Expert: Ronald Levy, M.D. - 2/14/2008

Question
I understand that amnesia is a "desired effect" of drugs such as Versed.  However, I am wondering about other options I may have.  I need to have a hernia re-repaired.  During my first hernia repair, I was given Versed and I lost all memories of about 4 hours of conscious activity where I was talking and responding.  I must be unconscious and paralyzed for the surgery, but I don't want to have memory loss for hours after I wake up.  Is there any way that I can be "knocked out" for the surgery and then when I wake, be creating memories?  Someone mentioned to me that without Versed, I could wake up and feel the pain during surgery.  Does that mean that the pain meds I am receiving during surgery are insufficient and that Versed just ensures that if I actually feel the pain that I just don't remember it?  I am actually considering refusing the surgery unless it becomes a medical emergency.  Thank you so much for your opinion.

Answer
First of all the Versed has nothing to do with waking up and feeling pain. Versed does cause amnesia in most people but not reliably enough that an anesthesiologist would use it instead of a pain med. As for options for your surgery, you have several. You could have a spinal anesthestic. This would ensure that you have no pain during surgery and then you could be as sedated or awake as you want. There is no drug that "turns off" exactly at the end of surgery but the closest is probably Propofol. You could have a general anesthetic with Propofol and no Versed. You might still have amnesia for longer than the surgery but probably not as bad.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston