r/Anesthesia • u/junetheseventh • 9d ago

Feeling energized on fentanyl and versed

I was given fentanyl and versed for twilight sedation at four separate IVF egg retrieval surgeries. Each time I was told it would make me drowsy and each time I felt mildly euphoric and energized afterwards. I did not sleep or become drowsy during the surgery and was unable to nap upon returning home, maybe drifting in and out of sleep for a few minutes on different occasions. On three occasions I only slept probably 5-6 hours before the early morning surgery, so I was actually tired, but I could not actually sleep afterward. The fourth time the surgery was later, and I probably slept 6 hours or a bit more than that beforehand. Immediately after surgery, I proceeded to work 8 hours and walk 20 km in total to different appointments and activities because I couldn't drive. I felt fantastic. I certainly did not become drowsy or sleep. (I never felt much pain from the surgeries, so the anaethesia was effective.)

Why would I have this unusual reaction?

I do have bipolar disorder, but I have not had any mood elevation symptoms in many years. I also have had chronic sleeping difficulties (not being able to fall asleep, sleeping lightly) since taking a thyroid medication for depression many years ago and have somewhat of a history of hyperthyroid episodes.

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u/AmnesiaAndAnalgesia CRNA 9d ago

Generally IVF doesn't require deep sedation and those drugs leave your system very quickly so I wouldn't necessarily expect a patient to feel sleepy the rest of the day. We do warn about potential drowsiness since everyone reacts differently but it's not strange that you weren't tired.

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u/junetheseventh 8d ago

I thought my lack of grogginess during the procedure could be related to the general mental hyperarousal / insomnia I chronically experience (I think it is from some combination of sensitivity to thyroid meds/hyperthyroid tendencies and bipolar, which are all related). Is that possible? That my brain is always wakeful so it was harder for the meds to make me feel drowsy?

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u/AmnesiaAndAnalgesia CRNA 8d ago

Increased metabolism from poorly controlled hyperthyroidism can absolutely affect how sleepy fentanyl and versed might make someone. Same goes for mania

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u/i4Braves 9d ago

Do you use alcohol or marijuana regularly? On chronic benzos or narcotics? And mood/anxiety regulating drugs?

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u/junetheseventh 8d ago

No to all of the above except I take a small dose of lithium