I have not undergone conscious sedation myself, but I have administered the anaesthetic (midazolam, diazepam, propofol, fentanyl) for hundreds of gastroscopies and colonoscopies. Sometimes the patients are more or less fast asleep for the whole experience. Other times, they seem to be fully awake, talking to you with only a slight slurring of their voice, as if they have had a few beers. In fact, benzodiazepines are not that dissimilar to alcohol pharmacologically, and patients who go into delirium tremens from alcohol withdrawl are treated with large doses of diazepam. (It is ironic that any adult can buy as much alcoholic beverages as he wants, but for diazepam, which basically has all the effects of alcohol but is much safer, a prescription is needed.) The dose of the anaesthetic agent in conscious sedation is titrated according to how the patient responds: if he is very anxious the anaesthetist might give more midazolam, which is primarily given for its anxiolytic effect rather to induce amnesia, while if he is complaining of pain more fentanyl is given. Not everyone has complete amnesia for the procedure afterwards, but even if amnesia were guaranteed, certainly no doctor would deliberately allow a patient to suffer just because he won't remember it. The only situation I can think of where midazolam might be used primarily for its amnestic effect is with young children (you squirt it up their nose!) who need to have a series of unpleasant treatments, and would become very distressed each time if they could remember the details of their last experience.

--Stathis Papaioannou

Jonathan Corgan wrote:

Russell Standish wrote:

This leads to a speculation that memories are an essential requirement
for consciousness...

I agree. Had I known then what I know now, I would have asked the nursing staff and doctor to question me in detail about my first person experience *while it was happening*, since all I can think about now is how I felt before and after.

Was I oriented to time, place, who I was, and what was happening to me?

Did my first person experience of consciousness "seem" any different? (Aside from the obvious mellowness that any sedative induces.)

While I was undergoing the procedure, and feeling the pain, did I regret the decision to be "awake" but not remember later?

Knowing that I would forget this, is there anything about what I was experiencing that I'd want to be noted so I could read about it afterward?

etc.

So I do wonder, if I was "awake" and responding accurately to verbal cues, but not "laying down memories", was I really conscious? Of course, it *seems* to me now that I was unconscious the whole time, with some odd "emergent effects" as the Versed wore off. But as I've gathered from reading folks like Dennett, what things seem like and what actually is happening can be very different things.

Performing the question & answer session described above is at least part of my willingness to undergo conscious sedation again.

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