General anaesthetic .....fear of

[eastern wiseguy]

Hi Folks. This is not really aviation related BUT as a lot of you medical folks post here ......I may(for those who know me I stress MAY) have to have a procedure done under a GA .My only experience of them was when I was a kid at the dentists in 1963 and having my appendix out and tonsils removed both in the late 60's early 70's. They were all nightmare experiences.Waking up I felt dreadful....sick...and unbelievably poorly. Have things improved?What can I expect?:uhoh:

Thanks in advance

EW

[gingernut]

What's the procedure EW?

[hippotamus]

Last time I had a GA , it was a fairly major one requiring intubation and the like, it was fine.

No pre med , so fully conscious up until last minute (important for me as I have this control freak thing going on) , Anaesthatist explained that I would be given three drugs, you feel weird after two of them but don't go unconscious till the third.
Woke up , thrashing around a bit , felt a bit like a dream where everything is just out of reach.
Once I woke up properly I felt great , I really mean it , I think i was high, I did a pretty good impression of the guy from trainspotting , talked solidly for the next half hour!!!!
Felt a bit sick afterwards but they give you an antiemetic before you wake up and leave a standing prescription for the nurses if you need it.
I wasn't sick , just didn't fancy much in the way of food for the next day.

I also had an anaesthetic about tgwenty years ago and I would say things have improved a lot. With the first I felt sick and tired for days afterwards and had memory loss associated with the anaesthetic , none this time at all.

If it is for a minor op things are even better , husband was alert and raring to go home about 20 minutes after his vascetomy

[obgraham]

Things are much better these days, Wiseguy. The meds used at the beginning and at the end do a lot to relieve the aftereffects such as nausea. And most folks remember little about the whole adventure.

It does depend on the procedure, like gingernut asks. If they are tugging and pulling on your innards, there's more odds of nausea. And sometimes a regional anesthetic (spinal, epidural, whatever) is a better choice.

Try to arrange an anesthetic consultation before the surgery. You can go over all the options in a less tense environment, and come up with a plan more specific to you. Anesthetists are well aware of this type of anxiety.

[db16]

Chaps, remember that the anasthesia guy is king, not the surgeon. Things are much better - I had a vasectomy in 1999 and had no bad effects fro a GA. db16:bored:

[kwachon]

Had GA 3 years ago to have right lung removed. Surgery was a bi-lateral thoracotamy (Split the breast bone and basically cut across the stomach in an inverted tee). Pre-med made me a little light headed, have no recollection of going in the theatre, woke up 3 days later stuffed full of tubes including an epidural for pain, never felt a thing, was being fed through tubes so no hunger, had a catheter so did not need to worry about a thing. Just watched the TV. You have nothing to worry about, the new drugs are wonderful. Good luck

[homonculus]

A lot of great reassurance here. For down to earth information, have a look at the Royal College of Anaesthetists' website www.youranaesthetic.info.

In fact the basic principles of anaesthesia are the same as in the 1960s, but it really depends upon what you are having done. Tonsillectomy is still pretty yuk, and appendicectomies are often done at night by low hour trainees! Most other elective procedures are not that bad.

Premeds are a rarity. Pain relief has improved tremendously, and for adult males nausea and vomiting is not that common.

Most anaesthetists now have preassessment clinics not only to organise tests and avoid last minute cancellations but also to provide information before admission. Make sure you get an appointment so you can discuss the options and get some reassurance.

[gingernut]

It's a shame my landlord doesn't serve the stuff I had last time I needed putting out.

The only thing you've got to worry about is saying something naughty to the recovery nurse!


Check your pm's EW.

[eastern wiseguy]

Guys....Thanks for the info and a degree of reassurance! I am looking at the invasive type of surgery so I think it will be "lights out" for a while.


"appendicectomies are often done at night by low hour trainees! " Looking at my scar I can well believe it!!


Gingernut.....thank you!

[David Horn]

Hey there,

I've had two GAs in the last three years and neither of them has presented any problem at all. I daresay the drugs have improved a huge amount since 1963!

You simply fall asleep, then the next thing you know is feeling wonderfully relaxed as you float your way back up to the surface in a warm bed. You don't know where you are and you don't care, and eventually you flick open your eyes and everything comes flooding back.

I've heard people say that the waking up is the best part about having a GA, and I can easily agree with them.

[Shunter]

Only had 1 (last year), and it was far, far better than I had expected. I was freaking out a little whilst being wheeled down to the knockout room with a very rusty appendix. The man with the drugs gave me a shot of midazolam to calm me down, which is pretty awesome stuff. I descended into a state of complete giggling verbal nonsense after that and didn't even notice him putting me out.

Came round 4 hours later and opened my eyes briefly. Almost like waking up thinking "oh no, time to get up", then realising it's only 4am and happily drifting right back off to sleep again.

As has been mentioned, the anaesthetist is king. The nurse was chortling away all afternoon, but she wouldn't tell me what I'd said.

[Loose rivets]

Despite three attempts at a pre med, I chatted so long and tirelessly during a delay, that the anesthetist and his two helpers fell asleep.:} Well, they were glazing over anyway.


Anyone know what type of pain killers they may have used for an eye op?

Could it have been Pethadine Sp?

BTW, Here in the US, they don't seem to use that name.

[henry crun]

If you have a choice, ask for Pethadine.

On the first occasion I was given it I quietly drifted away up to the ceiling and looked down at myself lying in the bed, marvellous stuff.

[Loose rivets]

I'm getting away from the main subject, but I would just say that when finally they made a determined effort to shut me up, it was quite pleasant, and the next thing was them trying to wake me.


Sadly for me, Pethadine (probably) causes severe Anaphylaxis.

I'm not sure why or how this started but certainly is very unpleasant even with a tiny amount cut from the side of a tablet.

After the surgery, I came to with this crushing feeling on my chest and other symptoms that I recognized. They wouldn't believe that I knew what was going on and gave me nitroglycerin just in case -- I would have thought that was the opposite to what the epi-pen does. But, it all went away in a few moments.

[obgraham]

Pethidine = meperidine (generic name) = Demerol.

Versed is becoming more popular now. Less nausea, more amnesia.

[Loose rivets]

Thank you for that, it might be wise to test this on myself prior to any surgery (that seems to be inevitable now.)


This is a somewhat graphic description of my reason for being careful with reactions. The Pethadine reaction was just the same feeling, but not nearly so bad.

http://www.pprune.org/forums/showthread.php?p=3654185&highlight=Monty+python#post3654185

[Breakfast Creek]

Modern day GA drugs are generally very safe and effective. However I had a cousin who had severe dementia after undergoing GA for a major surgical procedure. Her quack indicated that some people are susceptible to such unfortunate side effect; just like some people who " mentally " refused to go under with GA...their physical body is numbed and paralysed by they remain mentally alert and aware of intense pain during the surgical process!

[gingernut]

As a patient, I once experienced the delights of "Midazolam," (actually a sedative, not an anaesthetic,) which lists, "changes in libido,inducement of sexual fantasies" as a possible side effect.

I briefly remember making some comment to the rather buxom recovery nurse, but I'm glad to report my libido returned to its normal state when they dragged Mrs Gingernut in to help settle me down.:\

Good stuff, the horror stories are few and far between.

[eastern wiseguy]

Guys,

Just to say that I had the procedure. I went under without even knowing it and woke up 2 hours later. Absolutely no problems. Thanks for the advice!

EW

awake and alert!:ok:

[ndeke]

Just a few clarifications: := Versed (midazolam) is an anxiolytic drug (fear killer), whereas pethidine (demerol) is a pain killer. They each serve different purposes in anesthesia.

Resistence to anesthesia doesn't exist. Awareness happens because just because of bad knowledge of pharmacology by the anaesthetist, or the fact that he forgot to switch on the sleeping gases...

Do u know the definition of an anaesthetist? "A guy who's half awake next to a guy who's half asleep (= the patient)" :p...

I don't think there is a medical job as close to the one of a pilot as the one of an anaesthetist: taking off, cruising altitude, landing, lots of buttons, lots of technical acts, etc... :the patient is the equivalent of the aircraft, the type of operation is the strip, the anesthesia machine and pumps are the cockpit, the surgeon is the unforeseable element like the weather...

Except that if there is a crash during anesthesia, the anaesthetist is outside the cockpit :}...

The flying gasman...

[homonculus]

Ndeke - the full quote is

anaesthesia is the art of the half asleep watching the half awake being half murdered by the half witted.

[ndeke]

great one :ok: