NHS refusing GA for painful procedure after failed sedation experiences

[JackieAndJu]

I've been told I need to have a fairly minor but painful diagnostic procedure, which I have had three times before.

It was previously tried doing the procedure under sedation but the sedation didn't work - they might as well have injected me with caffeine, I was so alert - and it had to be abandoned, and thereafter I had it done under GA. This was privately.

My condition has worsened and I'm now on an urgent pathway, which isn't covered by my insurance. The NHS have offered sedation but simply won't accept that sedation does not work on me, and are refusing a GA. I'm now stuck in limbo.

I wondered if anyone had experience of this or advice on how I can get them to listen.

I would consider keeping an open mind - I’d find out who would be doing the sedation (anaesthetist or non-anaesthetist) and how they’d do it before making any decisions. Sedation works on everyone if you give enough. Non-anaesthetist protocols have to be very well defined though to keep them safe whereas anaesthetists are more used to managing higher doses and the side-effects safely.

Thanks for your reply. It genuinely doesn't work, it seems to have the opposite effect on me, making me hyperactive and aggressive (not at all how I usually am), Last time I ended up tearing the equipment out of my body and screaming. I can't face that happening again.

What was the sedation method?

I can and do fight midazolam for example and have become aggressive with it, physically fighting my way out of the dental chair, thinking I'm being attacked by the dentists....

Have you discussed it with an anaesthetist?

Colonoscopy? Many places don’t allow GA in first instance as the waiting lists are so long/such pressure on slots that it becomes a real problem for scheduling. Add in that it needs to be done within the 28 day window and lots of places don’t have regular GA scope lists, and it becomes an uphill battle as then you need a theatre slot (competing with surgical waiting lists…).

Do you have a copy of the report where you ‘failed’ sedation? If you can send it to them it may help them see your history, as unfortunately people do lie to try and avoid trying a sedated scope, and most manage ok.

Also, if a colonoscopy have you tried gas and air with or without the opiate part of sedation (as it’s the midazolam that makes people jumpy/agitated).

If not a colonoscopy then worth asking what alternatives there are to the sedation you had before. Again with a copy of previous reports.

There's also the fact that general anaesthetic comes with a lot of risk, people don't seem to realise. A skilled colonoscopy team can & do ensure decent sedation - you just need to make them aware first.

The NHS have offered sedation but simply won't accept that sedation does not work on me, and are refusing a GA. What exactly have you done already in terms of requesting, escalating, formally complaining?

If it’s a colonoscopy (just adult) Dd is in the same boat. Had two failed attempts under sedation. I asked about the camera pill which I knew someone else had had at that hospital but the consultant said it wouldn’t work. Not sure why. So they just discharged Dd as they said they couldn’t help her if she wouldn’t have the investigation. And that’s that 🤷‍♀️. So it’s ok to be in pain, and bleeding out your bum and they don’t do anything.

For clarity, GA does not come with ‘a lot of risk’ as a rule. In fact, for some people GA is actually safer than sedation. Thats probably not terribly helpful for the OP though.

I have the same problem with normal sedation. For colonoscopies I juat have them without. Totally fine.

However, deep sedation with propofol does work on me. But that requires an anaesthetist. Have you tried that before? If not could you ask to try it?

This is appalling, I'm really sorry this is what's happening to her.

Best bet might be to turn up to the appointment and talk to the clinician.

What procedure is it? Because some you do genuinely have to be awake, as awful as it is.

I thought that-surely they wouldn't offer it routinely for hysteroscopy if it was that risky (and I know some women have struggled to get that, and some don't want it, but all the women I know who've had it in the last year got offered it).
OP, have you asked your GP for advice-maybe tehy can help you word a response, if you can get an appointment, or suggest other options like spinal (which I guess isn't relevant here, but they would know of anything else that might work for you).

There’s more than one kind of sedation and a full nhs hospital will have more options at their disposal than a private hospital generally

Thank you for your helpful replies. I explained the situation fully to my GP at the referral stage - it wasn't passed on. Now I can't get past the 'gatekeepers' in the department who are stonewalling me with GA not being an option, only sedation.

The last experience was so frightening, and it's been like that all my life. As a child I suffered from bone dislocations and I was given some kind of gas sedation to relocate the bones which was supposed to knock me out and didn't (this was over 40 years ago) and it was awful. `I just seem to be 'immune' to anything short of a full GA.

Go to any appointment you are offered. Discuss with the anaesthetist / ask to speak with them as part of a pre-op asse. They are highly trained specialists and can talk you through the options.

Go to the appointment. There are many forms of sedation. Speak to the specialist in person and make an informed decision with them and in conjunction with their consideration of your notes. Them reviewing your history and deciding Youre unsuitable for sedation will probably prompt different next steps to you talking to an administrator

I disagree with posters saying to turn up to your appointment and discuss your options on the day. My experience is the staff will do their utmost to bully you into whatever is most convenient for them at the time.

I had to go for a colonoscopy and the staff didn’t believe me when I said sedation doesn’t work very well for me. I was in excruciating pain and got told to shut up and stop screaming because I was scaring the other patients. I will never set foot in that department again.

Get agreement on request for a GA your before you go.

I've had it previously under GA in the private hospital so it's definitely possible. If I could afford it I'd pay privately myself but because it's an urgent referral pathway, my insurer won't cover it.

read this article
https://www.theguardian.com/society/2026/aug/16/women-routine-womb-examinations-hysteroscopies-pain-nhs

look up the NICE guidelines for offering general anaesthetic for the procedure you need. and quote them

There are lots of different types of sedation but often diagnostic procedures do not have anaesthetists present so can only stick to a set protocol of what drugs they can give and how much.

It sounds like you had something like midazolam- some people do react with agitation.

Do you have any notes from when you had the last procedure with the failed sedation? If you could contact the department with the specifics of what failed last time that may help.

If you are comfortable to say what the procedure is that you need it might also be helpful to advise on how to navigate this.

Are you hypermobile at all? Just wondering as you talk about dislocations and local anaesthetic (and I think sedation) not working as well can be a sign of Ehlers Danlos syndrome.

I don't where your located OP but I would consider moving to a different NHS Trust in this case - one that offers 'enhanced sedation' under Propofol - you can find a few without too much querying.

My personal experience was that the hospital provided an anaesthetist for the endoscopy suite so hence could use Propofol sedation rather than the usual Midazolam/Fentanyl. Don't turn up on the day hoping this will be the case though, this needs to be setup well in advance. But the anaesthetist will work as they can dial things up or down depending on what you need - the unsung heroes in my opinion.

I didn't attempt the endoscopist sedation - I'd heard too much negative feedback and as someone who fears any form of medical intervention I requested the enhanced sedation from the start (I didn't want to try it and then find out it wasn't enough and that would scare me off for life). I did leave it quite a while between appointments but the staff were very helpful in sorting this out for me once I'd engaged.

Best of luck!

One thing I did find when researching private options was that the anaesthetist isn't the bulk of the costs - and the US maybe cheaper than the UK...

I managed to get a colonoscopy under GA, but only after multiple failed attempts under sedation. Can you say what the procedure is?

Contact PALS and explain that you need to get hold of someone in that department to pass on some vital information, 🤗