To be scared of anaesthetic?

[TrueFriendsStabYouInTheFront]

I am having an operation at the end of October and I keep getting cold feet as I'm so scared of the thought of anaesthetic. Please tell me IABU and that all will be fine!

Could I ask for your experiences if you've ever had surgery?

@Butchyrestingface - I have to have regular endoscopies (camera down the throat to look into the stomach), which only involve sedation rather than a GA, but I hate having them done as I always vom as the camera passes down my throat so I always ask for the absolute maximum amount of sedation and warn them "I will fight you!" I literally have to have my arms pinned down as I claw at my face trying to remove the mouth guard and camera and then start hitting out at those around me when they stop me.

I am 5' 3" and about 7.5 stone, so who I think I'm going to hurt I have no idea, but I always warn them, just in case!

@TrueFriendsStabYouInTheFront - I've had 3 GAs, one as a 9 year old (no recollection) and 2 in the last year. The first was as straightforward as most PPs have described and the second only varied slightly in that I started to regain consciousness (bloody hell, that took me 3 attempts to spell correctly, must be bedtime!) about 2 or 3 seconds before the breathing tube was removed from my airway. I tried to breathe in, but couldn't because of the tube in my throat (it's an odd sensation and very hard to describe - it's like you're trying to breathe through your wide open mouth, but with a straw down your throat... nope, doesn't make a lot of sense to me either!) My adrenaline spiked and I felt a huge panic, then almost immediate relief as the tube was slid from my throat and I reflexively took a breath.

I've got surgery scheduled for Jan/Feb next year when my Gastro Surgeon is going to remove my stomach . In spite of that moment of panic when waking up from my latest GA, I have no concerns about going under again (in terms of the GA - the surgery itself terrifies me), as I have discussed what happened with my Drs (and will mention it again to the Anaesthetist on the day), so they will be making doubly sure that it doesn't happen again.

In my experience, Drs, Anaesthetists, Nurses and Surgeons have all been willing to listen to and consider any concerns I have and will take all the time you need to explain things and help to allay your fears. I wish you the best of luck for your operation and huge success for the exciting changes ahead for you!

Miljah there is really no need for that snarky patronising post.

It's perfectly normal to be anxious about a GA. For anyone.

I've had 20+ general anesthetics and also had my entire stomach and duodenum removed through illness so a similar but much larger operation. The anaesthatist will talk you through everything he's going to do and the pp saying you have no conscious passing of time are right. Good luck. x

I have a massive fear. I needed an emergency appendectomy. After they put the mask on and began the gas, I was drifting off and the nurse pushed down on my throat. I felt i couldn't move or breathe.

Since then, I'm terrified of GA. Intellectually I'm aware I'm safe, I just can't control it. I always discuss it with my carers if I require GA and I tend to get strong pre-meds. Lol.

Sometimes they use a disinfectant before the procedure, it’s a yellowish brownish colour. Depending on what you’re having done, this gets all over the sheets like you’ve crapped yourself, don’t be alarmed by this. It is quite comical looking at the horror on some people’s faces as they see it for the first time thinking that they shit the bed . See op it ain’t all doom & gloom at hospital.

You’ll be fine. Modern anaesthesia is very safe and as someone’s already said, you’re more at risk driving to the hospital than you are in theatre.

I do agree with Miljah about not asking for specifics - unless you’re a trained anaesthetist, in which case you would know not to ask anyway. Definitely don’t ask for “a child sized tube” - there are different sizes of tube for different sizes of children. You want the appropriate tube for an adult human female which is going to be a 7. For obesity surgery you definitely don’t want a narrower one (basic physics - pressure, flow, volume considerations).

I wouldn’t use gas to get you to sleep either - everyone gets a cannula - but definitely not for obesity surgery. It’s far safer to have the cannula in first. I haven’t used gas anaesthesia for years, even in children.

I make all my patients 3 promises - they will fall asleep, they will sleep all the way through and they will wake up at the end. I make no guarantees regarding pain, or nausea (though I obviously try) but I promise those 3.

I have had two major and couple of minor ones .
OP i was terrified mainly the major ones but i came through fine .Please tell the anesthetist when they come round to see you before hand .Mine were just amazing each time put my mind at rest , one came back soon as he was told i was awake just to see me because i was pure bundle of nerves before hand, he was really lovely .I did get better with each op and if i needed one now fingers crossed i never do i would be fine .I remember one i had blinding migraine i went to theatre come round migraine gone so best sleep i ever had .It is a normal fear op but it is done everyday and anesthetistist are well used to nervous people so you will be fine .Good luck .

It’s always fascinating to see what people believe/remember about anaesthetics....hope that a few of these points based on the op/other peoples’ responses may be useful...

For bariatric surgery as someone’s already said, it will be an IV induction (and quite possibly iv maintenance rather than anaesthetic gas/volatile) but there will be an oxygen mask to breathe through going to sleep.

They don’t ‘pump carbon dioxide into the stomach’, they inflate the peritoneum (the space outside the abdominal organs) and that gas is absorbed into the blood and mainly removed from the body via the lungs (ie it’s largely exhaled not farted) over a short period during & after the surgery. Guts generally don’t like being poked & prodded & can stop/slow down for a while after an operation and that can contribute to a feeling of trapped wind/Olympic level flatulence post-op!

The shoulder pain is due to the (slightly bizarre) plumbing if the nervous system - the shoulder tip & diaphragm’s sensory nerve supply is shared. CO2 dissolves in fluid to make an acid which is irritant (and while the surgeons to release as much gas as possible before closing the holes and the rest is absorbed into the blood fairly quickly there’s always a little bit that manages to get left behind & can take a few days to absorb). Blood is also very irritant and can contribute to diaphragm irritation (but again the surgeons wash as much out as possible before closing).

There will be a breathing tube for almost all laparoscopic surgery and certainly for bariatric surgery.

In emergency surgery and some elective operations it’s a normal part of the anaesthetic induction to press on the front of the neck. Most people don’t remember it, but some do & while it can be uncomfortable it doesn’t mean something’s gone wrong (most anaesthetists would warm you though if they thought it was necessary to use this technique).

Anaesthetists/ODPs/recovery nurses are generally nice people and quite reassuring, and will have seen people in all the various stages of terrified before. We’ve also seen most of the different stages of chatty/angry/disinhibited in the recovery room too and are really quite hard to surprise!

Hope some of that is useful & the operation goes well.

I had a GA four years ago for knee surgery. The anaesthetic was a doddle. Blink and you're back.

I'd advise being very cautious with your intake to begin with as I didn't feel at all unwell but that didn't stop me spectacularly vomiting after a good lunch.

@Greybeardy that's really informative thank you!

Ask for a pre med. I had midzolam which was like being happily drunk. They were trying to reassure me about the needle and I was "I'm not scared of the needle, it's the anaesthetic!!"
Honestly I was terrified and it was fine. Turns out I react well to anaesthetic, I spring awake after and then don't sleep for 36hrs as I'm wired. And also get very hangry

Only 1 GA and I was terrified.

Utterly unfounded. I remember ‘going’ and waking up. I felt slightly dizzy as I came round but was fine very soon afterwards and went home that evening.

I also ask for as much anti sickness as possible as I have emetophobia
When I say ask, I don't mean demand but I ask politely and it's never been refused. Every anaesthetist I've had has been brilliant and the staff afterwards are always amused how quickly I come around and ask when I can have a cup of tea tea is life

I was terrified of having a general, I'd had a lot of dental issues & had twilight sedation loads (which is great).
Anyway I would actually opt for general again next time, it was a really relaxing experience, the team were amazing.
Don't worry at all about it.

I cried my eyes out for an entire day at the hospital before having general anaesthetic. Kept apologising for my behaviour. Paced the floors. Was utterly riduculous. Had to be sedated, which wore off anyway before the op.

It was for nothing! The "fear" of the unknown.

I was more than fine! Had the anaesthetic and felt like three seconds later I was woken up by a nurse.

Operation over.

You'll be fine!!

I wouldn’t use gas to get you to sleep either - everyone gets a cannula

I'd wondered about this, @HicDraconis, since several said they've been inducted with gas. Is it still possible, do you know?

I realise it's pretty stupid of me, but it's just that I've got a real horror of needles ...

I’ve had a couple of emergency surgeries so not really worried about the anaesthetic side of things but I had a planned surgery earlier this year and was petrified.

The anaesthetist was really nice, she told me I was healthy and didn’t have any reasons I would be at risk for anything going wrong. When they took me into the pre surgery room bit and hooked me up they did have to give me something to calm me down. I was worried and anxious, I think it’s only natural really.

When I woke up I was so happy I cried 😂

I had a general anaesthetic last year and I felt exactly the same as you. I even burst into tears as soon as the anaethastist (sp?) came round and introduced himself.

The staff were wonderful and really reassuring and obviously woke up fine. You'll regret it if you don't go through with it.

I've never had any problems with GA. The only awareness I have is that the ceiling seems to slide away, but before I can comment on it, I'm asleep. Not unpleasant at all.

Waking up is like being woken from a deep sleep. At that point I do wish the nurses would let me sleep, but they're as persistent as my mum getting me up for school. Unlike my mum, they then let me doze off again.

I've never felt sick from a GA. But I'm a bit of a silly for several days until it works it's way completely out of my system.

I like it when the surgeon tells me exactly what I will feel, where I will be etc when I wake up. Because there's absolutely no awareness while you're 'under', it feels instantaneous. So this pre-knowledge gives you something to recognise so you know the op is over.

I've had a GA 4 times, each time I was out like a light and when woken up in the recovery room by lovely nursing staff telling me "you're all done". The GA made me cry lots, but that was just the medication. I felt a bit away for the fairies for some time after, but as you, I was petrified 1st time round, but was really put at ease. Good luck!

@Puzzledandpissedoff gas induction is possible in some circumstances, but it’s usually much smoother and often safer to do an IV induction, particularly in adults. Gas induction is contraindicated in some circumstances (largely relating to the risk of inhaling gastric contents or if there being difficulty managing the airway/breathing). Everyone eventually gets a cannula whether or not it was a gas induction because a) there’s usually quite a few more drugs than just the induction agent to give and b) because if an emergency arises during surgery then that iv access will be needed quickly. Hope that helps clarify.

@TrueFriendsStabYouInTheFront - I wanted to share because I have a condition that actually makes anaesthesia a bit dangerous and I had to have surgery this January, and it was completely fine. Anaesthetists are incredible professionals. But still, I was so shit scared on the way to the hospital that I asked my DH if we could go to the airport instead

When I got there, I got worse. I was SO nervous; good Lord. But the anaesthetist was AMAZING. I’ll remember him probably forever. They’ve seen everything, they prepare for everything, and they are there for the entire surgery monitoring you carefully, doing nothing but watching all your vitals and giving you the right meds to keep you safe and asleep. That’s their only job - watching and monitoring you.

I came through with flying colors, and I’m a more difficult case than almost anybody I know my age. Also, when I came to, I was so grateful for how kind the anaesthetist had been, that apparently... I was telling everyone I loved him. And my MIL took video

Anaesthetists really have trained for it all. You won’t even know you fell asleep and then you’ll be waking up (and yes, it does feel strange). Oh, and about the throat tube - in all my surgeries, they’ve never put it in until I was already asleep, and it’s been taken out before I woke up. BUT before I had surgery, they did ask about all my teeth and if I had any tooth issues, so make sure you do tell them you have a wobbly one!

Good luck, OP. You’ll wake up from anaesthesia having taken a huge step to take control of your health and your life. Be brave!

Thank you very much, @Greybeardy - that all makes perfect sense

I’m a retired anaesthetist, and I can assure you that none of us want to have patients dying under anaesthetic. The paperwork would be horrendous!
Joking aside, the time that you spend in theatre will be the most closely monitored and looked after of your whole life. Every breath is controlled, every heartbeat monitored, your blood pressure continuously checked and displayed on screen, your oxygen and CO2 levels ditto. We are there with you for the whole procedure, making sure that you’re stable, and we don’t hand you over to the recovery nurses until we’re happy.
We spend five years training as doctors and then another two as juniors before even starting a further seven years or so of specialist anaesthetic training and further exams, to become consultant anaesthetists. During all that, we pretty much get the hang of keeping people alive!
Don’t fret, OP. Trust the anaesthetist to do her job, the same way I have to trust the pilot when I get on a plane. Afterwards you’ll just be very relieved and wonder what you were so frightened of! Best wishes for a speedy recovery.

@puzzledandpissedoff it depends on the anaesthetist. I won’t use gas to get anyone off to sleep these days, or to keep them asleep. Partly for environmental reasons - the volatiles are all greenhouse gases - and partly for physiological reasons - the IV anaesthetics seem to be associated with less brain cell damage, and lower cancer recurrence rates (and most of my case load these days is cancer).

One of the trickiest parts of any anaesthetic is the small window of time between getting someone to sleep and getting the breathing tube correctly positioned. If there are any problems during this that may need immediate medication to sort, then it’s safer to have the drip in already.

If I have to breathe someone off to sleep, then put the drip in, then put the tube down, this time period is longer and it leaves the airway out of my hands longer. It also means I have no way of rapidly responding to things the way I would if the drip was in before you went to sleep.

Some of my colleagues still use volatiles, some of them would still use them for induction. I don’t know any that would use gas for someone over around 13-14, but there is probably someone out there that will.

I do have patients with absolute needle phobia and each one is managed differently depending on the background. Numbing cream helps for some, putting the drip in away from theatres and then bandaging it over helps others, a support person in theatre with them until they go to sleep can help (far better for you than a sedative premed, although I use those too as a last resort). I have a script, sort of, which is mildly hypnotic, and I play whatever music the patient really likes. From hymns to Metallica! They watch music videos on an iPad or movies, whatever, as distraction therapy if they prefer, and they get local anaesthetic before any cannula of any size - and most of them don’t realise it’s happening until it’s in (I do tell them but they’re more relaxed and don’t realise it’s in until I’m putting the dressings on).

With children - numbing cream beforehand, sitting on a parent’s lap in theatre with one arm behind the parent’s back, cartoons on the iPad, drip in when they’re not looking. Again, telling them what I’m doing but using appropriately non scary language. They tolerate it very well.