why do patients under concieous sedation sometimes fight the doctor during procedures?
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Different parts of the brain are responsible for different cognitive components of our awareness and behaviour, and respond differently to sedation.
Responsible for rational decision-making and executive function, the cerebral cortex is quite sensitive to sedation. Residing near the brainstem, the medulla oblongata moderates reflexive responses and is closely associated with basic fight/flight emotions. It is less sensitive to sedation.
Going into and (more commonly) coming out of sedation, the medula oblongata stays active longer than the cerebral cortex, which creates brief windows in which a person may misinterpret and overreact to stimuli.
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