Procedures With Sedation

[Barsel]

When you have a procedure where you can choose to have sedation, what's the maximum amount (of whatever it is they give you ) they can give you? x

[anneasquith]

and during your surgery dizmo you felt no pain ?

[stuey]

I think that age is also taken into consideration in determining the amount of sedation used.

[Sqad]

There are certain procedures that are done under general anaesthetic that require the anesthesia to be "light" i.e you may hear talking but you cannot feel pain. Sound is the last to go during induction and the first to return on awakening. Caesarian section and certain brain operations need to be done under "light" anaesthesia, for obvious reasons.

So in the above cases, there is little difference, to the patient between sedation and light general anesthesia.

I am not an anesthetist so my explanation may be a little...."basic."

[Dizmo]

anneasquith: I had been drinking alcohol, to a point the hospital breathaliser was unable to give any reading above 500 in breath. My BAC was through the roof. I didn't feel any pain before the surgery. To be honest they could of probably done it without any anesthetic at all.

And before you say it, no, a reading of 500+ didn't put me unconscious. The hospital staff couldn't understand how I was so responsive. I was pumped full of morphine as well so...

[Barsel]

Thanks for all your replies. I suppose the only thing i can do is to ask once more if they will give me the 'maximum' dose as per the guidelines and if I still feel uncomfortable (that's putting it mildly) then I'm outta there and not going back.

[Ann]

I read this post with interest Barsel - as this happened to me. I had already had a bad experience with an endoscopy (throat) procedure when they were doing a "trial" that morning with absolutely no sedation to be given - just a numbing throat spray. The consultant admitted he had put the camera down my windpipe instead of food pipe, as I was gagging so much - he did apologise for this and had to start again. After this trauma I was so scared at having another endoscopy several years later, the doctor reassured me they would give me a knock-out drug (he said it was the date-rape drug where you can't remember anything afterwards) but as I was starting to have it done I knew everything that was happening - it wasn't working at all so they had to stop. The doctor said he was amazed I needed so much sedation, but he very kindly upped the dose a lot which eventually worked, thank goodness. Please don't suffer, tell them you need more .....

[Barsel]

Thanks Ann.I forgot about the throat spray, that's horrible as well ! yes I'm determined to let him know that if he doesn't give me enough sedation this time, I won't be back again next year.x

[Peter Pedant]

Sqad - down boy


it is NOT guesswork but a matter of training and reading things like this

http://researchinpem.homestead.com/Lancet_early_online.pdf

( that should be a link to Krauss and Green review's of sedation in the Lancet 2006 )

the one I really like and has stood the test of time is
Royal College of Radiology advice on sedation

https://www.rcr.ac.uk/publications.aspx?PageID=310&PublicationID=186

and it all kicked off because Charles Cote (Coat-ay ) wrote an exxpose here
http://pediatrics.aappublications.org/content/105/4/805.abstract

but was not able to say how many sedation occurred in the time scale he was looking at.

[Peter Pedant]

It will be OK Baarsel

I have had a bronchoscopy under sedation when they thought I had an awful disease called PCP. It went OK

I have also had a colonoscopy without sedation because I wanted drive.
( taxi didn't arrive - dog started howling and so I piled it in the car and drove to the Hospital - but then how was I going to get it back home ?
Obviously well motivated not to have sedation during the colonoscopy )

it will OK Barsel

[Sqad]

PP.

\\\\\\but very, very educated guesswork based on the pharmacology of the drug and human and animal studies. \\\\\

That is how i described......."guesswork."

If one goes to an operating theatre, at the beginning of an operating list of say, 12 patients, one will find each patient has his/her medication already drawn up in syringes. Same drugs, same dosage for all the patients.

[RATTER15]

I wish I hadnt been sedated for my colonoscopy, I was awake throughout and watched the whole procedure on the screen in front of me, but I remember very little now, which they told me would be the case, I felt virtually no pain, just some very mild discomfort. I wish I could remember it all, now I just remember it being quite fascinating, and I remember them saying the found a polyp and removed it. I wonder if they have it on video?

[Peter Pedant]

Sqad - erm I 'm gonna pass on that one

If you watch Helicopter Heroes where all the pukkah Brit doctors scrape various injured Ozzies off the road, beach, or wherever - when they are doing a kid you see the white board behind them where the suitable doses and tube sizes are inscribed for that particular patient age and weight. Very up to date and APLS......

[Dizmo]

RATTER15: I loved watching my colonoscopy.

[Dizmo]

I said "How far are you in", she replied 'nearly done now', "no, not how long is left, where about are you in my colon", 'oh, we're descending down your left colon'.

[Peter Pedant]

No I didn't like mine that much

At one point, the surgeon said - there is your carcinoma of the colon !

and I looked at the bunch of grapes and thought Christ I can die from this

[RATTER15]

Diz, the colonoscopy was a walk in the park, however, having to drink 45 gallons of that laxative the previous night was not such a great delight! I must have done it right, the consultant commented: "your colon is so clean you could eat your dinner off it"
If I remember correctly, I gave a blow by blow account on AB during that evening lol.

[Dizmo]

RATTER15: I didn't mind the laxative. I suffer from IBS so I don't have any problem with defecating like that!

I was given 12 sachets. They sent too many! It's only diarrhea...

[Dizmo]

My colonoscopy took just over an hour though so.... The doctor in charge was going to give up but luckily this other lady was willing to give it a crack. There were 6 people in the room watching - I'm assuming they were trying to learn.

[RATTER15]

Diz, "It's only diarrhea..." is it? I had pure clear water cascading from my bottom by the gallon, and I'm talking gallons by the millisecond!!

[Dizmo]

RATTER15: Such fun! I had the same me ole fruit.