Amazing Isn't It?

Here we have yet another patient trying to figure out how to prevent the use of Versed. This person has ALREADY HAD a LIFE THREATENING adverse reaction to this poison and wishes not to have it. Look at the Yahoo Question in situ; Limiting anesthesia consent? - Yahoo! Answers
Here is the post...

Ed Smith

Limiting anesthesia consent?

I'm having outpatient surgery (elbow with a Bier block) and a colonoscopy. Due to previous severe reactions to sedation I need to have these done without sedation and nobody has a problem agreeing to this verbally. I'm adding: "I'm not consenting to sedation or general anesthesia" to the anesthesia consent to make sure that I don't end up with a life-threatening adverse drug reaction (again). My question is: who should I have sign the modified consent; the anesthesiologist or the crna or both? thanks

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Here's one of the answers;

by Pangolin

Good luck with that.

I wouldn't sign anything that limited my ability to take care of you.

Bier blocks use a lot of local anesthesia, and if the cuffs fail, you will have local anesthetic toxicity and probably have seizures as a result of it. The treatment for that would be to give you drugs used in sedation/anesthesia. I would not restrict my ability to save your life.

What is the anesthesiologist supposed to do if you become combative, or out of control in some other way? Very unlikely, but not unheard of. What if you have some other complication, such as a perforated colon during the colonoscopy (I've seen that happen personally 3 times)? That requires emergency surgery with a general anesthetic.

Tell your anesthesiologist what your reactions were, and to which drugs. We can work around that.

Source(s):

I'm an anesthesiologist.

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I am not a Dr., I'm just a patient who has been damaged by the same arrogant ideas as have been put forth by the person calling herself Pangolin. She LOVES Versed and constantly is looking for posts such as "Ed" put up, so that she can tell everybody how wonderful Versed is. Look at how she says she will refuse to provide medical care if you don't allow her to use Versed! Really? She won't sign something that restricts her use of Versed! There is no way I would allow this. Cancel surgery and get another MDA who CAN help without using a drug that has already caused a life threatening reaction.

Look at the next to last sentence if you don't believe me. "Tell your anesthesiologist what your reactions were..." DON'T DO IT! Not unless they have already signed the legal document to refrain from any use of Versed. Here's why; They will decide that your reaction isn't a reaction to Versed. They will probably decide that there is no "allergy" or anything else to Versed. It's the "ABV Syndrome" again. Then you will get Versed. They will claim that you became "combative, or out of control in some other way." She's telling you ahead of time what the excuse(s) will be! Listen to her.

I have had a Bier block for wrist surgery. I did NOT receive sedation as well. I got Fentanyl for pain (tourniquet pain gets pretty rugged after a while, no pain from Beir block area at all) which doubles as a very mild sedative. My alternating tourniquet malfunctioned and I could feel the bubbling effect up my arm. I did NOT have the "anesthetic toxicity" that Pangolin baldly states you WILL HAVE! I did NOT have a seizure. I did NOT panic! I did NOT need sedation (and amnesia) for this problem. I did NOT have to have general anesthesia because my tourniquet failed. Are you getting my drift? All problems encountered in an OR have alternatives to Versed. It truly isn't needed at all. It's simply DESIRED by your medical team. The desires and WHIMS of anesthesia providers should not be the PATIENTS problem! Pangolin stated on another of her posts that it is the WHIM of the anesthesia provider which dictates what you will get. That is unacceptable to me! What about you?

Also, anybody who has any empirical evidence that the (ONLY) treatment and or reversal for "anesthesia toxicity" due to numbing agents in extremity surgery being Versed, please send me the documents. I have seen where providers WANT to use Versed to treat seizures... That's an OFF LABEL USE of Versed, as in NOT approved by the FDA! (in my opinion Versed should never have been approved in the first place. Not after all the deaths associated with it) I am very cautious about that. There haven't been enough studies to warrant this off label use. Along with the awful side effects of Versed, it doesn't stand to reason that Versed is the ONLY drug for seizures. These people are after the amnesia, not the anti-siezure properties that Versed may or may not have. So once again Versed isn't NECESSARY!

Pangolin goes on about colonoscopy perforations. I have read that there are zero perforations without sedation. I mean you'd think that SOME perforations would occur without Versed and/or Propofol in use wouldn't you? I'm not seeing data to support that you are at risk of perforation due to lack of sedation. The opposite is true as far as I can tell.

I AM, however seeing anecdotal comments about it from health care providers! It's that whole "relaxing" lie again! Oh yes, it will "relax" the colon and prevent perforation. Or maybe not... If you are screaming, fighting, writhing and trying to escape the torture like you do while on Versed, that might not be the best thing to be doing if you want to avoid perforations. I'm after scientific empirical PROOF that Versed sedation prevents perforations.

Sedation-free is the only way *I* would go on the colonoscopy. It reduces the risks associated with sedation, which are many, regardless of what medical people say. Look it up. Here's my theory; no sedation=no perforations=no g/a. For Ed, no sedation=no life threatening reactions as well.

Be careful out there! Have the crna, his/her supervising MDA, any other "witnesses" such as the OR or Endo nurse sign the Versed refusal, as well as the Dr. who is performing the procedure(s) at point of service. Read everything, right down to the manufacturer of the document itself. Strike anything that has to do with "Dr. can decide," anything that says anything at all about g/a or sedation etc. You may want to interview the person who will be doing the anesthesia PRIOR to meeting the first time in an intimidating place like a hospital. They WILL call you on the phone ahead of time if you insist. That way you can make sure you don't get somebody like the above anesthesiologist. I have no problem demanding that MY needs are met and that the person I am going to enrich with a LOT of money realizes that I'm in charge, not them. There are medical people out there who consider the patient important. I know because I managed to find one. I'm in charge of what happens to me, which means NO VERSED! (It also means no G/A unless extant circumstances arise which *I* will determine necessitates G/A. Not the anesthetist or surgeon, endo doc, whomever.)

NOTE; I speaking of ELECTIVE procedures of the non-life threatening sort, not an emergency. I cannot have Versed under ANY circumstances (medical jewelry tells them that) but it is conceivable that I might need G/A if I'm crushed by a horse, crash my motorcycle etc. BUT, I will never, ever need Versed.