questions on versed usage

[J.R.theR.N2b]

i have just read an interesting account on the internet concerning the use of versed, either alone for conscious sedation, or in conjunction with other anasthesias for surgical procedures. the article mentioned that versed was an amnesiac which when used erased any and all memories of the performed procedure. i have had versed used in four colonoscopies, and found this to be true. i remember being given an IV beforehand and being wheeled to the procedure room. the next conscious thought i had was waking up and being told everything was over. to this day that is all i remember about any of them. from someone who had told the nurse "i do not want to even see the operating table" before my cardiac bypass surgery in 1995, was just what i wanted to hear. i have learned since however, that while an amnesiac, versed has no analgesic properties. so my question is-----in a procedure such as a colonoscopy, does the patient actually feel the pain and discomfort involved and simply not remember it? thank you very much.

[neveragain]

Take this with a grain of salt, as I am one of those who was traumatized (no drama) by Versed being used on me. Versed is not necessary for pre general anesthetic. Once you are knocked out that's it. The excuse is intraoperative awareness, but this has not been documented to be significant. There is no real reason to use Versed other than its benefit for the staff in most cases. Similar to sedation dentistry where only a few phobic patients actually require this medicine, most people would be just fine without it. This drug makes the patient easy to control, in that you will follow their orders without question. Apparently the amnesia isn't reliable as approximately 10% of patients actually do remember. I have read that the patients are "chatty and amusing" while under the influence. I have recall and in my case I was silent. I couldn't speak coherenly which was part of the trauma, so I shut up. I still wonder if this is why my CRNA kept on giving me more and more Versed even after I was immobilized. Maybe an OR nurse can answer that. Is being talkative a part of knowing whether the patient is properly sedated? Also this medicine is a cost driver in minor procedures. There is extra nursing care and extended PACU time involved with this drug. If more patients had recall more patients would be traumatized by the care they received while under the influence. I did not find this drug relaxing in the slightest bit, but it did make me obedient even while I objected to the slurs that were spoken about me and the administration of general anesthesia drugs which I had declined and for which there was no informed consent. My CRNA says that I gave consent after he gave me 9 mls of Versed. I consented by "not objecting." There was no attempt at patient "care" as they expected me to have amnesia. The exception was my OR nurse. She was so good that I called the head nurse at the hospital and said that this nurse should have been in charge of the whole operation. I just wish she had the authority to tell me what the CRNA was planning on doing! There is plenty of evidence out there about long term anxiety disorders directly attributed to Versed. These are being dismissed as anecdotal. I would suggest NEVER allowing Versed to be used on you UNLESS you are a medically phobic patient and feel you just can't handle the procedure. If you have a history of fighting anesthetics (I do) this drug is probably not for you. If you like knowing what is happening, if you want to be involved in your health care, and are concerned about the long term anxiety, just say no. Everybody is different. There is no excuse for assuming that everybody would welcome the amnesia, obedience, inablility to speak coherently, inability to stop the procedure, inability to sign out AMA if you don't want more intrusive procedures than you signed for etc. You will need to get a medic alert bracelet too so that EMT's don't give Versed to you.

[versedsuffer]

I have been reading the remarks concerning versed. I personally know the side effects of this drug. I have experienced terror for two years due to being given this drug. Not remembering an unpleasant experience is not the same as not having the experience. Waking after 11 hours of not being aware of your actions is terrifying and in my case not knowing that you have been given this drug is the equilvalent of rape. I had so called professionals at all levels refuse to discuss the fact that I had been drugged and told me my memory loss was good for me. What has happened to informed consent. I am an LPN and a social worker. I am and will continue to fight for all the hundreds (that's right hundreds) that have been injured at the hands of those that still believe this drug is safe and good for the patient. It should be left up to the patient to decide after recieving full disclosure. Not professional remarks about " something to relax you" I guess my death would have been a type of relaxation though after the overdose of this drug.

[J.R.theR.N2b]

Take this with a grain of salt, as I am one of those who was traumatized (no drama) by Versed being used on me. Versed is not necessary for pre general anesthetic. Once you are knocked out that's it. The excuse is intraoperative awareness, but this has not been documented to be significant. There is no real reason to use Versed other than its benefit for the staff in most cases. Similar to sedation dentistry where only a few phobic patients actually require this medicine, most people would be just fine without it. This drug makes the patient easy to control, in that you will follow their orders without question. Apparently the amnesia isn't reliable as approximately 10% of patients actually do remember. I have read that the patients are "chatty and amusing" while under the influence. I have recall and in my case I was silent. I couldn't speak coherenly which was part of the trauma, so I shut up. I still wonder if this is why my CRNA kept on giving me more and more Versed even after I was immobilized. Maybe an OR nurse can answer that. Is being talkative a part of knowing whether the patient is properly sedated? Also this medicine is a cost driver in minor procedures. There is extra nursing care and extended PACU time involved with this drug. If more patients had recall more patients would be traumatized by the care they received while under the influence. I did not find this drug relaxing in the slightest bit, but it did make me obedient even while I objected to the slurs that were spoken about me and the administration of general anesthesia drugs which I had declined and for which there was no informed consent. My CRNA says that I gave consent after he gave me 9 mls of Versed. I consented by "not objecting." There was no attempt at patient "care" as they expected me to have amnesia. The exception was my OR nurse. She was so good that I called the head nurse at the hospital and said that this nurse should have been in charge of the whole operation. I just wish she had the authority to tell me what the CRNA was planning on doing! There is plenty of evidence out there about long term anxiety disorders directly attributed to Versed. These are being dismissed as anecdotal. I would suggest NEVER allowing Versed to be used on you UNLESS you are a medically phobic patient and feel you just can't handle the procedure. If you have a history of fighting anesthetics (I do) this drug is probably not for you. If you like knowing what is happening, if you want to be involved in your health care, and are concerned about the long term anxiety, just say no. Everybody is different. There is no excuse for assuming that everybody would welcome the amnesia, obedience, inablility to speak coherently, inability to stop the procedure, inability to sign out AMA if you don't want more intrusive procedures than you signed for etc. You will need to get a medic alert bracelet too so that EMT's don't give Versed to you.

your response was, as were all the responses, very thought provoking. the whole point of my original post was to question how the amnesic properties of this drug were used. i continually asked myself, if i were completely anesthesized and "out of it" so to speak, then what was necessary for me not to remember? this was 100% non accusatory with absolutely no ulterior motives. it was simply the question of someone desiring knowledge. the point you made about being a "medically phobic patient and feel you just can't handle the procedure" is typical of me in one respect. for a reason of which i am completely unaware, i have always been extremely anxious concerning the procedure of urinary catheterization, so much so that i am positive it would cause me to be uncooperative and fight the insertion, even though i would initially consent. this would seem to matter only in the emergency room which is about the only place in the hospital patients would be catheterized alert and awake, which begs the question of whether the use of versed would be helpful?

[suanna]

I have told my medical providers over and over " I don't want "not to remember the pain", I don't want to feel it in the first place!!". Given the choice between a little versed and a lot of demerol or visa-versa I'll take the demerol every time. I don't remember my circumcision but that dosen't mean I was OK with it at the time! In answer to you question - no Versed has NO analgesic properties. For some patients the use of benzos alone can lower thier pain tol. and make the perception of pain worse!

[neveragain]

There are studies in dental phobia that show Versed, because of its amnesia effect is not good for alleviating the phobia. Since there is no memory 90% of the time, there is a continuing panic reaction to dentist visits. I also feel that the roughness because the patient "won't remember" could also exacerbate a phobia. My suggestion is a good nurse, one who will talk to you, hold your hand, explain every moment of what is being done. There are some absolutely fabulous ones out there who are more than happy to "talk you through it." Yes it *may* take more time than just administering Versed, but oddly once you have been through it, know what to expect, and have somebody who understands your problem you may find that it wasn't so bad after all, and will feel silly! Trust me I don't like being catheterized either. Its embarrassing, (I am super modest) and a little uncomfortable at first, but not painful. For me Fentanyl is best for pain relief and light calming effect without the rest of the problems with Versed. I am not sure that they would do this for a simple cath, but if they use Versed for it, Fentanyl looks tame by comparison. Demerol makes me combative and makes me hallucinate. Not a good combo for the nurses! A good nurse is better than all the Versed in the world.

[J.R.theR.N2b]

There are studies in dental phobia that show Versed, because of its amnesia effect is not good for alleviating the phobia. Since there is no memory 90% of the time, there is a continuing panic reaction to dentist visits. I also feel that the roughness because the patient "won't remember" could also exacerbate a phobia. My suggestion is a good nurse, one who will talk to you, hold your hand, explain every moment of what is being done. There are some absolutely fabulous ones out there who are more than happy to "talk you through it." Yes it *may* take more time than just administering Versed, but oddly once you have been through it, know what to expect, and have somebody who understands your problem you may find that it wasn't so bad after all, and will feel silly! Trust me I don't like being catheterized either. Its embarrassing, (I am super modest) and a little uncomfortable at first, but not painful. For me Fentanyl is best for pain relief and light calming effect without the rest of the problems with Versed. I am not sure that they would do this for a simple cath, but if they use Versed for it, Fentanyl looks tame by comparison. Demerol makes me combative and makes me hallucinate. Not a good combo for the nurses! A good nurse is better than all the Versed in the world.

i did not mean to infer that the drug versed was used as sedation prior to urinary catheterization. in fact, i have been told by emergency room nurses that patients in the ER are not sedated for catheter insertion due to the risks involved. my extreme anxiety over this procedure is psychological, which i fear (know??) will cause me to be uncooperative and to fight the procedure. i am not asking for sedation or any specific intervention, just advice on how i can overcome this? i have had anasthesia referred to as "conscious sedation" for all my colonoscopies, and remember nothing. i wonder if medical records of my procedures may include references to this? i also underwent cardiac bypass surgery in 1995 and remember very little of it, prompting the question of versed usage. i am not saying this is a bad thing per se, however it is cause of wonderment. does one actually experience the pain and simply forget about it, or does the anasthesia used prevent this? i certainly agree with the statement made in a prior response-------i don't want to FEEL any pain, not merely to FORGET about it.

[chevyv, BSN, RN]

For me personally, I think it depends on the circumstances surrounding the use of versed. I was in an accident and lost my toes on one foot along with damage to the joint and other stuff. They were able to save my foot though, so no complaints. The first bandage change was very difficult for me because it was a teaching hospital with brand new interns that came running in and just basically saw only my foot. I was already afraid it was going to hurt (and I truly had been in so much pain already), and couple that with 3 newbies who couldn't even id themselves was too much.

They stopped ripping bandages when I told them I was seriously going to kick them each in the face. The head doc decided to take me up to icu and give me some versed. There was one new intern that took time to tell me his name and chat a few minutes, so he did the procedure. I do remember chatting and telling him I was pretty tired. He told me to go ahead and sleep if I wanted to. I was very relaxed, but do remember telling him when I felt things. They would give me more versed then. That was our agreement going in, that I wouldn't feel anything. So for me, even though I remember, I was grateful.

What stops me in my tracks 4.5 yrs later was being brought to the hospital directly after the accident and having 2 docs clean my foot. My foot was almost severed by mower blades, so they really had to clean it well. I was getting morphine every 3 minutes and the nurse was yelling at the doc to give me more. They cleared out the er before they cleaned the wound because they knew how bad it was going to hurt. Nurses took turns letting me sqeeze their hands. I was squeezing so hard they had to take turns. That pain was the worst I've ever felt. Why they didn't give me versed then, is just beyond me. I still tighten up like a ball when that memory pops up!

[neveragain]

Versed merely blocks the memory of the pain. For me the idea that I may be in pain, screaming and writhing while my caregivers assume that I won't remember it is the stuff of nightmares. Babbling on about things that would absolutely humiliate me in my right mind is also disconcerting. Did you have this anxiety before this drug was ever used on you? I have major anxiety over medical stuff now, but not prior to getting Versed.

[porterc]

Can i refuse versed for toe surgery - using fentanyl instead?

[Hoozdo, ADN]

Can i refuse versed for toe surgery - using fentanyl instead?

You can refuse anything you want. Typically in surgery, versed and fentanyl are

used together for moderate sedation.

[NeoNurseTX, RN]

C-Scopes can be VERY painful. I've read a lot of accounts of just getting versed for them on here and it scared me to death. I had versed with propofol for mine and remember nothing about it. Was it painful? I have no idea. I've seen cardiac echos with versed and the patient writhed and moaned the whole time. It was horrible to even watch!

[NotReady4PrimeTime, RN]

I've seen cardiac echos with versed and the patient writhed and moaned the whole time. It was horrible to even watch!

Echos don't hurt unless they're being done over a fresh sternotomy. They're ultrasound exams. Did you mean cardiac CATHS?