IV sedation drugs for pain/sleep or just amnesia? Drug choice for Sedation

[seeking truth]

This is very disturbing information regarding local plus IV sedation method that I think need to be address.

It seem that there is a certain drug that just will wipe out your memory of the traumatic surgery no matter what actually happen during the surgery. So for all you know, you would be experiencing anesthetic awareness during the surgery but memories of the event are erased which may cause psychosocial issues.

I have always been under the impression that IV sedation was to make you fall asleep/dull pain while local anesthesia was to block the pain at the sight. So you will go to sleep then wake up after the surgery.

I read that the common drugs used for this are propofol, etomidate, ketamine, fentanyl, and Versed(aka midazolam)


Versed was not design to stop pain but rather " make you forget" the ordeal. This is basically the real life version of the men in black movie's memory erases.

So you could theoretically have a horrifying experience during surgery( anesthesia awareness) but be made to forget it afterwards.

Google "Versed busters" for more information on what I'm talking about.

Do doctors use only Versed as the " sedation" drug or is it usually mixed with other drugs for sleep/pain management" 

I am going into surgery on Monday and the nurse told me that they use Versed. I am not sure if I should protest this and demand a different drug instead after what I read on that site.


Can anyone give me advice on what drug I should recommend and if I should avoid the drug versed at all cost or at least make sure its accompanied by a different drug.

I want to be out during the operation with a local plus sedation however I don't want to have a bad experience made to forget. I don't want the bad experience in the first place.

Thank you.

[Dr. Elliot Jacobs]

Versed is a wonderful drug -- it is primarily used to help allay anxiety.  It is never used alone -- at least in my practice.  My anesthesiologist uses a cocktail of multiple short-acting medications, all of which are specifically tailored to the needs of the patient.  The result is a pleasant, relaxed sleep with no pain and no awareness whatsoever.  And a very quick recovery with no nausea or hangover.

If you plan to have surgery under IV sedation or general anesthesia, it is most likely that Versed will be amongst the medications that will be used.  It would be a good idea to speak with your anesthesiologist prior to surgery -- but it would not be wise to try to dictate to the anesthesiologist what drugs he can and cannot use.

Your fears of a "Men in Black" memory erasure are way out of line.

Dr Jacobs

[Alchemist]

Versed is a wonderful drug -- it is primarily used to help allay anxiety.  It is never used alone -- at least in my practice.  My anesthesiologist uses a cocktail of multiple short-acting medications, all of which are specifically tailored to the needs of the patient.  The result is a pleasant, relaxed sleep with no pain and no awareness whatsoever.  And a very quick recovery with no nausea or hangover.

If you plan to have surgery under IV sedation or general anesthesia, it is most likely that Versed will be amongst the medications that will be used.  It would be a good idea to speak with your anesthesiologist prior to surgery -- but it would not be wise to try to dictate to the anesthesiologist what drugs he can and cannot use.

Your fears of a "Men in Black" memory erasure are way out of line.

Dr Jacobs

Hi Dr Jacobs,

I have had Versed twice with various procedures.  Both times I woke up nightly for about a week afterwards with panic reactions at having broken memory linkages.  Those are the only two occasions in my life of this kind of occurrence and for a week or so each time.  In my decades of working HMO and insurance software and participating in a variety of health care forums I have heard lots and lots of reports of some similar nightmare or panic reaction awakenings in a lot of people after Versed.

I have no idea how common or uncommon this may be.  However, I have had no such problem with any other drug prior to the widespread use of Versed.  I intend to discuss this and alternatives with the anesthesiologist prior to the next planned  usage.

[Dr. Cruise]

I understand your concern when you put in terms of wiping your memory out like "men in black". However, the real concern here is trust in your doctor. For this reason, you should be very careful who you entrust with your body. A surgeon who is dedicated to gynecomastia and has built a reputation will guard his reputation with his life. He will protect you as if you are family. Of course, you should ask all the necessary questions but when it comes to the surgery and the anesthesia it is best to let him do what works best for him.

[letsfixthis]

Versed is a wonderful drug -- it is primarily used to help allay anxiety.  It is never used alone -- at least in my practice.  My anesthesiologist uses a cocktail of multiple short-acting medications, all of which are specifically tailored to the needs of the patient.  The result is a pleasant, relaxed sleep with no pain and no awareness whatsoever.  And a very quick recovery with no nausea or hangover.

If you plan to have surgery under IV sedation or general anesthesia, it is most likely that Versed will be amongst the medications that will be used.  It would be a good idea to speak with your anesthesiologist prior to surgery -- but it would not be wise to try to dictate to the anesthesiologist what drugs he can and cannot use.

Your fears of a "Men in Black" memory erasure are way out of line.

Dr Jacobs

I just wanted to let Dr Jachobs and the rest of this community know that I went into for an unrelated surgery( shoulder surgery not gynecomastia)  and reading Dr. Jachobs post ahead of time really help calm my nerves and put me at ease before the surgery.

The anesthesiologist group had something kind of like what Dr. Jacobs described where the versed was only 1 drugs in a combination of many types used to put me under very gently.

I was also given something that was like fenarol, local " shoulder nerve block)  lidocaine tracer Propofol and a mystery drug which was described to me as a type of modified general anesthesia which allowed me to breath on my own(without a machine)

Anyway, I think the problem is when people are given Versed only then treated very poorly with the idea that they won't remember anything afterwards. I think in my case, I was completely out so there was nothing bad for me to remember even without the versed.

Anyway, I just wanted to say thanks to Dr Jachobs for taking the time let people know about versed and say that it really helped me to read his post.

P.S. If anyone knows what type of modified version of general anestesia allows for the person to breath on their own, I would sure like to know about it. I know it used Propofol for the initial stage of going under than another drug to keep me asleep during the operation.      

[Paa_Paw]

I am old enough to remember having surgery where the anesthetic was Ether.

I've witnessed surgery done using Paraldehyde administered rectally.

Of the drugs in common use today, Most did not exist in their present form 15 years ago.

The problem with any discussion of drugs is that anything a person says will be out of date very soon.

My personal belief is that the original premise of this thread was based on watching far too much TV.

[Dr. Elliot Jacobs]

What you have described is basically what many surgeons (including myself) use today -- it is called "conscious sedation" or "twilight sleep."  There is no machine breathing for you, no tube down your throat and yet you are indeed sleeping, unaware of anything and in no pain.  And yes, Versed is used along with a cocktail of other short-acting medications.

When this type of anesthesia is administered by an expert anesthesiologist, the entire operative experience is made much more acceptable.  I am proud to say that my anesthesiologist and I have been working together for over 21 years -- so we are a terrific and well coordinated team.

What's nice about this type of anesthetic is that there is virtually no hangover after the procedure -- you awaken refreshed and rested.  General anesthesia usually needs at least 24 hrs for one to get over the effects of the drugs.

Glad your recent surgery went well.

Dr Jacobs