twice when my the surgeon was hammering my knee. I felt no pain and I was asleep again within seconds but it was very real.

It was midazolam

I had this done a few years ago. I was asked if I wanted throat spray or sedation. With throat spray you can go home quicker. I chose throat spray.
It was truly the most horrific thing I have ever endured. Like every single pain of every single childbirth rolled into one and magnified × 1000
Awful!!!

sorry. also had an endoscopy with sedation that I can recall nothing about. then another one just with the throat spray that was horrendous. Never ever ever again.

Midazolam can be overcome with adrenaline as I understand it. An anesthetist should be managing your dose throughout.

I've had it several times for dental treatment (phobic), and I get aggressive on it.... I've apparently tried to punch the dentists, swung for people, pulled at cords and equipment - basically I see everything as a threat and fight it.

I've only very limited flashes of being in the chair but do remember a dentist shouting at the anaesthetist "for God's sake give her some more".... I've had nasty bruising on my jaw and neck a few times where they can't keep me in the chair without seriously damaging myself and others. Oops.

The idea with sedation is generally to be aware but to not care what's going on. Most endoscopy sedation is done by physician/nurse sedationists not anaesthetists and is heavily (appropriately) protocolised to avoid disasters due to oversedation. Sedation in this context shouldn't get rid of the gag reflex, but the idea is for the patient just to not really care about the gagging (you'll still gag even if you're quite deeply sedated). Propofol is a potent gag reflex inhibitor, but also stops you breathing and has some funky cardiovascular effects so requires anaesthetists to manage that safely (especially as endoscopy is a 'shared airway procedure') - while anaesthesia without airway control may be what most patients think they want, it's not usually safe.

Part of the problem with sedation from a professional POV is that two patients can look exactly the same but both have very different recollection (or no recollection at all) of the experience and the same doses of drugs could provide light sedation or deep anaesthesia for different patients. The safest approach is usually to start with lowish doses and see how it goes and respond to that than to wallop the drugs in and then find you have a blue, apnoeic patient 2 minutes later, just as the endoscopist is half way through the procedure. It is arguably much harder to get sedation right than anaesthesia (saying this as an anaesthetist).

OP, if you need to have another procedure done in the future it's worth asking them to look at the record for the recent one and tell them your experience - they will hopefully be able to use that then to titrate drugs and get things better the next time.

I have been sedated twice and the first time all good, very relaxed and sort of unaware and almost asleep.

The second time was horrendous as you describe and I found it really traumatic that they could see and hear I was struggling and really distressed but as I could t speak to tell them to stop they carried on regardless.

I complained afterwards and was told I was given only one type of sedation instead of the mix of two the first time and was told it ‘depends on the doctor’.

Next time I have to have one I will be very strong about being heavily sedated as it honestly traumatised me.

@PinkFootstool this is how my dh reacted with his dental treatment I think his fear fuelled it.