When Anesthesia Fails

Let'sgoflying!

Let'sgoflying!

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Dave Taylor
There was a tv show called this, on about 2 years ago iirc, involving people who claimed they were wide awake and feeling everything during their (ostensibly, very painful) procedure. The thought was that the paralytic drug was working just fine (they could not move or talk, to signal anyone of the problem), but the cns depressant that should have made them insensitive to cutting, tearing etc was not working at all for some reason. I sort of watched with bemusement, skepticism etc.
Late last week a friend of mine (a dvm too) from a neighboring town (perfectly sound mind, was working and alert right up to the time of his operation) underwent a single bypass and pacemaker implant. He did ok but as he was waking, they noticed rapid heart rate and sweating, bug-eyes etc - he could not talk or move much til the paralytic wore off completely and the et tube was pulled. When they pulled it he was finally able to tell his wife and the staff that he was wide awake during the entire surgery, could relate conversations during the surgery, music etc and of course, a few hours of agonizing incisions through unanesthetized skin, sawing of breastbone, that sort of thing. Last I heard, he thinks they are going explain it away by saying he dreamed it.

What about that?
 
Like a nightmare, only real. Oy!
 
we may have identified a hospital with a problem. (I think most are excellent care providers.)
Story this pm is, they told him firmly no leaving the bed to use the bathroom; must have assistance. So he rang and rang and rang and rang the bell for >20 minutes and had to pee in the bed finally. :(
Later, they said Drs orders are pain meds q4h...so 4:30 passes and he is getting uncomfortable and no nurse - so he calls one. "Well, we'll see", pretty casual attitude. Bad pain and still no meds, the evening drags on - finally they acquiesce.
 
I've never had a patient complain of remembering the surgery during a general anesthetic. Even with paralysis, there are other physiologic parameters that can be followed for depth of anesthesia. Heart rate is one thing, pain will usually cause a tachycardia. Heart surgery would probably be the easiest one to under-sedate because the heart is stopped so heart rate obviously isn't reliable. Even so, the amnestics that are given during surgery are so good it is difficult to remember anything even if you were awake. We do lots of surgeries with IV sedation and local anethetics(Lidocaine shot). Technically, they are awake, they just don't remember that they were.

Barb
 
Let'sgoflying! said:
we may have identified a hospital with a problem. (I think most are excellent care providers.)
Story this pm is, they told him firmly no leaving the bed to use the bathroom; must have assistance. So he rang and rang and rang and rang the bell for >20 minutes and had to pee in the bed finally. :(
Later, they said Drs orders are pain meds q4h...so 4:30 passes and he is getting uncomfortable and no nurse - so he calls one. "Well, we'll see", pretty casual attitude. Bad pain and still no meds, the evening drags on - finally they acquiesce.
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Sadly, I know of one in a major metro area that left me with the impression of being much the same way. The staff was way overtaxed and didn't do a great job. At least they got the meds pretty close to on-time, but were quite unresponsive on other basic needs. Just my opinion.
 
I had one pretty long operation many years ago, and I did dream while I was under the anesthetic. Good dreams, actually (almost all of my dreams are good, or at least neutral). Have had several other surgeries and didn't dream during them, so that one was unusual.

No pain, thank god, at least not until waking. I can't even imagine what that would be like.

Even very good hospitals can seem bad from the point of view of the patient. My husband was in an ICU for ten days a few years ago. I had to be his advocate the whole time, even though the ICU nurses only had two patients each. They were responsive to his concerns, though, but I had to talk to them myself, as they weren't really listening to him.

Judy
 
I was a Cardiac Anesthesiolgist for some years. One uses a TON of narcotic, like in the range of 1-2000 milligrams of morphine equivalent, because it does not depress the heart like the slam-bang gone-pow awake stuff.

But recall is possible. The ones that I've interviewed all say there was no distress (hurt, pain, etc) but they were/are very disconcerted by the awareness.

Opening the heart is near the technical limit of anesthesiology. Really. There is a celebrated Virginia Mason Clinic case in which there was awareness- despite the continuous brainwave fourier analysis monitor that indicated a hypnotic state.
 
I have a clear memory of my tonsillectomy when I was 6 (this is the mid-70s). I clearly remember dreaming that I was eating the world's largest pancake.

That's it - and it was only subjectively 2-3 minutes long through the whole operation.
 
MSmith said:
I have a clear memory of my tonsillectomy when I was 6 (this is the mid-70s). I clearly remember dreaming that I was eating the world's largest pancake.

That's it - and it was only subjectively 2-3 minutes long through the whole operation.
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Believe it or not I was awake during my tosillectomy. The surgery was conducted about 25 years ago and they were afraid to put me under due to me being a diabetic.

Glad things have progressed since I've had 5 surgeries in the last 7 years and have been put under each time.:yes:
 
i took the knock out laughing gas for my wisdom teeth. was probably one of the top 10 enjoyable experiences of my life so far. waking up with cotton balls in the mouth wasnt that pleasant, i took them out, then the nurses scolded me. Now that Im over 21, I recognize that I was at the equivalent of a LOT of beers at that point.
 
anesthesia - one of my most unpleasant experiences. I've gone under 3 times in my life... waking up is horrible for me. I am aware of everything around me in the recovery room for over an hour (timed by my wife) and am unable to respond - like I'm paralyzed. The first time really upset her, as the nurses told her "he's starting to wake up - go ahead and pull the car around and we'll have him at the door waiting for you" ... 15 minutes later she parks again, comes in to find out I'm "still not awake" ...

She was prepared for this the next couple of times, but it truly sucks. It's like having a nightmare that you can't wake up from, can't shout for help, can't run away from ...
 
bbchien said:
Wrong kind of anesthesia, Greg....that sensation is needless and can be engineered out.
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Well, Doc, that *good* anesthesia was just not on his insurance plan.
 
fortunately I had the middle grade insurance plan. Basic plan had two choices of anesthesia; baseball bat or ballpeen hammer...

glad to hear it can be corrected - if I ever have to be put under again, I'll make sure they review my files and use something else.
 
Fortunately, I have only been put under twice in my entire life. Once was as a child for tonsils. I don't remember a thing about that one.

Many years later I broke my ankle and had to have it pinned. I woke up for a few minutes during that sugery. I can tell you that they hammer in the pins! I can also tell you about the conversations. It wasn't a dream. I remember the conversation word for word. I am friends with some of the hospital employees including the head nurse who verified everything with me later.

It was very strange because I was fully aware of everything, but I felt no pain for the first time since the accident. I was in no distress at all. I was only awake for a few minutes. The doctor looked at me and must have realized that I was awake. They put something else in the IV and the next thing I remember is being on a stretcher in the hall feeling very cold. The nurse covered me with a very warm blanket and I dozed back off. My next memory is the recovery room much later.

Since I know nothing about medical "stuff". I can only conclude that they must have been using the minimum sedatives required, which I suppose is prudent.
 
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This is not a rare occurrence. My father, a neurosurgeon, makes it a practice that no one ever speaks a diagnosis or lab report out-loud, because people have been known to wake up and know what the biopsy results are.

Personally, I've been under general anesthesia once, and had no issues with it. Woke up just like waking up from normal sleep, of course I might have fallen asleep on my own, since I didn't sleep that well the night before....


Having worked at a vets office for several years, I've also watched different animals go under general anesthesia, and their reactions can be interesting to watch. Several times I've been under the impression that the dogs and cats were hallucinating, the doctor used a valium/ketamine mix as the initial knock out, and I suppose that would do it. We would keep them out with isoflurane, but I don't think thats known to cause hallucinations.

Always made me wonder though, what would a dog or cat see when its hallucinating?
 
Let'sgoflying! said:
Late last week a friend of mine (a dvm too) from a neighboring town (perfectly sound mind, was working and alert right up to the time of his operation) underwent a single bypass and pacemaker implant. He did ok but as he was waking, they noticed rapid heart rate and sweating, bug-eyes etc - he could not talk or move much til the paralytic wore off completely and the et tube was pulled. When they pulled it he was finally able to tell his wife and the staff that he was wide awake during the entire surgery, could relate conversations during the surgery, music etc and of course, a few hours of agonizing incisions through unanesthetized skin, sawing of breastbone, that sort of thing. Last I heard, he thinks they are going explain it away by saying he dreamed it.

What about that?
Click to expand...

I believe him. My ex girlfriends dad was an anestesiologist and he was telling me about it happening to a patient he had. When the guy came out of the paralytic, and Rus checked on him, the guy said "That surgeon is bloody rough with a knife!" He said he was always amazed he didn't get sued for that. I imagine it happens more than we suspect that people wake up or don't go under. Luckily, when I went under, I went under...
 
There's a 78 year doc in these parts, who had EIGHT children all of whom are docs. They all work at the Hopedale Medical Complex in Hopedale IL. Dr. AL as we call him, recalled to me that when he hit general practice in 1949 (!!) Novocaine had just become commonly, commercially available. That means, the then to-him old time docs would simply say "this is going to hurt a bit...." and then "YEOW!!!!".

This is all within a lifetime.
 
bbchien said:
There's a 78 year doc in these parts, who had EIGHT children all of whom are docs. They all work at the Hopedale Medical Complex in Hopedale IL. Dr. AL as we call him, recalled to me that when he hit general practice in 1949 (!!) Novocaine had just become commonly, commercially available. That means, the then to-him old time docs would simply say "this is going to hurt a bit...." and then "YEOW!!!!".

This is all within a lifetime.
Click to expand...

That was Dad's method of giving stitches to teach you to be more careful...:eek: :eek: :eek:
 
When my niece went under for a bone marrow biopsy about 3 years ago (I think 3, not sure, it seems so much longer), when she came back out of her anethesia, she woke up swinging, and punched one of the nurses right in the nose.

When the doctor heard, he thought it was funny. My moron brother in law thought it was bad behavior that should be punished. I hate that guy, sometimes I wish....well. Sigh.
 
I canNOT imagine what sort of an a-hole one would have to be to PUNISH a child, fighting for her life, for behavior that came about while she was regaining consciousness from anesthesia. :mad: But one would have to be some sort of huge, flaming jerk to do that. :yes: Your sister stood up for the kid, I hope! :eek:
 
bbchien said:
and then "YEOW!!!!".
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Around here (well...home - I'm in Montana right now), they call it "brute-i-caine" when they just physically restrain you without drugs to do "minor" procedures.
The nerve block didn't work when they tried to cut my thumbnail off a few yrs back (agonizing blood blister) and I involuntarily sent the entire staff sprawling, tables and instruments clattering to the floor. (it is a form of chinese torture, I believe) Finally talked them into some narcotics.
Its the Wild West out here, ah tell yuh!
 
etsisk said:
I canNOT imagine what sort of an a-hole one would have to be to PUNISH a child, fighting for her life, for behavior that came about while she was regaining consciousness from anesthesia. :mad: But one would have to be some sort of huge, flaming jerk to do that. :yes: Your sister stood up for the kid, I hope! :eek:
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Yeah, the whole family did, including the doctors. I don't like the guy. Before she went in for the surgery, she was scared (obviously) and didn't want to go under anesthesia, and that jerk told her "You do not want to be awake for this Erin, its gonna hurt."

I almost knocked him out right there.....Just thinking about this is getting my blood boiling again. Why my sister is still with that guy, ugh.
 
Let'sgoflying! said:
Around here (well...home - I'm in Montana right now), they call it "brute-i-caine" when they just physically restrain you without drugs to do "minor" procedures.
The nerve block didn't work when they tried to cut my thumbnail off a few yrs back (agonizing blood blister) and I involuntarily sent the entire staff sprawling, tables and instruments clattering to the floor. (it is a form of chinese torture, I believe) Finally talked them into some narcotics.
Its the Wild West out here, ah tell yuh!
Click to expand...
Dave - I would have suspected they would have at least tried the John Wayne anesthesia... shot of redeye, bite on this bullet or leather strap, and yank that puppy right off. Cauterize it with a branding iron and you're back in the fight!
 
Let'sgoflying! said:
Around here (well...home - I'm in Montana right now), they call it "brute-i-caine" when they just physically restrain you without drugs to do "minor" procedures.
The nerve block didn't work when they tried to cut my thumbnail off a few yrs back (agonizing blood blister) and I involuntarily sent the entire staff sprawling, tables and instruments clattering to the floor. (it is a form of chinese torture, I believe) Finally talked them into some narcotics.
Its the Wild West out here, ah tell yuh!
Click to expand...

I take it from that display of strength that you are in a large animal practice. :p
 
I had all of my wisdom teeth out about 3 years ago now.

It was, hands down, one of the eeriest experiences of my life. I was awake, gassed up, pumped full of painkillers (local and IV), and a bit of Xanax due to my, ahem, aggressive nature at the dentist (when I was a kid, I had to be restrained when they plucked tartar out of my teeth)

I remember looking out the window at the beautiful maple swaying in the breeze, looking around the room, quite relaxed, as the doc snapped my teeth out (they were past-horizontal impacted in my lower jaw) in three pieces. On the last tooth, he didn't have enough leverage, so he swapped sides and grunted loudly. I still have nightmares from that; at the time I couldn't be bothered, but now I have this detached fear of having that happen without being able to control it.

Cheers,

-Andrew
 
SkyHog said:
When my niece went under for a bone marrow biopsy about 3 years ago (I think 3, not sure, it seems so much longer), when she came back out of her anethesia, she woke up swinging, and punched one of the nurses right in the nose.

When the doctor heard, he thought it was funny. My moron brother in law thought it was bad behavior that should be punished. I hate that guy, sometimes I wish....well. Sigh.
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Well played! ...talk about hijacking your own post.... Maybe you should write the society column for the local rag.
 
tonycondon said:
i took the knock out laughing gas for my wisdom teeth. was probably one of the top 10 enjoyable experiences of my life so far. waking up with cotton balls in the mouth wasnt that pleasant, i took them out, then the nurses scolded me. Now that Im over 21, I recognize that I was at the equivalent of a LOT of beers at that point.
Click to expand...

Yeah - whatever they gave me knocked me out while they cut out the first two, but I remember the last three. No pain at all, but I do remember that sound. They also removed one of my molars as the lower right wisdom tooth coming in was coming in underneath it and they managed to break that tooth - thus I had 5 teeth taken at once. I also remember trying to talk to the surgeon and him consistently saying 'you must stop talking or we won't be able to get this done' and finally 'shut up, please'. He was polite about it.

That was about 11:30 a.m. I was back at work at 3:00 p.m. and had a cheeseburger for dinner about 6:00.

For me it was more like the equivalent of many rum and cokes. I didn't drink beer then.....
 
Let'sgoflying! said:
There was a tv show called this, on about 2 years ago iirc, involving people who claimed they were wide awake and feeling everything during their (ostensibly, very painful) procedure. The thought was that the paralytic drug was working just fine (they could not move or talk, to signal anyone of the problem), but the cns depressant that should have made them insensitive to cutting, tearing etc was not working at all for some reason. I sort of watched with bemusement, skepticism etc.
Late last week a friend of mine (a dvm too) from a neighboring town (perfectly sound mind, was working and alert right up to the time of his operation) underwent a single bypass and pacemaker implant. He did ok but as he was waking, they noticed rapid heart rate and sweating, bug-eyes etc - he could not talk or move much til the paralytic wore off completely and the et tube was pulled. When they pulled it he was finally able to tell his wife and the staff that he was wide awake during the entire surgery, could relate conversations during the surgery, music etc and of course, a few hours of agonizing incisions through unanesthetized skin, sawing of breastbone, that sort of thing. Last I heard, he thinks they are going explain it away by saying he dreamed it.

What about that?
Click to expand...


Just saw an advertisement for the new movie "Awake". Looks like Hollywood read this thread....

http://www.awakethemovie.com/
 
tlglenn said:
I remember the anesthesiologist saying, "This will make you sleepy" as he injected something into my IV line. Then I woke up in the recovery room.
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I had one good and one not-so-much.

The good was when I had a cyst removed in my upper jaw in about 6th grade. They put the mask on and told me to count to 10. One... Two... and the world went black.

The not-so-much... Well, no pain, but when getting my wisdom teeth out the anesthesia was supposed to be some kind of drug that you're kind of awake, but you can't remember anything.

Well, it worked *just* long enough... I do remember "waking up" still on the bed, and having them walk me out to a different area, and they were telling my mom how to take care of me the rest of the day. She said "why are you telling me?" and the nurse said "Because he won't remember anything I'm saying." Ha.
 
That's kind of terrifying. I'm glad I didn't read that before I had gall bladder surgery earlier this year. I may have had second thoughts.

For what it's worth, I could have kissed the anesthesiologist who kept me knocked out. I vaguely remember him saying something along the lines of, "This will make you...," and next thing I knew, it was over. I woke up feeling great. No nausea, no headache, nothing.

The whole experience was excellent, actually... as surgery goes, anyway. Great surgeon, great anesthesiologist, great hospital, great nurses, and lots of prayers and support from my family and my church. I didn't try the food at the hospital except for a few un-saltines and some coffee, but my brother (who stayed during the surgery and drove me home) tells me that was pretty good, too.

So I'd have to say that I was pretty blessed to have good people all around (and inside of) me for my surgery. May God bless them all. Thank God, too, that the possibility of being awake and aware for the event didn't occur to me beforehand, or else I might still be one diseased gall bladder heavier.

Rich
 
That happened to me once. The dentist gave me gas and I was unable to tell him I was awake while he did a root canal. After he told the assistant to increase the oxygen to wake me up I started to come around enough to tell him what had happened. He didn't believe me until I told him what he and his assistant had talked about while they worked on me. He checked his gauges and apologized. It never happened again.
 
bbchien said:
There's a 78 year doc in these parts, who had EIGHT children all of whom are docs. They all work at the Hopedale Medical Complex in Hopedale IL. Dr. AL as we call him, recalled to me that when he hit general practice in 1949 (!!) Novocaine had just become commonly, commercially available. That means, the then to-him old time docs would simply say "this is going to hurt a bit...." and then "YEOW!!!!".

This is all within a lifetime.
Click to expand...


When that doc was in practice in 1949 there were many things they could not do that are routinely done now. Heck, in 1949 polio was an epidemic in the US. That's a disease caused by people ingesting bits of spent fuel rods. Very basic, very different.
 
RJM62 said:
Thank God, too, that the possibility of being awake and aware for the event didn't occur to me beforehand, or else I might still be one diseased gall bladder heavier. Rich
Click to expand...
Huh... if you're experience prior to surgery was like MINE, I bet you WOULDN'T still have the thing! I'd have taken mine out with a soup spoon if they couldn't do it for me! :eek:


I DID have anesthesia problems, though - made me sick as a dog. After the first surgery, the resident forgot to tell me not to pick anything up and I ended up with an incisional hernia. Fixing it the first time, they didn't believe me when I told them I was sensitive to anesthesia, so I woke up throwing up - blew out the repair in the recovery room. By the SECOND repair, I made it clear I was getting tired of abdominal surgeries, thankyouverymuch, and they did their research and - voila! - no nausea! :)

damn belly still looks like a road map, though... :mad:
 
steingar said:
When that doc was in practice in 1949 there were many things they could not do that are routinely done now. Heck, in 1949 polio was an epidemic in the US. That's a disease caused by people ingesting bits of spent fuel rods. Very basic, very different.
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HUH??? Where did you get THAT????

Polio is a viral disease. Not a lot of spent fuel rods world-wide in the 40's, you know. And a vaccine wouldn't work all that well against something like that, would it?? But they did work, which is why the last wild polio was eradicated in the late 70's in the USA.
 
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