What did the author experience during the EMR surgery?

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Author Remained Conscious During Endoscopic Mucosal Resection Despite Sedation

During an Endoscopic Mucosal Resection (EMR) procedure to remove a colon polyp, the author remained fully conscious despite receiving the maximum dosage of sedative. The author speculates that a rapid succession of endoscopic procedures, with the EMR occurring less than ten days after an initial colonoscopy, may have led to a diminished response to the sedative. This experience contrasts with the typical patient experience during EMR, where sedation is administered to ensure the patient is unaware of or comfortable during the procedure.
EMR Procedure and Sedation Practices

Endoscopic Mucosal Resection (EMR) is a medical technique used to remove precancerous polyps or early-stage cancers from the lining of the digestive tract, such as the colon. This procedure involves using an endoscope, a flexible tube with a camera, to visualise the area and specialised tools to resect the abnormal tissue. To facilitate patient comfort and minimise any potential discomfort or awareness during the EMR, patients are typically administered sedatives. The goal of sedation is to induce a state of relaxation or even deep sleep, rendering the patient unaware of the surgical steps being performed.
Possible Factors Influencing Sedative Response

The author posits that the close proximity of the EMR to a prior colonoscopy, occurring within a 10-day window, might have contributed to their unexpected awareness. In medical contexts, it is sometimes observed that repeated exposure to certain anaesthetics or sedatives, particularly within a short timeframe, can lead to a phenomenon where the body develops a reduced sensitivity or a form of "immunity." This can necessitate adjustments in dosage or alternative anaesthetic strategies to achieve the desired effect in subsequent procedures. While not a universally documented occurrence for all sedatives and all individuals, such variations in patient response to anaesthetic agents are a known aspect of clinical practice.
Patient Experience During Sedated Procedures

Generally, patients undergoing EMR with appropriate sedation are expected to experience minimal to no memory of the procedure. The level of sedation can range from conscious sedation, where the patient is drowsy but responsive, to deeper levels where they are asleep. The absence of recollection is a primary objective, ensuring a less distressing experience. The author's experience of remaining "wide awake" throughout the EMR, despite receiving what is described as the maximum sedative dosage, highlights an unusual individual response to the administered medication.

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What did the author experience during the EMR surgery?

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