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Is 11mg of (Versed) Midazolam excessive?

Endoscopy procedure.

I was given Versed 1-3mg every 2-3 minutes for 10 minutes totaling 11mg (eleven mg) of Versed. I'm a light weight at 130 lbs. I mentally went out completely after receiving the first 2mg. Not sure why they continued to give me an additional 9mg over the next 8 minutes? Trying to know if that is excessive?

Stats during,
Oxygen recorded 100% every 5 minutes
BP was 115/55 to 117/60, pulse of 83-92.

Normal everyday BP (Just to compare)
125/75, pulse of 60

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I wasn't supposed to get anything. The doc said right before the procedure not to worry, no sedation yes I know, we won't drug you yes yes I know. Yea, doc clearly lied.

-- If you don't want drugs
1. Telling the doc no drugs is not enough! TRUST ME I WAS DRUGGED.
2. They make you sign a consent form relating to medications "for emergencies only"
   = So on this form you MUST WRITE - NO DRUGS, NO EXCEPTIONS unless needed in a life threatening situation to keep patient alive, no exceptions. NO SEDATION! It probably won't say anything about being sedated but it is important to write it on every form too. Just to be safe. I declined sedation on this form by the way and was still sedated.
> Then get the doctor to sign the consent form stating NO SEDATION. It is not enough not to have it, you must have it in writing that you "will not be sedated".
   = Then write: See additional consent forms for medication. Here you can make your own form should you decide to accept medication for any type of sedation.
On your consent form write:
        o: additional consent forms required for each medicating.
        o: can not exceed this ______ dosage amount.
        o: no repeat dosages with this consent. (or they might repeat the same dosage over and over)
        o: not valid with out patient signature.

It normally doesn't get this bad but for your protection if you choose mild or no sedation it must be done like this just in case. I'm talking from experience now.
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My question is: Is 11mg of Versed 1mg/ml excessive over 10 minutes for conscious sedation. Thank you.
27 Responses
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Avatar universal
I think 11mg would take down an elephant.  

I've gotten Versed a number of times for colonoscopies and have always been awake with gradual doses of up to 4mg.

When I heard I was getting Versed for my upper endoscopy I was worried that I'd be completely awake with all the terror of having a tube down my throat and being unable to talk or swallow.  I told the nurse that I'm always wide awake with Versed and she told me that they needed me to be responsive for the procedure.  So, I was pretty worried.

I found out later that they gave me an opening dose of 5mg.  

The feeling I got was the same one-second "brain freeze" that I've gotten with Propofol - a numbness at the top of my head -- and then I felt my eyes plunge close and I completely blacked out like I just got hit by a heavyweight fighter.  That was the last thing I remember.

I came-to in the recovery room in a completely different position, and was so impossibly sleepy that I took three tries and about 15 minutes to completely wake up.  

The odd thing is that you don't get the instant time-travel feeling like with Propofol.  I felt like a lot of time had passed but had no memory of it and afterward had a 15-20 minute hangover where I couldn't wake up.  My total dose was about 8mg.
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Avatar universal
I was given versed before a TURP surgery, trans urethal prostate resection,
I remember being in the operating room and asking where is the doctor who
was not there yet and I noticed the big blue garbage cans and I said the operating table has a seat belt and let me help you get me on it and then feeling the nurse pull the strings on the back of the gown and then black out.
Was I still awake while they stripped me naked and hooked up those electrode patches ?

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Avatar universal
I had a colonoscopy two days ago and am still feeling oozy from Versed 11mg dose.  They said I started to look uncomfortable during the procedure so they gave me fentanyl  120c and Versed 11 mg.  I am so angry as it was supposed to be a 90 minute stay in the clinic that has been a 2 day nightmare for me.  I don't remember that day at all and very little of yesterday.  I am feeling a little less oozy today, but still not normal.  Then the arrogant physician would not even let my husband see the pictures.  I am sick and tired of the arrogant (not all as there are some very fine Drs. out there) physicians who have truly believe that most of their patients are stupid and have no rights.  When I called and asked about the surgery, I was literally brushed off and treated like a child.  I am not finished with this yet...
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Avatar universal
i was injected with fentanyl and versed 10 sec apart...i had no knowledge tht these injection were going to be given to me. I was told general anasthesia only. A couple of seconds past after the versed injections i became paralyzed and unable to breath. Now i have memory loss and respiratory problems along with muscle and nerve damage...all this for a 10min surgery.
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Avatar universal
My wife just had an oral surgeon remove a tooth in preparation for a future implant.  She told him repeatedly she did NOT want to be put to sleep or have IV sedation. He admitted there are other options but would not elaborate on that and just kept badgering her into accepting IV sedation with the typical "oh, you will be relaxed" lie. He NEVER told her what drugs she would be given and NEVER said at any time that she most likely would have amnesia after. I found out by pressuring the recovery room nurse that they gave her Versed, Nubain, and Phenergan. It was NEVER written anywhere we could see it. The combination of all three generally makes most people go out cold. She believes she was able to stay awake during the procedure but cannot be sure. It seems she remembers most of it at least. I asked the recovery room nurse why she was in recovery so long and if they had put her to sleep. Her answer was "yes we did" matter of factly. When I got angry and informed her my wife was NOT supposed to go to sleep is when answers came forward. She knew I was ready to rip her a new one. I was, and still am, LIVID about this as is my wife. I have since found out that Versed, Nubain, and Phenergan is "establised procedure" at that oral surgeons office! They do it to EVERY patient, no matter WHAT your getting treated for!
I personally want to go deal with that doctor my way but my wife is begging me to not do it. The FDA and AMA will NOT stop these doctors from chemically abusing patients. Maybe we need to deal with by another means? This insanity needs to STOP!

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Avatar universal
I had a colonoscopy a few years ago....and I would have given anything if the drugs had worked on me...but for whatever reason they didn't...and the experience was a nightmare for me.  I am supposed to have another one soon and I am delaying it because of the traumatic experience I had.  If I do decide to go through with it, the anesthesiologist and the gastro doctor and I are going to have to have a very serious talk prior to the procedure about the drugs and what happened to me previously.  Trust me....there is a reason why they give you Versed....be grateful if it works!
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Avatar universal
ANY amount of Versed is excessive. That poison is dangerous and messes people up for life. I had it one time to break up a gall stone and it almost killed me. It's been years now, I while I have nightmares about the experience and have been suffering from PTSD ever since I was given Versed, I have no memories of my children growing up, or about a 15 year span of my life...it's like it never existed. Versed stole that from me...I can't think of anything worse happening to a person than that. Steer clear of this **** and put on ever medical form you fill out that you are allergic to it. I even bought Medic Alert bracelets for all of my family and best friend stating that they are allergic to Versed.
I wouldn't want what happened to me to ever happen to anyone again. I was lied to, tricked and given WAY too much of this poison and it pretty much ruined my life...I can't believe the FDA ever approved this drug for use on humans!! It should be banned.
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Avatar universal
List versed as an allergy since you know the amnesic effects therefore you will not receive it again.  I hope since you have voiced feeling suicidal that you are back in counseling for your  PTSD.  Sounds as if you have been keeping a handle on things for a long time and know your triggers.  That is  excellent knowledge to have.  Once you know the triggers then you can prepare yourself and try to prevent, omitt, and reduce the number of triggers that you have to face.(which you were trying to do in this case.)  Also I'm sure since you have been dealing with this for years that you also have a plan in place of how to handle the triggers of your PTSD healthly when they cannot be avoided. Do you have a regular counselor, family member, pastor or friend that helps you in these times of need?  And also when or if someone asks you what your allergy to versed is you could answer by saying that is makes your PTSD worse...Tell them that it causes you to decompensate...You do not need to go into detail.  I do not think that there is a doctor out there that would touch that comment medically or legally with a ten foot pole.
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Avatar universal
Moo79,So you can relate to the previous conversations of how they feel about the time lost.  I can fully understand your situation and only used that example because that is kinda what she was reminding me of in relation to the emotion she was expressing about the time she could not account for. ........ As for the contradicting myself.... no it is not a secret........ Some people are wide awake and follow directions and carry on normal conversations while other people who for lack of a better term are "light weights" when it comes to how they react to medications are "napping" with the same dose.   This too is my last posting because it is very clear that you have a very negative perspective of all healthcare and I am very sorry that you have experienced such awful things.  I hope in the future that you will be able to trust your doctor and have a much more pleasant experience.   But as I mentioned before....For the one of you that confronted the doctor and have wrote out your wishes.... Sounds as if you may have a malpractice suit on your hands......If you continue to have issues with what has happened counseling is NOT a bad option.  In a sense you were assaulted just not in the "normal or routine way" society thinks of when they hear the word assault.
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Avatar universal
I don't know what I was looking for? I thought maybe I'd feel better confronting the doc that he had no consent. He even admitted I staid stop-no. Only problem is that I was drugged after that and kept being drugged I told him. (This is what he was hiding from me) He wanted me to believe it was a reaction to a small amount. So he knows that I know I was drugged against my will. I guess I was hoping for a valid reason. I only posted this to help other people learn what can happen when they sign papers. Maybe this thread will save someone else the trouble I had. :(
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Avatar universal
I spoke to my doc figured why not, he's going to lie anyway. He said that I said stop, no more and he said he stopped medicating me. I said interesting that I said stop before you started. Then he got frazzled and said I was talking to him during the exam telling him about my life and that I just don't remember. But just before that he said I was completely sleeping and snoring. It was confirmation how things went. Badly. Now it makes sense why they gave me so much so fast to make sure I went out. :(
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Avatar universal
I too was given Versed for a procedure, even though I specifically said No Versed.  I did not want the amnesia because I was drugged and raped as a child by my babysitter who was a med student, and have had periods of PTSD since then.  So to me, nothing is more traumatic than not remembering.

My doctor later told me that it was my fault because I didn't tell him about being raped.  He told me that saying I didn't want amnesia, or that amnesia would cause me great anxiety was not enough.

I think it is unreasonable to expect a patient to have to talk about being raped right before a hospital procedure where she will be in a room full of people and is practically naked.

Since the procedure 8 months ago, I have had a really severe relapse of PTSD and have become suicidal.  How can I ever trust that people whose job it is to take care of me will not lie to me and hurt me again?
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Avatar universal
This is the last time I'm posting here, it's too upsetting for me.  I just wanted to point out that your comments today contradict what you stated on 11/1  about Versed :

"It does seem to everyone that they are unconscious after they receive this med but actually people are wide awake, carry on normal conversations, follow directions very well "

and then today :

"Most physicans do not mention the amnesic effect of versed because they give it for sedation. And if you sedate  someone, just like if you take something to help you sleep, most of the time you are not going to remember so basically the point of telling that effect is moot if you are taking a nap."

So which one is it-  are we "wide awake" or " taking a nap " ?  Or is that a secret ?
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Avatar universal
Not telling a patient he/she will experience amnesia when given Versed is NOT a "moot point." Because  I specifically requested to be awake for my colonoscopy, I feel the doctor was then obligated to explain that I would most likely not remember the procedure.  When I confronted him about it afterward,  he told me, " You WERE awake - we had you watching the monitor" (and then he actually CHUCKLED!) I feel like a cruel joke was played on me. I feel mentally violated to think my mind was stolen from me for 2 hours (includes recovery time) and I do not know what I said or did in that time,  or what REALLY happened to me. I do not believe for one minute that doctors don't know how upsetting the word "amnesia" is to some patients (not all).  Nurse555, both crystalfresh & I (and hundreds of other people) have lost a lot of respect & trust in medical professionals because of our traumatic experiences with doctors who do not care about the PERSON behind the procedure. You may be a wonderful caring nurse, but if you clearly understood how much chrystalfresh & i have been hurt, you would not defend them. I may never completely trust any health care providers again.
Chrystalfresh, you are not alone. I care about what happened to you.
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567946 tn?1219760872
I just underwent a colonoscopy yesterday and despite telling the doc beforehand that I wanted "bucketloads" of sedation because (and he knows this) I have a very poor pain tolerance and very high drug tolerance (am on chronic narcotics for multiple chronic pain syndromes incl fibromyalgia), I only got 4 mg midazolam and 100 mcg fentanyl - I'd have given anything to have had your dosages given that I was wide awake all the way through and screaming my head off as he wound his way round my "long and tortuous" colon.   Unfortunately apparently, for me at least, this is the max dose they're allowed to provide if you're going home afterwards so nothing he could do for me, but at least he empathised with how dire it had been and at least I'm also fortunate enough in having had a relatively negative result which means I won't have to undergo it again for a LONG time!!   But for me at least, I'd be begging for the meds I'm afraid - wuss that I am LOL!  (PS - I'm in the UK).
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Avatar universal
Yes it was a nurse that was giving me the drugs but I stopped the nurse from giving me drugs and she backed off looking at the doctor for further instruction.

On every line where my signature is I write personal notes just in case I don't understand the forms so my feelings are clear. Then make the person handing me the forms sign it so they understood I put the notes there. It's sad that we have to do these things to this extreme.

I never had surgery before.
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Avatar universal
I also agree that it sounds as if you had a terrible experience. I cannot answer as to why they would not answer your questions.  Was it a regular nurse or an anesthesia provider that was administering your unwelcomed medication.  I think that part of the confusion is the term "conscious sedation"  it can also be referred to as "monitored anesthesia care" or "MAC" for short if given by an anesthesia provider.  Conscious sedation is sedation that is given for procedures to be done. That does not mean that you will be wide awake. That is why you do have a "recovery period" after conscious sedation just like you do if you had general anesthesia or also referred to as "being put to sleep."  When anesthesia personell say conscious sedation or MAC they mean that they are going to sedate you, you may and most likely are going to sleep but you will be breathing on your own and will remember nothing of the procedure. There are many methods and drugs used to do this. Versed being one of them.  When they say that they are going to put you to sleep for a procedure or use general anesthesia.... they mean that you are going to be totally unconscious and have a breathing tube placed and a machine will breathe for you. Drugs in a gas form will flow with oxygen through the breathing tube to keep you asleep until the end of the procedure then after the procedure you will be awakened and the breathing tube removed.  Have you ever been put to sleep for surgery?? Do you ever remember the breathing tube being removed?  In essence you are placed on a ventilator when you are placed under general anesthesia or "put to sleep".  Does this clarify any of the terms that are used?  Most physicans do not mention the amnesic effect of versed because they give it for sedation. And if you sedate  someone, just like if you take something to help you sleep, most of the time you are not going to remember so basically the point of telling that effect is moot if you are taking a nap.
I hope that this has clarified some of the confusing terms that are used when sedating or putting someone to sleep.  I just wish that you had known this information prior to your incident.  But that still does not excuse them from giving you drugs if you specifically requested No drugs.  Next time could I suggest something..... When you sign consent for sedation or consent for procedure.... if the two consents are seperate.. DO NOT sign the sedation consent.  If they are together.... There should be a line on any consent that you sign that says ..." I consent to any and all procedures except ____________.  Fill in that blank with your own handwriting "NO DRUGS"  or "ONLY DRUGS BROUGHT WITH ME". All facilities in all states have somthing similiar to this on their consents.  If not , write in your own handwriting above your signature...I do not wish to receive any type of sedation.  That way if the consent is altered or if you are gven any type of medication then you have a legal case.......  
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Avatar universal
I can tell you why I think they "put you to sleep"... because it's easier for the doctor ! I am horrified by what happened to you. I can relate to what you aid about being obsessed thinking something must have "gone wrong", because that's how I felt when the nurse at the endo center didn't return my call when I said I wanted to know what really happended to me during my procedure.  I requested my records, but they didn't say much, and some things were actually crossed out ! (WHY??)  I also thought the word "conscious" meant awake & alert...as I mentioned in my previous post, I believe doctors deliberately don't explain it. And I ALSO agree with your final comment -
more harm can be done by being deceptive to a patient than letting a patient feel pain.
Nurse555, if you're still reading these posts, I'd love to hear your honest feelings about what happended to crystal. (I noticed expressed no surprise or apology for what happened.)
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Avatar universal
They had me sign papers approving use of drugs in the event of an emergency only. Otherwise I stated no drugs. The doctor knew and repeated back to me that no drugs would be administered. I said no matter how much pain I am no no drugs - staying awake and alert so I can self medicate if needed - had meds on me in hand for emergency. I have other medical problems that are life threatening and may have needed more of them during the procedure. I was having a problem before the procedure and had taken have my meds but the are short term acting so I planned if there was a problem to just take more. But I was out, and couldn't have done that if needed. I suppose I am alive so that situation didn't happen I guess or if it did they treated me for it with out telling me.

For this reason it was explained to the doctor who told me he understood and said yes he knew no drugs. I asked for 1 shot "just a little" and said no more thinking it would take some pain away prior to. I said no more and stopped them from giving me more. I needed to be "alert" to know if another problem was happening so if they had to stop I could self medicate for my other health problem that can be very severe very fast. I even made them wait before doing the procedure until I felt how the shot was affecting me to make sure I would still be "alert". It was given IV.  I said the shot was more than I wanted but fine, no more I am still alert. Lets start the procedure. No more drugs!!!! So it was clear at that moment too.

Well the doc said I was sleeping through the procedure, snoring. I thought something sneaky was going on when they moved my IV line behind me. I didn't make a big deal about guarding my IV line because I said no in so many ways before about being medicated that I thought this could never happen. The doc repeated back to me, that he would stop the exam before giving me drugs because he understood how much against them I was and because I wanted to be alert.

Honestly there was no doubt in any way that it was clearly expressed in the drs office 1 week before, over the phone days before, told to the nurse, stopped them from drugging me, told the doc again to remind him 10 minutes before he drugged me behind my back, he repeated back to me no drugs, no putting me out, ect.... This was so overly discussed.

They also tried to hide the fact that I was drugged too from me after by refusing to answer my questions to what happened why did I go out, how much drugs was I given. The answer I received finally from the doc over the phone was "I don't remember" I first asked the nurse 20 minutes after waking up and no answer to the amount. But an hour later after waking up more I was STEAMING ANGRY about it thinking something went wrong. Then it took all this time to get someone to release the info to me about what happened. The doc gave me no help at all I had to research through the hospital.

This was clearly being hidden from me. I thought something went really wrong and I went out. I was thinking for me to go out with out drugs it had to be serious, did I stop breathing, ect... How long was I not breathing.. I don't know no one told me I was put out against my will so I could only guess at what might have happened. They let me keep thinking this.

The doc could have said, yes we had to put you out, but as you read above the doc clearly did not have permission so they could not tell me why I went out hoping I'd just let it go. I started asking questions days later to the doc like was I breathing, pulse, pressure trying to find out what happened? The doc still did not tell me I was drugged letting me think something was really wrong. He said don't worry it was fine you slept through the whole thing. Well sleeping through was kind of strange, not sure how many people "wide awake" could just fall a sleep let alone have tubes shoved in to your body... I think sleeping through was a problem if I didn't have any drugs I'd think. People just don't pass out and if they do that's more of an ER issue when they can't be woken up.

No one can tell me why they put me to sleep? The doc lied to me already so I can't expect the truth from him. Just looking at my blood pressure it would seem that I was deep sleeping because I have never had pressure that low even sleeping before. Breathing seemed consistent from the chart so doesn't seem like I felt anything either. I can't see how I could be awake. Based on that I think I would have to be sleeping. I also had trouble waking up because I was soooooo sleepy and kept thinking all I wanted to do was keep my eyes closed and sleep. I also didn't remember dreaming. I kept thinking that as I was trying to wake up, with eyes closed, that why when I sleep I didn't dream? Also when I was waking up I couldn't understand anything so I don't think there was anything to forget as it didn't make sense coming in. So not sure if I actually forgot anything as much as I wouldn't have been aware of anything to remember. But still, my blood pressure would make me believe I was unable to speak or move. Any movement would have had to raise my pressure I would think but maybe not I don't know because I was so drugged. The doc did say that I was not awake even though it was written on my chart that I was somewhat awake. I believe I was not because of my blood pressure. Had I forget that I was awake my pressure would have been much higher indicating that I could have been awake.

No one will tell me why I was put out. The original papers said NOTHING about being put out that I can remember reading. I made sure to read all of it before signing. If it said conscious I would have thought it meant awake and alert. Maybe it said that and I didn't understand it. But in any case the doctor understood it because I stated no drugs when we got started. None Zero, Nadda. The nurse was afraid to drug me because I kept saying NO, we are doing this with out drugs I said. I remember all that very clearly.

Maybe I opened the door by allowing them to give me the first shot before but clearly stated NO MORE. THATS IT. STOP. THIS WAS MORE THAN I WANTED. That was pretty clear. Maybe they thought I would keep thinking it was a delayed reaction to the first shot later on? Thats what they allowed me to believe.

This whole thing was shady. The whole thing that has me wondering is why did they put me out when their was no reason. I was very willing not resisting at all? Not complaining, just being a good patient. I even made it a point not to ask questions before to be distracting.

??? Sad :-(

I have nothing to do with that doc anymore, having a new doc review results and go from there. Trying to get all medical records released so another doc can take over. If the old doc thought he was doing me a favor by trying to save me from feeling a little pain he did just the opposite by hurting me like no physical pain ever could. I will never trust anyone for the rest of my life.
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Avatar universal
The discussion as to "why" a patient doesn't want to be sedated should occur  BEFORE a procedure or surgery.  Even if it is in the patient's best interest, a doctor should not knowingly go against a specific request, without having that discussion, and being upfront about what drugs will be given, and what their effects will be. As far as "Informed Consent" is concerned, I don't really think there is such a thing.  Some doctors use consent forms that are deliberately vague, so that they can actually do whatever they want.  Sometimes patients don't even know what questions to ask. (I had never heard of an amnesia-causing drug, and it was not explained either verbally or on the consent form I signed. I would not have agreed to being given Versed had I known.)
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Avatar universal
The maxium dose that I can find is 20mg IV prior to a procedure.  So I guess your 11mg is well with in the guidelines.
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Avatar universal
Is there a specific reason that you did not want any drugs for the endoscopy procedure??? And if so... Did you sign the conscious sedation consent form?? The only way to sedate someone is with drugs.  And as I mentioned before.. With Versed ...You are still conscious... you just do not remember the trauma of the actual procedure.   The only reasons that I can think of to give you such excessive doses is if after the initial doses you were still tense and resistive that they could not perform the test until they could get you more relaxed.  I can also say that from working in the operating room that I have seen it take quite a bit of the actual induction drugs (propofol and succiniate) to work on different people.  With all drugs it is the same .... everyones tolerance is different.  There are what everyone considers the "norm" doses... those are usually the average dose that most people respond to.  That is the dose that I had mentioned in my earlier entry.  Then you have the other doses that (like you apparently) certain people have to have to get the same effect as the average person.  I will look up and see what the maxium dose is recommended by the manufacturer.
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Avatar universal
i had 3 lots of ercp and was supposed to be sedated each time i was given a different sedative but none worked. the dr's cant give me an explanation of why repeated doses of sedative did not wok for the proceedure - was very aware of what was going on and had to be physically held down - i just wish the sedation had worked for what was a very traumatic form of endoscopy.
i am sorry you feel the doctors went against your wishes they proberbly had their reasons to sedate you.
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Avatar universal
11mg is  a pretty high dose. Working in an OR where 2mg is the standard pre-op dose.  It does seem to everyone that they are unconscious after they receive this med but actually people are wide awake, carry on normal conversations, follow directions very well ( and may I add that people only follow directions that they would only follow under normal circumstances.)  For endoscopy procedures Versed is the ideal drug because especially for an EGD remembering having a rather large tube passed down your throat (one larger than a NG tube) making you gag and having it in place for longer than a minute or two in something most people would rather not remember.  Having the patient awake helps so that they can actually swallow the tube and have the bodies natural motions help feed the tube down.  One way not to get the drup is to state it as an allergy.  My sister is actually is allergic.  She becomes combative when given it.  I know that it is sometimes disturbing not to know a certain period of time what has happened to you (like during a test, surgery etc.) but take it from me .... sometimes the procedures that you have to go through to have things diagnosed or corrected,.... it would be far worse to remember or to know what you or your body actually had to go through.  Just ask some one who has had to intubated (had a breathing tube put in for surgery) while they were still awake. It is hard enough just to have to watch.
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