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General Anaesthetic

(85 Posts)
mrsblakey Wed 22-Jan-14 18:35:57

Am having surgery in a few weeks.
I haven't had a GA since I was young & can't really remember much about the procedure.
I am feeling more apprehensive about that rather than the surgery itself!
I have been told I won't be able to meet the anaesthetist until the day of my surgery so am bottling up more nerves.
I think my main fear is not waking up afterwards - I feel really silly admitting that!
Anyone had a similar anxiety?

digerd Wed 29-Jan-14 20:48:17

I have had may over many decades. The most recent was in 2006.
I was given a bed in the hospital and eventually I was wheeled into the operating theatre, given the drug in the back of my hand -canular- and then I woke up seemingly within seconds.
Only once did I have a sore throat afterwards.

AnneEyhtMeyer Wed 29-Jan-14 20:12:16

I've had 4 GA. Each time I've been scared of not waking up / dying. Each time when I've woken it has been as though it was a moment since I went under, still worrying about what I was worrying about before I went under and then realising I was out the other side.

The worst bits are the feeling of the coldness creeping over you and the waking up with an oxygen mask on your face. So not much really, and nowhere near as scary as you think it going to be.

duchesse Wed 29-Jan-14 20:06:59

Scary, I expressed for tiny DD3 in NICU after GA #2 and was still breastfeeding her for my third surgery. The anaesthetist both times said that once you are awake it's proof that the drug they use has left your body and the amounts that end up in the milk for a short procedure are negligible.

scaryg Wed 29-Jan-14 19:56:04

Hi, what a useful thread, I'm going for a pre-op appointment tomorrow in preparation for oral surgery next month. When I was referred I mentioned I was still breastfeeding my DD (only at night, she's 25months). It was suggested I could choose between IV or GA? what is considered best in this situation?

AHardDaysWrite Wed 29-Jan-14 19:55:51

I feel for you, Susan. I've had two lots of gynae surgery and it's bad enough knowing that people I've never met put my legs in stirrups, saw my genitals etc whilst I was asleep when I'd consented to it - it must've been awful to experience that without being prepared for it.

SusanC5 Wed 29-Jan-14 19:31:47

You are right InPursuit, I felt violated after my surgery. I woke up after my accident, in hospital, naked under a gown and with a catheter in place.

Obviously, at some point, someone had removed my clothes and inserted the catheter. I was incredibly upset that the student (male) doctor, who thanked me for allowing him to observe my operation (without my consent) had probably seen me naked and may have seen the catheter being inserted. I struggled with the idea that total strangers would have washed my perineum.

I know I should be grateful that the HCP put me back together, but I still burn with the humiliation that there are people out there who touched me in the most intimate way, without my knowledge or consent.

InPursuitOfOblivion Wed 29-Jan-14 17:41:54

Right then, anaesthetics and emotional responses.
I've tried to keep this as brief and simple as I can;

The drugs used during anaesthesia do have the ability to alter mood and change perception at the time of use. With the use of opiates, for example, this can be advantageous because it often promotes feelings of euphoria and relaxation.
Occasionally though the opposite is true and the patient can feel anxious, confused or tearful.
Currently, as far as I am aware, there is no credible evidence that there are any lasting (longer than 72 hours) psychological side effects due to anaesthesia.

But . . .

Many people do report feeling or behaving differently after surgery. (If you google this there are a hundreds of pages of people sharing experiences)
The accepted explanation for this is that it is unresolved psychological factors that are responsible.
Surgery is a deeply disconcerting experience. For a start, you wouldn't be there if there wasn't something very wrong. Illness and especially pain are enough to trigger low moods and anxiety. If you've been waiting a long time for the op there is a chance for the anxiety to build. Conversely the news that you require surgery might come very suddenly and be overwhelming.
You then have to put your trust in a group of strangers that are virtually speaking another language to you (medical jargon) you have limited control, often little information and the surgery itself can feel undignified and violating.
Our response to this? ''Oh don't worry, you'll be fine!"
It's no wonder that patients become emotional after surgery!
I'm not a mental health professional, so it's not my place to comment really, but I personally think some patients do go on to suffer post traumatic stress disorder.

I'd be really interested to hear a MHPs opinion/experiences of this.

duchesse Wed 29-Jan-14 10:39:00

I've had four in the last 6 years but they've all been fine- all of them about 1-1.5 hours long. I seem to react rather well to GA- I wake up feeling really perky and as though I've had a really good night's sleep. Some other women on my wards seemed to vomit a lot afterwards. So reactions can be variable I think.

princessalbert Wed 29-Jan-14 10:35:46

I had a GA 6 weeks ago.

As it was going to be quite a quick procedure - I believe that I had just a short acting anaesthetic.

I remember my arm hurting - feeling heavy - as the drugs went in. very strange.

When I woke up I was totally wide awake and perky. I was looking forward to a bit of snoozing, but it wasn't to be. I couldn't even sleep that night when I got home.

So, it just shows that there must be more types of anaesthesia than I thought.

ChestyNut Wed 29-Jan-14 06:57:24

Thankyou pursuit thanks

Does scholine allergy have a hereditary component?

InPursuitOfOblivion Tue 28-Jan-14 22:44:23

fairykisses there are pros and cons with both. For me, I find the risks of regional more acceptable. One of my mentors told me there is no way he would consider it for himself though, so it horses for courses.
I'm also a massive control freak, it doesn't make a difference really but I just feel more in control if I'm awake and not sedated.

1944girl Tue 28-Jan-14 22:37:06

Wednesbury

I know how you feel about GA for EMCS. Although it was awful not being able to see my babies straight away, the sections were life savers.

When I was a student nurse working in the theatre, one of the aneasthetists would always tell the patient that they would soon have a taste of garlic in their mouth then go to sleep.Most of the patients would look at him bewildered at the word garlic. This was in the 60s when alot of people had never tasted garlic!.

Best1sWest Tue 28-Jan-14 22:32:41

I was one of those children's who had GA in the dentist's chair 40 years ago. Terrifying. Had a proper hospital one for a laparoscopy and that was fine.

fairykissesforyou Tue 28-Jan-14 22:27:46

InPursuit

Thanks for your really clear answers and useful information.

Now I just have one more question, why would you choose regional over general anaesthetic for yourself?

InPursuitOfOblivion Tue 28-Jan-14 22:02:10

Everybody hates the cannulas!! I used to think patients were just being a bit whingey until I had one myself and then I understood.

Chesty- I wouldn't say lidocaine is routinely mixed with propofol but it is quite commonplace. There is evidence that lidocaine destabilises the propofol emulsion, although this does seem time dependant.
If you are allergic to scoline (succinylcholine) this is a BIG deal. Push for a test.

raydown this is a common side effect of the anaesthetic induction agent. Deeply unpleasant, but nothing to worry about.

I'll answer the questions about anaesthesia and emotions tomorrow if that is ok. It's kind of complex and I'm too tired to give a succinct answer!
If you've asked a question and I've missed it, I'm sorry! Pm if you like.
If you've got an op coming up and you do have questions it's probably wise to phone the department of anaesthetics and have a chat with them.

raydown Tue 28-Jan-14 21:16:35

Just after the anesthetic was injected I had a choking feeling in my throat. It was like a very bad taste/smell and felt like I couldn't breathe, no time to panic though because then I felt my eyes go heavy and I was asleep. What causes the choking/nasty taste?

Wednesbury Tue 28-Jan-14 20:59:51

Thank you very much StillNo and InPursuit especially for your answers and kind words. It being syntocinon or similar first time round making my heart race makes sense.

Although obviously the EMCS under general was not pleasant in that it was an emergency situation (though far worse for my DH I think!), I am OK with what happened under/after the GA. The quick action of all medical staff saved my DD's life and ultimately probably mine (they told me they had a 'decision to incision' time of 12 minutes). I know that I couldn't have got up to see her any sooner than I did or I would have, and it all felt very detached, but she is here and alive and well and so am I ... I am very, very thankful for modern medicine and to all those who practice it. It could have been very different. In fact it was the anaesthetist who gave it away to me that I was going under general as I heard him say 'I'll just get my GA gases mixed' or something and I thought oh right, this really is an emergency!

InPursuitOfOblivion Tue 28-Jan-14 20:47:55

Shouldnthavesaid I've got no idea what your anaesthetists were up to!!
Awake intubation is rare as rocking horse shit these days. It does happen from time to time but I've only seen it once when I was a student.
I've seen many difficult intubations where the anatomy is bizarre to say the least and it was always done using a flexible, fibre optic scope. Makes things much easier!
TBH given the choice I would also opt for regional anaesthesia over general myself, it's not for everyone though. And yes, opiates can be used. Some patients can feel rather . . . erm . . . Amorous shall we say? Others seem keen to reveal every detail of anything you would wish (or not) to know!

I can't really comment on dental procedures as I've so far managed to avoid that particular speciality. (Both personally and professionally.)
I know some dentists can give IV sedation. Wouldn't be keen myself!
When it comes to wisdom tooth extraction, I'm guessing, although I'd have to ask somebody else about this, that a reinforced, flexible endotracheal tube would be used and secured to one side.

QTPie Tue 28-Jan-14 20:36:37

Had my first GA just over 13 months ago and, like you, was VERY nervous...

It was absolutely fine and was actually like a nice nap. Everything was calm and had no anxiety before or afterwards.

Have had two heavy sedations (not far off GA) since and both were absolutely fine too smile

FruitbatAuntie Tue 28-Jan-14 18:53:31

Wednesbury - the stuff that increased your heart rate was probably Syntocinon (Oxytocin)

Yes, when I had my CS they said the same to me about my heart racing when they gave me the syntocinon - and it raced like mad and left me feeling very, very peculiar for a few minutes!

I have had 6, my most recent one 14 months ago. There really is nothing to worry about and the medical staff will be lovely, I have always had really good experiences.

14 months ago I had my gall bladder removed when my twins were just 7 weeks old. It was fabulous, I got to have 6 hours uninterrupted sleep after the surgery and was looking forward to it for weeks smile Even the nurses commented how much I had slept was disappointed when they sent me home, I wanted to stay the night

ToffeeOwnsTheSausage Tue 28-Jan-14 18:43:53

I have had two. Apparently I sold my youngest hmm.

I feel really off for a few days after, I am also allergic to something in it but never remember to tell them hmm and I would like to not have another ever.

I hope all will be fine for you.

shouldnthavesaid Tue 28-Jan-14 18:39:06

Eau they are awful, last op I had I needed to shower the next morning but was still not feeling great. Stumbled into the shower and somehow I yanked it out. I remember looking at the blood, muttering that there was a lot (made worse by the shower water) and pulling the alarm. Landed up on the floor shivering and wrapped in a towel with the nurses telling me I'd fainted.. I never thought they would hurt but they do, it's a weird naggy pain.

Laura I had a psychiatric reaction not to the anaesthetic but to the sedative they gave me - had the same as a child. Both times I apparently became very aggressive, had to be restrained. I had flashbacks of the most recent time and can remember shouting at the doctor telling him I knew he was poisoning me, I threw an oxygen mask at him as well and I think I pushed one of the nurses out of the way when she tried to give me a hairner. Needless to say I'm not allowed sedation apart from extreme circumstances - and even then they'd apparently try gas and air etc first.

LauraBridges Tue 28-Jan-14 18:09:02

I've never had one.
Is it true that sometimes in rare cases the patient wakes up with a bad mental state, a sort of adverse reaction? I have read a few accounts of that.

EauRouge Tue 28-Jan-14 17:55:54

I had my first and only GA a year ago. Best 2 hours sleep I've had since 2008. When I was coming around, I heard a nurse say that I'd just been in surgery and I replied woozily 'what surgery?' grin

The worst thing was that damn cannula, they're so uncomfortable. I just wanted to rip it out afterwards when I was in recovery.

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