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Comment by jillesvangurp | Hacker News Reader

Many years ago, I received a mild sedative while undergoing an endoscopy via my throat. Apparently, that's not a pleasant experience. I say apparently because I have no memory of it other than asking the nurse when they were going to start ... after the procedure was completed. I remember getting injected with the stuff and I remember me asking that question because I was getting bored just lying there. I don't remember losing consciousness, being asleep, or waking up, or anything like that. It's just a gap in my memory while they did their thing. Amazing stuff. I'm assuming I was conscious and responsive throughout.

I had proper surgery a few days later which involved being knocked out for two hours or so. That's a whole different situation. You start counting down and you are gone within a few seconds.

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I've had an endoscopy with no sedatives/anesthetics etc. It was definitely not fun but doable. As soon as the scope went down my throat I went into panic mode. My heart rate was through the roof, and I couldn't stop retching. But after it passed that initial gag reflex point, it settled down. The nurse holding my hand holding my hand soothed me as well.

Then I got up, walked to my car and drove myself home with my brain at 100% (albeit with more adrenaline and cortisol than normal).

The drug they typically give to erase your memory is Midazolam.

You can give someone a small dose of Midazolam, they might report feeling a little dizzy, or say they feel like they’ve had a few drinks, but they will have absolutely no recall of the experience, despite interacting like a slightly tipsy “conscious person” - I like how they call it “conscious sedation” - most people end up believing they were unconscious.

Right, midazolam (aka versed) is a common one. So is propofol (colloquially known as "milk of amnesia").

I've read some horror stories online about people having postoperative nightmares about what they experienced while on the operating table while under versed, so I was really afraid to take it when I went under general anesthesia myself.. but I've had it a bunch of times now, and never experienced anything like that myself.

My postoperative amnesia has been complete, and I'm happy for that.

On the other hand, I still worry about what I might have experienced that I don't remember.

I really hope they verify these anaesthetics by doing brain scans during surgery to check whether any pain areas in the brain are activated.

At least for some anesthetics, the pain centers will be active while under anesthesia. Rather, interconnectivity between brain areas is disrupted, preventing your conscious experience of pain. Whether or not that is a case of amnesia regarding what you experienced, or a genuine lack of experience, is an open question. Although I firmly believe that brain wide integration is necessary for consciousness and so there is no experience of pain.

I guess another test would be to try to interrupt connectivity without amnesia or paralysis. This could lead to evidence for pain.

I wonder if the pain sensation in your brain , despite not being connected consciously to your experience, has some lingering after effects. Like the engine room of a ship springing a leak but the bridge is just fine and never noticed it when it happened.

Great song by Gaylord, Milk of Amnesia:

https://youtube.com/watch?v=cFfQILesiXE&feature=share7

Falling asleep at night after an upper endoscopy, I had a vague recollection of the feeling of retching during the procedure. I know that they try to sedate as lightly as possible, so maybe they undershot slightly in my case. I think I had asked the anesthesiologist what they gave me when I was waking up, because I felt particularly hung over, and they said it was propofol.

Propofol is also common with endoscopy, and sometimes combinations of drugs, so it's hard to say what GP received.

There's also an interesting thing where the anesthesia you get is likely to be very different for the same procedure if you get the procedure at a hospital versus an outpatient clinic. Because anesthesia at a hospital is typically a department with influence, and turf wars happen.

Startup idea: video content moderation service for big social media companies with moderators given medically supervised Midazolam; no more high turnover due to PTSD and no counseling needed

The TV show Severance feels as though it's along those lines of thinking. Separate your work self from your personal self....completely

I got a small dose of that for my colonoscopy. I was 100 % there, looking at the camera feed, complying with the doctor's orders, I even remember being a little surprised that I feel and remember everything. An hour later, sipping a milkshake at McDonald's I realized I didn't remember the procedure at all. Just these disjoint flashes of consciousness, the sound of the machine, the feeling of the tool moving around, but no real coherent story. Interesting experience.

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