There was a time, circa 1990’s when patients actually had a sit-down, scheduled, pre-op meeting with a CRNA or anesthesiologist. In that meeting, we would determine your anesthesia risk, discuss the anesthetic plan, answer anesthesia questions and provide informed consent. In 2017, you probably won’t meet your specific CRNA or anesthesiologist until right before your operation. We will still discuss all those topics, but on the day of surgery, it can be hard for patients to concentrate and remember…
What Anesthesia Questions Did I Want To Ask?
This post is the first in a series where I’ll answer the questions I hear most often.
Are You Giving Me The Michael Jackson Drug?
First of all, my sympathies to everyone involved in this tragically bizarre, only-in-America-event, but: Yes. You will get propofol, aka “The Michael Jackson Drug.” However, blaming propofol for Michael Jackson’s death is like blaming your oven for burning the casserole. Maybe you set the oven at 450, put the food in and then left the house. For the day.
According to Google (?), the cardiologist who gave MJ propofol did not monitor Michael’s vital signs properly and he left the room after giving the anesthetic.
When hospital people recall this incident, 100% of the time we do the “What the ****?” look. Slack, slightly opened mouth, wide open eyes, head tilted to the left and shaking no, struggle, struggle, struggle to formulate the words … We’re so incredulous that seven years later, we are still searching for the words. None of us can fathom the use of propofol in a private residence. By a cardiologist.
Yes. You are going to get propofol and someone trained in anesthesia. Meaning, someone who knows how to monitor your oxygen level, expired carbon dioxide level, heart rate, blood pressure, respiratory rate, temperature, and IV site. Resuscitative equipment that works and people trained to use it are standard.
Be not afraid of propofol. Be afraid of someone coming into your bedroom, starting an IV, giving you a powerful anesthetic drug and then leaving the room.
Am I Going To Say Something Stupid While Under Anesthesia?
No. Probably not.
General anesthesia works quickly and the time between being awake and being asleep is brief. If someone asks you to count backward from 100, you probably won’t make it to 95.
Monitored Anesthesia Care, or MAC, is what your surgeon will likely describe as “twilight” anesthesia. It’s when you are awake enough to breathe on your own, but you won’t care or remember much. This type of anesthesia is what used to be known as “local anesthesia with IV sedation.” The local anesthesia provides the actual pain relief and the sedation makes it “all better” psychologically. Patients receiving local with IV sedation are the most worried about saying things they normally wouldn’t.
If you do speak, you will likely ask something about your operation such as “How’s it going, is it what you expected?” You will sound like you are with it, but you aren’t. After a short pause, you’ll ask it again. The second time, the entire OR crew will, with measured deliberateness, and in unison, slowly turn to anesthesia and glare at them with THE LOOK.
It’s equal parts frustration, annoyance, and impatience.
The Repetitive Questions Are Not Your Fault
You have no short term memory while these medicines are working. If you speak about things other than your operation, we will most likely deepen your anesthetic. We know this is sacred territory and we respect it. We want to protect your mental/emotional privacy the same way we instinctively cover up your exposed body.
The operating room can be a frightening place.
If the cold, the bright lights, the sharp instruments, and the powerful drugs don’t scare you, maybe giving up control does. Maybe you are afraid of never waking up from anesthesia or waking up too soon. With this series of posts, I hope to assuage some of those fears.
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