To trust that General Anaesthesia is safe?

[perceptionreality]

A friend of mine is consumed by the idea that a GA is not as safe as we are told.

He says his mum is a nurse and has seen more than a few people die of a GA when they were otherwise healthy with low risk factors. He is adament that any procedure he has will be done with a local anaesthetic.

Personally, I'm glad he didn't say any of this before I had my operation a few weeks ago. Both times I had a GA I found it a pleasant experience in terms of immediately before and after.

And GAs are far more refined and modified than many years ago aren't they? What do you all think?

This thread has made me realise though, that there was nothing at all in my mums medical notes, or on her death certificate, that alluded to the GA being in any way related to her death. So, is it possible that the problem is more common than statistics would have us believe?

I should add, my dad had 3 very major ops, (one of them which took 13 hours) and had no problems with the GA at any time. (He died due to medical negligence though too, so forgive me if my faith in the system is somewhat tainted).

Wow

YANBU

I have had about 8 or 9 I think. The longer you are "under" the worse the after effects IME.

Also my mum was an anaesthetist and a. it is v unusual for people to die as a result of anaesthetic (though can of course happen there are risks with everything) and b. she never called herself a "gasman" (how bizarre)

local anaesthetic does not work on inflamed tissue, inflamed tissue is too acidic.

My DH is an anaesthetist - it is extremely rare to die from having a GA. Those that do tend to be very old, obese, or have a pre-existing condition.

The negative after-effects that other posters have mentioned above are caused by the actual operation, not the anaesthetic. The drugs which put you to sleep are out of your system very quickly.

Your friend should consider the risks of the alternatives. No drug is risk free.

I broke my ankle 10 years ago. Like your friend I was terrified of the risks of GAs so asked fir my pins to be inserted under a spinal block. Spinal block uses morphine and five mins after it was inserted I had a massive allergic reaction. For me a GA would have been safer. Have had two GAs since with no problems, no side effects and no after effects. That's just me but it illustrates the danger of blowing up one set of risks and not realising all our choices carry risk.

I have had six general anaesthetics- and bizarrely quite enjoy them! The anaesthetists are always lovely and chat for a long time- and make sure I don't get bad reflux.

I had a wound irrigated under local anaesthetic- and the injections were so painful I started crying. I also had a gastroscopy under 'twilight sleep' and founf that to be a horrible feeling- you can feel the procedure but it's like it's miles away and you feel stoned for about three days after.

What is 'twilight sleep'? The main positive thing about a GA is that you literally lose the time of the operation. You're asleep, then you're awake. It happens so quickly you wonder if they've done it yet!

Clearly there have been some bad experiences for people on this thread though. But my friend said that his mum had seen several cases of people dying where they were not obese, very old or having another condition already. I don't know what he'll do if he really needs one, one day.

Your friend might change his mind after an experience like mine the other week: 50 minutes of cutting and poking with no effective pain relief because, as quoteunquote pointed out, local anaesthetics don't work on inflamed tissue (and in my case there was simply too much pus in the way).

After 50 mns the doctor gave up because she said the rest of the infection was too deep down. But if we hadn't had the option of GA, I would have had to put up with it. It was not pleasant as it was.

My mother was obsessed with this, she used to rewrite & widely distribute her will every time she needed an operation (she needed quite a few). It was amusing to watch her change her mind with each revision!

She died of smoking-related diseases in the end, of course.

I think most medical professionals are so aware of the risks that they would only suggest it when benefits out-weighed the risks.

A frequently quoted figure is 1 in 100,000 people undergoing general anaesthesia will die as a result of the anaesthetic. So a very low risk. Obviously for some the risk will be higher and regional (such as spinal or epidural) or local anaesthesia will be used. As for keeping an eye on them during spinal - erm, no IME people are generally sedated (not for this reason, honest )

IMO it is those who try to terrify other people with anecdotes who are BU.

As a dentist I get it time and time again so for Drs & anaesthetists it must be so much worse.

There's no story in: " I had my wisdom tooth out, took two minutes & didn't hurt at all". Much better to say to your friends some rather fantastical story which unnecessarily worries them sick.

Do you really think that in the presence of approximately ten people involved in even the smallest theatre procedure, Things are sufficiently bad that you need an observer to make sure they behave themselves?

OP YANBU, your friend or whoever started this silly story is BU.

Yep, I do think it is that bad and yes I would like an independent observer if I had an op under ga, #grumplestiltskin#
Not that I think there's any chance of that but if it was an option I would most definitely take it
No chopping off the wrong leg, taking out the wrong kidney or covering up medical malpractice that way

Just scrolled back a bit to see what you were talking about mercibucket.

I am very shocked by what you said about your son - you chose the most traumatising method of treatment for him because you didn't want to feel guilty?
I'm really shocked. I mean, I'm a pretty meany mum but even I wouldn't do that.

YY sardine

I administer anaesthetics several times a day, but on animals. I firmly believe there is a risk with every anaesthetic, but it is very very small. I also believe there is no such thing as a safe drug only a safe anaesthetist. Experience is very important, but when things do go wrong well rehearsed protocols are what saves lives. Even in my small veterinary clinic we practice our emergency protocols so that when things go wrong we all fall straight into our roles. Human anaethetist take it to an even higher level than us and even though I have been as sick as a dog after every one of the anaesthetics I have had I trust them completely even on one occasion with my 5 month old DD.

Hang on mercibucket pointed out that the person who would have been doing the GA wasn't an anaesthetist, I'm pretty sure I wouldn't agree to that either.

We've had the opposite with ds1 - in that he's had to miss out on various medical procedures that were needed (x ray to check for a broken ankle, MRI which might have provided some information, blood pressure testing when kidneys were potentially playing up) because the only way of carrying out the procedures would have been to give him a GA and the docs were not keen to do that.

In the case of the possible broken ankle, the consultant was initially going to be cast anyway until he realised getting it off would require a circular saw, and that would have needed a GA. They decided to leave him and presume the ankle would get better without casting whether broken or not.

Point being there isn't a set of rules really in medicine, variation in typical treatments can be used on an individual basis. DS1 for example is never given numbing cream before a blood test because it's thought that the feeling plus the waiting for it to take effect is likely to be more traumatic than restraining and getting on with it.

ive had 6 GAs. I love that feeling you get going under.

not as keen on the day 4 blues afterwards, but i think theyre as safe as can be. Youre well monitored all the way through

Safe for most.

However I have malignant hyperpyrexia so it wasn't exactly great fun for me.

Its a risk/reward thing isn't it?

For us the only time I have ever had to make the decision was for DS1. He needed surgery to correct talipes.

The anaesthetist was excellent, explained the risks and the decision was left to us. We decided the risk from the GA was more than balanced by the reward of him having a 'normal' foot.

Would I have one for shits and giggles? No, but if something is serious enough to need you to be out for it then I think it is worth the risk.

I've anaesthetised thousands of people (have been an anaesthetist for 12 years) and I've seen less than 5 deaths on the table, all related to surgical complications.

Any medication carries a risk of severe reaction and with a GA we tend to give several different drugs (to make you sleep, painkillers, anti emetics in a basic one) so there's always a risk of reaction. Anaphylaxis isn't common but I have seen maybe 3 cases in my career, all of whom survived although with an unintended icu stay.

Oh and I've never called myself a gasman either.

XXXOOXXX - you're a special case :) thankfully there aren't many of you around!

(MH - extremely rare, inherited reaction to the gas anaesthetics and some other drugs for anyone without access to google. There are still some agents that can be used but you could potentially have a reaction even with a trigger free anaesthetic. Like I said - special case and thankfully not common)

(unless you live in Palmerston North)

Iteotwawki thankfully !! I am also allergic to suxamethonum & Attracurum ...and still lived to tell the tale (after being given GA aged 8).

I've had 5 GA's and have lived to tell the tale! Unfortunately I get very sick after them and the only thing that helps is a drip as I can't even keep water down and get very dehydrated and even more sick IYSWIM. I know this now from bitter experience and was able to ask doc last time to write me up for a drip to save me hours of vomiting while a junior doctor was located to authorise me one.

Only bad experience was when one idiotic anaesthetist didn't give me any pain relief in theatre so I woke up in agony, poor nurses in recovery then panicked and gave me enough morphine to bring down an elephant which added to the sickness and meant an extra night in hospital as my blood oxygen got very low. That was definitely a one off and the other 4 times I woke up completely pain free and bounced home fairly quickly.

Not sure what the actual statistic is, but even the low sounding risk of 1 in 100,000 probably means a death a day in the UK (assuming something like 100,000 GA's in UK every day), or maybe every second/third day if slightly fewer GA's and some of those complications are saved, rather than dying from the reaction. But your chance of being hit by a bus is surely higher (especially around London ).

There are risks to a GA, and certainly risks of local would be lower... but you're hardly going to be offered local for open heart surgery are you? And not operating carries a risk too.

As does eating, drinking, having babies, walking up/down stairs etc etc.

Yes there is a risk, yes sometimes you need to be brave and do something that is risky in order to live... and sometimes things go horribly wrong. But that mosaic is called life, and to eliminate risks would be to sit in a padded room and never experiencing life.

That said, my parents (drs) always choose their anaethetist first and their surgeon who works with them second - easier to reset a bone (or whatever) than undo a anaesthetic mistake.