Sedation, Versed, and Your Procedure
When Talking to your Doctor About your Procedure:
In preparation for any procedure, you and your doctor should discuss your concerns around modesty, the selection of an anesthesiologist, and the drugs that might be administered to you before, during and after surgery. Your expectations should be clear in your own mind before you begin that conversation. Further, if you want to be sure your wishes are followed; you must write them on any consent form you sign.
Remember that healthcare is a business and like any business they are motivated by efficiency and a belief that they are professionals who know what is best for the patient. Because of this, your doctor will assume that you will allow yourself to be treated in the way he or she sees fit and will only answer the questions you raise - you will not be told any “unpleasant” details unless you specifically ask. This means you need to educate yourself so you ask the questions that matter to you and you clearly state in writing what you want.
There will be many drugs administered to you before, during and after your procedure. Some are related to the prevention of infection, others to relieve pain, and others to “sedate” or “relax” you. You should be familiar with all the drugs your doctor(s) plan to administer to you, what they are intended to do, and what their side effects are. It is also important to know that in healthcare “awake” means something very different than what it means to the layperson.
Below you will find information about Midazolam, most commonly known as Versed, but also marketed as Dormicum and Hypnovel. These drugs are commonly used in medical procedures and patients are rarely warned about how the drug will affect them.
What is Versed and What Does it Do to the Patient?
Versed is the most commonly used drug in a group of drugs
called benzodiazepines. These drugs depress the central nervous system (CNS).
Your doctor may refer to diazepam, lorazepam, midazolam, hyponovel, dormicum,
or others as they describe sedation or sedation management. This class of
drugs is designed to provide for sedation, hypnosis-like compliance, relieve
anxiety, muscle relaxation, and anticonvulsant activity. The “side
effect” that medical professionals most like about these drugs is
that they generally induce anterograde amnesia (prevent memory by blocking
the acquisition and encoding of new information). In other words, medical
professionals like these drugs because most people will not remember what
happens to them while under their effect even though they are “awake.”
In medical terms, this is called conscious sedation. While under the influence
of these drugs, patients feel drowsy or may sleep, they will be free of
anxiety, and will therefore be very compliant with medical professionals
(they will not advocate for themselves), and they will mostly likely not
remember anything about what happened. It is these last two consequences
that most appeal to the healthcare industry.If you’re given Versed
prior to being brought into the Operating Room, you will likely not remember
who is in the room, being placed on the OR table or being prepared for anesthesia.
Further, once surgery is over, you will likely be give a few more doses
of Versed, again that means you will likely not remember being in the PACU.
Versed is commonly used for minor procedures such as setting broken bones,
colonoscopies, endoscopies, some dental procedures, and some surgical prepping
procedures. Versed may also be used after surgery for sedation, or to help
keep the patient calm while on the ventilator. Versed may also be used in
combination with pain medications or other types of sedation.
Versed has caused very serious breathing problems, especially if used with
other medications that cause drowsiness (e.g., narcotic pain medications
such as morphine) in some cases. Keep this in mind: Versed or similar
sedative drug legally invalidates any patient testimony regarding their
treatment.
Concerns About Versed And How to Refuse Versed:
Beware when a nurse or doctor tells you that he/she will give you something
to relax you before surgery. It is very likely that the medication
is Versed or another drug in this class. Doctors, anesthesiologist or nurses
often administer these drugs without telling the patient what they are doing,
warning the patient that once the drug is administered they will no longer
be able to participate in healthcare decisions or remember what happens
after getting the drug. Patients are generally only told they are being
given “something to relax you” and often they are told this
as the drug is being administered.
Versed is not required for surgery. Medical professionals use it for convenience.
Once the patient is sedated, patients do not protest or complain about pain
or modesty. Some medical professionals give Versed to patients who are outspoken
about their wishes during procedures, particularly if they express concerns
about modesty or wanting a same gender medical team.
Though the FDA has approved Versed as an anti-anxiety drug, side effects
can be physically, cognitively and emotionally traumatic for patients. Your
doctor will likely not tell you about these. Some of potential side effects
of Versed according to Versed
Busters are:
Note that many medical professional refuse Versed or similar drugs for their own procedures because they see firsthand the consequences of conscious sedation.* Paradoxical reactions including anxiety, delirium and aggression. This includes patients attacking or trying to leave. They lose touch with reality, not knowing where they are or what is really occurring.
* Some patients experienced a distorted, nightmarish version of their procedure accompanied by feelings of abandonment and panic.
* A kind of sleep paralysis - patient is aware but cannot move and cannot communicate.
* Amnesia did not take place for some patients. Some patients only have a partial memory loss and they can recall a bad experience!
* Some patients report a "creepy obedience" overcoming them.
* Many patients report symptoms of Post-Traumatic Stress Disorder (PTSD) after having this drug.
* Panic or anxiety episodes ("flashbacks") for some time (weeks, months, years) post-op.
* Long term memory disruption. Memories formed prior to the use of Versed are lost. Some people are unable to retain new information or complete tasks.
* Slower recovery time.
Also note that Versed is also known as a date-rape drug. Versed is perfect for predators because it make the recipient completely compliant and generally induces memory loss of traumatic events. For example, a male nurse gave some women Versed and then raped them. Check out this case for more information. Any patient who is given Versed is in a vulnerable position to be sexually abused in medical settings. A patient who is sexually abused while under influence of Versed will rarely remember what happened. Keep in mind that a medical professional will rarely testify against another medical professional or even tell you if anything inappropriate happened. Check out Do Chaperones Really Protect Patients? If you were under the influence of Versed and you were sexually abused, it would be a difficult case because a defense lawyer will argue that Versed has an amnesiac effect and that you could not remember what really happened.
Other accounts of people’s experiences with Versed:
- Look under Personal Accounts section on Versed
Busters
- Hysterectomy
patient whose wishes were ignored for an all-female team (Maggie from
Utah)
Additional Articles about Versed:
- Medical
People Speak Out Against Versed
- Phony
Reason For Versed/Midazolam
- Examples of doctors and nurses’ misuse
of Versed:
Male nurse used sedative to kill and rape
A male gastroenterologist sexually abused a female patient who was given Versed
Consider Carefully
Consider the information above and any other information you have found
about this class of drugs before you talk to your doctor or anesthesiologist.
We recommend you not consent to Versed or any similar drug
and that you are clear about your wishes on any document you sign.
Our recommendation is based on two things: 1) once this drug is administered
you are no longer able to advocate for yourself or remember how you are
being treated. This is true even though you will be told that you will be
“awake.” 2) There are alternatives to this class of drugs that
allow you to remain more involved in your treatment and most importantly
recall what happened (see below) Regardless of your choice of sedation,
know that once you have been given Versed you are unable to give legal consent.
So if you have written on your consent forms your expectations for treatment,
your doctor cannot argue that you gave “consent” while under
Versed.
Other Options to Consider
Options for managing pain in procedures such as colonoscopies for patients who want to be awake are:
1) Fentanyl, (a pain medication) and Demerol (also a pain medication) this combination has been used in cases for pain control but where the patient will remain aware and be able to view the colonoscopy monitor and/or converse with the doctor during the procedure.
2) Fentanyl and Valium – A combination of Fentanyl and Valium during the procedure often allows the patient to converse with the physician during the exam. One patient shared that experience with having Fentanyl and Valium used during his procedure allowed him to converse with the doctor after the exam and could remember the conversation. He recovered quickly and was able to leave the hospital much sooner than those given other types of sedation. He was also not groggy during the day and even went dancing later that night!
In conclusion, there is no valid reason to ever purposely
induce amnesia during a medical procedure. The induction of amnesia is never
medically necessary. Medical professionals administer it to make their job
easier by making the patient more compliant and not be able to recall the
events of the procedure. We need to spread awareness to as many people as
possible about Versed and encourage them to take precautions to ensure that
they are never given Versed or similar drugs.
You should write on your consent form ALL your expectations. Specifically,
if you do not want Versed write, “I DO NOT consent for use of Versed,
Midazolam, or any benzodiazepines in any AMOUNT or at ANYTIME EVER”
Then sign your name. This also needs to be stated to your anesthesiologist
and written on documents he or she brings. Make sure you sign the consent
forms and share your wishes before they hook you to IV.
You also could type a document that says something like:
I DO NOT consent for use of Versed, Midazolam, or any benzodiazepines in any AMOUNT or at ANYTIME EVER.
I now boldly state amnesia must not happen anytime during this treatment (include name of surgery or procedure) under any circumstances.
Then sign your name. Make multiple copies of the form and give a copy to every medical professional that is involved in your care.
Sources:
Use of Sedative Medications in the Intensive Care Unit
Colonoscopy without sedation: Patient factors alone are less likely to influence its uptake