Guide to General Anesthesia: What Do You Need to Know Before Going Under?

Your anesthesiologist monitors vital signs and adjusts anesthetic throughout your surgery.
Your anesthesiologist monitors vital signs and adjusts anesthetic throughout your surgery.

General Anesthesia: What You Need to Know

For some procedures and surgeries, you may have a choice regarding the type of anesthesia used. Many times, though, the only good choice will be general anesthesia.

Below, you'll get a broad introduction to terminology, procedure, and what to expect.

General anesthesia implies loss of consciousness.

If you are "under" with general anesthesia, you cannot feel, see, or hear anything, and you do not respond to even painful stimuli.

What to Expect Before Surgery:

After checking in with a nurse and having an IV placed, you will meet your anesthesiologist to discuss your anesthetic. Midazolam or other sedatives are often given prior to other medications to "take the edge off." You may get this type of drug before you even leave the pre-op room. These drugs kick in within a minute and make you forget anything that happens for a period of time afterward, although the effect varies from person to person. For this reason, you may have no recollection (or only vague memories) of entering the operating room.

After you go to the operating room, you will be given oxygen to breathe and will have monitors such as a blood pressure cuff, an oxygen monitor, and EKG stickers placed.

Agents for Induction:

Most commonly, your general anesthetic is induced with medicines injected into your IV. Anesthesia providers use a combination of medications that function as sedatives, pain relievers, and hypnotics for the induction (getting you to sleep) phase of general anesthesia. You may or may not remember this if you were given a sedative in the pre-op phase.

After You are "Sleeping":

Once you are unconscious, your anesthesiologist will make sure you are getting enough oxygen and anesthesia. To do this, he or she may need to use a breathing device to help keep your airway open. There are various ways to do this, including using just an oxygen mask, an LMA (a soft rubber mask that sits inside of your mouth, just over the opening to your windpipe), or a breathing tube that slides into the windpipe between the vocal cords. The decision regarding the type of airway device is based on many factors, including any medical problems that you have and the type of surgery planned.

(Note: Although we use the word "sleeping," anesthesia is not like sleep in that you cannot be awakened until the drugs are removed from or metabolized by your body. Recent studies reiterate that it is better thought of as a controlled, reversible, coma-like state.)

Oxygen levels are monitored and maintained the whole time you are "asleep."
Oxygen levels are monitored and maintained the whole time you are "asleep."

Maintenance of General Anesthesia:

"Maintenance" refers to the process of keeping you "asleep"/"under" for the entire surgery. Usually a combination of gas, IV hypnotics, and strong pain medication are used for this important stage.

During this phase, your anesthesiologist stays with you, carefully monitoring your vital signs and keeping you safe. Your anesthesia is adjusted throughout the operation based on what is going on in the surgery. For example, it will be "lighter" during the time that the nurse is washing the surgical area with sterilizing soap—you need less then because this is not painful or disruptive for your body. Too much anesthesia when it is not needed causes the heart rate and blood pressure to drop. When the surgeons are ready to begin, your anesthesiologist will make adjustments to make sure you have enough.

Your unconsciousness is maintained by watching your heart rate, blood pressure, and breathing rate. Medications are increased or decreased based on your specific needs during that surgery. In other words, every anesthetic is customized to the needs of the patient.

Emergence ("Waking Up"):

When the surgery is over, the anesthesia gases are allowed to dissipate. Titration of pain medication continues so that you do not wake up in pain. You will move through stages of consciousness until, at last, you are awake and the breathing mask or tube is removed. Don't worry, you won't likely remember this, though. Most people don't realize they are awake until some time later in the recovery room.


Our anesthetics are much shorter-acting than those of ten years ago, but they are still going to make you feel pretty sleepy for the rest of the day after your surgery. General anesthetics have the unfortunate side effect of nausea and vomiting. If you are particularly prone to nausea (for example, from motion sickness), make sure to tell the nurses and doctors in the pre-op area. There are meds they can give you to minimize this side effect.

The pain medicines you will take after surgery have many of the same side effects. So, if you are still sleepy and experiencing nausea a couple days after your surgery, it more likely results from narcotic pain medicines than the anesthetic.

Common Questions About General Anesthesia

How do you know I'm asleep?

Anesthesiologists monitor all of your vital signs, continuously, throughout the surgery. Increases in heart rate, breathing rate, and blood pressure all signal "light" anesthesia. Changes do not mean you are awake. Your autonomic nervous system reacts to the stressful stimuli of surgery long before you wake up. You actually move involuntarily as a reaction to the surgery while still unconscious, as well.

What is anesthesia awareness?

Anesthesia awareness is an unfortunate situation where you are not fully unconscious during the surgery. People with true anesthesia awareness later report that they heard some of what was going on in the operating room. Usually, they can't feel anything, but may be very scared. Rarely, they can feel the surgery but can't move or speak. People who have medical or surgical issues where giving deep anesthesia is dangerous are at more risk for true anesthesia awareness.

Why do you say "true" anesthesia awareness?

There are many, many cases when people think they have been awake during general anesthesia, but in fact, they are mistaken. The most common scenario involves a surgery where they had sedation anesthesia or sedation in combo with a spinal, epidural, or regional anesthetic. Those types of anesthesia do not and are not supposed to induce unconsciousness. It is absolutely normal to have memories and be at least partially awake with these types, but memories may be fuzzy due to the drugs used.

Could you use a brain monitor to prevent anesthesia awareness?

Brain monitors have not been shown to provide protection from anesthesia awareness, but don't worry, your anesthesiologist knows what to look for. Monitoring for sweating, tearing, increases in heart rate, breathing, and blood pressure are much more reliable. Brain monitors may provide other valuable information, so your anesthesiologist may use one, but not to prevent awareness.

Why do I have to have general anesthesia for this surgery?

Many types of surgery simply cannot be done with other types of anesthesia. Obvious examples are brain and heart operations, but others, such as laparoscopic abdominal surgeries, require more explanation.

When you have laparoscopic surgery, the surgeons use skinny tubes with cameras and instruments on the ends to do the operation. This causes less pain than large incisions, but in order to see into the abdominal cavity with cameras, the surgeons need to make room to operate. To do this, they inflate the abdomen with gas, usually carbon dioxide, to create a domed space in which to work. The other types of anesthesia—epidurals and spinals—that used to be used for abdominal surgery just don't cover enough of the abdomen to keep you comfortable. Also, the table is often adjusted into a "head-down" position to improve working conditions even more. The combination of an inflated belly and laying head down makes it very difficult to take deep breaths and keep your oxygen level adequate. With you asleep under general anesthesia, we can use the ventilator to make sure your lungs are fully inflated, making oxygenation easier and safer.

Why can't I eat or drink anything after midnight before my surgery?

When you go under anesthesia, it's not like normal nighttime sleep. At the point at which you become unconscious, you also lose the protective reflexes that normally keep your airway clear. For example, while awake, if something irritates your vocal cords, they would reflexively close and you would cough to clear the irritant. While unconscious with anesthesia, you may be more prone to regurgitation of stomach contents and your vocal cords and the rest of your throat can't react to prevent the material from entering your windpipe and your lungs. This can lead to a dangerous condition called aspiration pneumonitis or aspiration pneumonia. Damage to or infection of the lungs causes serious complications in some people.

So the food and water you have in your stomach could end up in your lungs. While some studies show that the usual eight hour fast before surgery may be overly cautious, and some institutions are shortening the NPO (nil per os, Latin for "nothing by mouth") interval, some will not for another reason: Surgeries sometimes cancel or get moved around. If you are lucky enough to have your surgery moved earlier in the day, but you have eaten within the NPO interval, the operating staff will not be able to move your surgery earlier. And if they move someone else up, you may end up getting delayed even later.

Poll- general anesthesia, use comments to elaborate on complications.

Have you had any problems with general anesthesia?

  • Never had it.
  • Had it once with no problems.
  • Had it many times- no problems.
  • Makes me puke.
  • I've had it and had serious complications.
  • Other.
See results without voting

More by this Author

Do you have any comments or questions? I will try to answer anesthesia-related questions, but cannot give medical advice. 221 comments

Manutdmumto4 profile image

Manutdmumto4 5 years ago

This an excellent, informative Hub!! For those of us who find anesthesia scary, it really puts your mind at rest!! Thank You, I look forward to reading more of your Hubs x

TahoeDoc profile image

TahoeDoc 5 years ago from Lake Tahoe, California Author

Thank you :) I know anesthesia is scary and we anesthesiologists get all of 5 minutes to meet our patients, review the chart and labs and formulate a plan. We don't always explain the anesthetic very well. So I will do a series of hubs that I hope will help.

Baileybear 5 years ago

I recently researched & wrote a hub about Darwin. Pretty amazing to think there was no anesthesia a few hundred years ago (nor any knowledge about microbes), and 'surgery' was people getting limbs hacked off.

I've had 2 surgeries, and was knocked around quite badly - is it true it can take a month or more to get over the anesthesia? I've heard some say that the preservatives in it are the nasty part, and that preservative-free is available. Is this correct?

Is quite a freaky experience re-gaining consciousness again - hearing sounds etc, sort of like in a dream

TahoeDoc profile image

TahoeDoc 5 years ago from Lake Tahoe, California Author

Hi Baileybear- Love your Darwin hubs, and voted in that contest!

Local anesthetics have a preservative-free variety that we use in spinals and other sterile procedures, but there are not variants of the narcotics, hypnotics or gases that are different, for the most part (few exceptions). The preservatives are in the IV meds, mostly and are the same as in other medications. The anesthesia technically is out of your body within a day or so. BUT, having said that, there is SO much we don't know about how anesthesia works and the long-lasting effects. It's the best we can do right now and most people do very well with it. There's a topic that's an active area of research now (that I will eventually write a hub about) concerning "post-operative cognitive dysfunction". There are ongoing studies that are investigating how long the after-effects last. The interesting thing is that some of the long-term effects happen even with anesthesia other than general (like epidural or nerve block) that shouldn't affect the brain. There is likely some effect from just having your body disrupted by surgery, that there is some physiologic stress that occurs that makes it seem like it's residual anesthesia. Some people are more susceptible to different meds because of varied drug metabolism. It's possible that a combination of all of these things contributes in that sub-population of patients that don't seem to recover right away.

I'm researching it right now for a case that I'm reviewing and will write on it in a month or so after that's all done.

Baileybear 5 years ago

is the preservative benzoates? My son would have a high pitched scream & rage with the food additives sulfites and benzoates - he would have no recollection afterwards; apparently a neurological irritation. Some people on the food intolerance forum seemed to think that anesthetic has these kinds of preservatives. I get migraine from the same chemicals.

We both get "drugged" by food chemicals, even natural ones like salicylates in fruit. I don't tolerate histamine-rich/producing foods well - give me migraine, upset gut and allergy-like symptoms. No good with dairy or gluten either.

My son has never had a surgery yet. Was wondering if could be dangerous given that he has such severe neurological reactions to benzoates (assuming that is the preservative)

TahoeDoc profile image

TahoeDoc 5 years ago from Lake Tahoe, California Author

Yes. Benzoates are included as preservatives, mostly in local anesthetics, I believe. I will check the labels tomorrow or the next day and see what I find.

There are preservative free "locals". Even if your son has general anesthesia, point out that the local anesthetic may have preservatives he is sensitive to because they inject local anesthetics before or after surgery to help with pain relief. They should be able to find a preservative-free variety.

The other drugs, I will have to check. The propofol that is used to get people to sleep has either a sulfite type preservative OR a benzyl alcohol. I find that people with sensitivities do better with the benzyl alcohol ones.

If he ever does need surgery, contact me first and I'll see if I can get you a list of which medicines have which preservatives. I'll start looking into that, as well.

I'm sorry you both have such sensitivities. It's like dodging landmines, isn't it? Exhausting to have to think about every single think you do and eat. You have my sympathy and respect.

Baileybear 5 years ago

Yes, I was very sick for years and doctors didn't know what was wrong with me - some drugs they gave me made things worse.

Eventually, I figured out the food sensitivities, when I decided to see if the screaming in my son was diet related (he'd always been sick too, and I knew casein didn't agree with him, but doctors dismissed my ideas).

My thyroid was packing up and my health improved dramatically when I went gluten-free (no more bone pain, easy bruising etc). I am still allergic to dairy (life-long condition, I believe), but my other food sensitivities have improved a lot.

I still get more tired than most people my age (not surprisingly with my body in chronic inflammation for years), but I am doing so much better.

My son can enjoy a wider diet than me (tolerates A2 milk and butter, plus gluten). I've read about metabolism difficulties and those on the autistic spectrum (we've both learned we have aspergers).

I've written hubs about all this, in case others have similar mystery health issues.

I was bedridden for 2 days recently, because I ate some gherkins (in vinegar - histamines). My diet is rather bland, but I pay big-time if I eat something that doesn't agree with me.

Ibuprufen gives me depression, just the same as asprin and other salicylates. Even rubbed on a sore wrist gets into my blood stream and affects my brain for several hours. My boy gets depression and/or rage from these chemicals (and we both like fruit - we choose only the ones lowish in sals)

Andrew 5 years ago

I have had four abdominal surgeries recently (using general anesthesia). My question is while on the operating table I'm given something while everyone is moving about and it makes me feel very warm and produces floating feeling and severe anxiety, so much that last time I grabbed the nurses arm and started crying (I'm in my 20's) and she assured me this was a normal reaction and I was okay. What might this drug be they are putting in my IV?

TahoeDoc profile image

TahoeDoc 5 years ago from Lake Tahoe, California Author

Hi Andrew. I have had 2 major abdominal operations myself (removal of my entire colon for ulcerative colitis, then reconstruction) so I send you my sympathies.

Usually, the first drug you get is Versed, generic midazolam, or some related drug. These are like valium in the IV. Usually, they make you feel like you've had a couple drinks, very relaxed and "floaty". They are anxiolytic drugs, meaning they usually take away anxiety. Some people (we see it more in kids, but adults sometimes too) have the opposite reaction and get more worked up and anxious. We don't know in adults if this is a reaction to the drug, or a reaction to not liking the feeling of the change in your body and mind. I don't know if this applies to you, but I've had patients tell me that they tend to be the more "control freak" type and don't like the loss of control that the drug makes them feel.

There are other medications given early in the process too, while you are still awake that can have the same effect, even some of the anti-nausea medicines, although their effects are usually described more as feeling flushed or warm, although I've seen a couple people get anxious with them.

If it's right as you are going to sleep, it could be fentanyl (a narcotic) or the propofol (the sleep medicine). Most people drift quickly and peacefully off to sleep, but some have a bit of an "excitement" phase right before losing consciousness.

The good news is that the nurse was right, these are side-effects and you are ok. They are not bad or dangerous reactions to the drugs.

If you have another surgery (and I hope you don't have to), tell the anesthesiologist about this ahead of time. Ask if he/she can give the meds one at a time and tell you what they are. You can then figure out what causes it and tell them when you don't feel right. It will probably make both of you feel better.

My best guess is the midazolam (versed).

Andrew 5 years ago

Thank you so much for answering, and I hope you don't have to go through any more surgeries either! I hope you've fully recovered. I have another question for you, but it's a bit private regarding the medication and medication I'm taking already. Perhaps you could e-mail me or message me? If not I understand. i zaqb lue (at) yah oo is my e-mail. If you are too busy it's okay. Thanks- Andrew

Momma Mia profile image

Momma Mia 5 years ago from North Carolina

Great hub here and very informative. I have been in a coma for a week due to one surgury and complications with almost all procedures. I have a rare form of leukemia ( mastocytosis) but now realizing my basophils are 20 percent on a wonderful day and the mast cells and basophils are what seems to be causing my allergic reactions (anaphalaxis many times a week) I would like to know more about what you do for your patients that require extra care. Thank you for your hubs and your time.

Happy New year



TahoeDoc profile image

TahoeDoc 5 years ago from Lake Tahoe, California Author

Hi Mia, thanks for your comments. Your strength in the face of debilitating illness is inspiring.

I review the medical history of every patient before planning their anesthetic. Sometimes special monitors are used and sometimes the medication has be adjusted radically. For someone with frequent or severe allergic reactions, I would pre-treat with steroids (if there was no contraindication) and IV benedryl to suppress the reaction. I would monitor blood pressure more closely, maybe even placing an arterial line (iv in an artery for beat-to-beat blood pressure monitoring) and pay close attention to the resistance of the lungs, treating as necessary.

Unfortunately, those of us with health issues are the ones who keep getting slammed over and over. As anesthesiologists, we are constantly fighting physiology in sick patients. We cannot overcome every problem and sometimes, we let people wake up more slowly in the ICU instead of rushing it in the operating room.

My motto is "don't create more problems than you solve."Sometimes surgery is necessary, even knowing that there is significant risk and we do have to think very carefully about the least of all potential problems. It's not very satisfying or enjoyable when it's like that, but you do the best you can.

If you have specific questions, I can try to answer them if you'd like.

Momma Mia profile image

Momma Mia 5 years ago from North Carolina

Thanks so much Tahoe Doc......

Benedryl is a very bad trigger for me....can that be replaced with allegra? My CNS has been compromised and many meds cause issues with my breathing. It appears these mast cells and /or basophils infiltrate my organs, so I have had liver failure, gall bladder rupture,, and removal, neurological tics,tremors an MS and parkinson type symptoms since age 40, Diabetes with insulin shots and just very sick with vast amounts of phlem and hives, I actually will out of the blue have an open lesion that looks like a scratch and then bleed. The immunonlogist(2) and masto specialist have all but given up on me .

However I have not ! My liver repaired, as did my diabetes is now competely gone ( normal blood sugars for 3 years . I have been told I should not technically be alive.

I am so allergic to almost anything that anyone can be allergic too. I live is a purified room at the moment and my family feels so helpless. MOld is a huge trigger... I have researched mold much...its not going away here in NC my family thinks I should move to Arizona, however I have read that some people have worse asthma there............that is now an issue for me as well.... I am sharing all this for I see your compassion in your words and I know that kind of compassion has to be coupled with your passions. As a mommy myself, an a past of (10 years) as a nanny I know you kiss boo boos too a doctor you desire to help as many as you possible can. If you have any advice for the patient that actually should be living in a bubble ( my docs tell me) I can't even go to the dentist for the local shots they give me.....causes seizure like body movements and head jerking....I can't visit most of my family ( as they dont understand my extreme sensitivities) and their clothes have mold attatched to their clothing........or worse have cats or dogs.....I now(4 years) eat all organic or all dyes, preservatives, monosodium glutemate ect. Purified water only and very little wheat or refined sugars. So as you probably can see I am an advocate for my heathcare and do not expect an instant cure from God or docs......I just would like to have a life outside my purified box.

Again thanks for your caring response and any help or advice you could give would be so appreciated.

Looking forward................always


TahoeDoc profile image

TahoeDoc 5 years ago from Lake Tahoe, California Author

Wow Mia, I'm so sorry for what you are dealing with. Mold is definitely more of a problem than people realized for a while, especially for people like you. Different people have sensitivities to different things. Arizona and other deserts are great for some, but others (like me, mild reaction only) react more to the allergens there. Here in Tahoe, some people find relief with the mountain air, but others are debilitated by the pine pollen in the summer. Sigh. I'm sure you have probably been on steroids at various times (prednisone, etc). I don't know what other options have been tried...biologic immune suppressant drugs? I don't know if they are indicated or worth a try for what you have or if they would just suppress you too much and cause more problems than they solve.

Yes, allegra or the like might be helpful, although maybe not as "powerful" if benedryl is not an option. Also, ask your doc if adding an H2 agent (histamine-2 receptor blocker) might be useful. These are drugs like zantac and pepcid usually used for acid reflux. I add them to benedryl when someone has, or is at risk for, a bad allergic reaction under my care.

Of course, your history is quite complicated and nothing I say should be taken as medical advice without consulting the docs who know your WHOLE history. I'm just trying to brainstorm with/for you in case I might be able to help at all. I fear, I won't have anything new or useful to add. I can at least send a ((hug)).

Momma Mia profile image

Momma Mia 5 years ago from North Carolina

Thanks for the hug and the advice. I have only been on prednizone once ...for a 4-6 week period. Massive amounts of it. Worst muscle cramps i have ever I use to work out hardcore I tested positive with my ANA titer test and came back speckled as well..(My mom did as well and she has systemic lupus) Docs here say I don't have that. Test after test, no real answers but I know it lies within my basophils being so high. My tryptase comes back normal I was told. I feel a move to the beach would be helpful and I live a few hours from the coast here. I visited for a week last summer and did well. I carry my hepa filters and a de-humidifier.......but at the moment I am having to sleep in a bathroom , due to carpet I would guess. My skin gets all sunburned when I go into my bedroom so I am trying to build my immune system up the next week and head out for the coast.

Thanks again for all your help...means much that someone is trying.

Take great care and kiss the baby for me! They do grow so fast.

as always



melpor profile image

melpor 5 years ago from New Jersey, USA

Good and informative hub. Thumbs up. I will read the rest of your hubs very soon. Thanks for the information.

TahoeDoc profile image

TahoeDoc 5 years ago from Lake Tahoe, California Author

Thanks Melpor. Loving your hubs too!

LLM 5 years ago

Thank you for a very informative hub. Recently, my Wife had eyelid surgery. She is 54 and weighs about 120. It was to be local only. She reported being in a lot of pain, but not being clear headed enough to say anything. We requested the records. She was given 2mg Versed, followed by 40mg propofol (IVP) and 8 mg etomidate (IVP) back to back at the beginning. No narcotic was used. She did not consent to a general. The center now claims that this was "moderate sedation." What are the chances that she was even conscious after these meds? Do things like this happen often?

TahoeDoc profile image

TahoeDoc 5 years ago from Lake Tahoe, California Author

Hi LLM, Local only would mean that NO sedation would be given and an anesthesiologist or anesthetist wouldn't even be present. She had a sedation, but I can't really say what she consented to or what effect it had. It sounds like the doses she got was a moderate sedation dose BUT some people depending on their metabolism (not just general metabolism, but specific liver enzymes responsible for metabolism of different types of drugs) and other meds and medical issues and level of anxiety, etc can range from wide awake to nearly unconscious with the meds you mention in the doses given (even at the same weight). It's really up to the anesthesia provider to titrate the drugs to a patient's need.

In a case of local or local plus sedation, the sedation is the anesthesia provider's responsibility, but it doesn't take away all or even most of the pain. Pain relief and control are provided by the local anesthesia injected by the surgeon. The anesthesia meds help with relaxation and altered consciousness of varying levels so that a patient is less aware of or doesn't care about the discomfort, but those drugs are not really pain meds.

I'm sorry for your wife's bad experience. My best guess is that she had some resistance to the local anesthesia and it didn't 'take' as well as it could so she was given the sedatives OR she got the sedatives as planned and they took longer to take effect OR she felt the injection of the local anesthesia and her brain, under the influence of the anesthesia drugs, didn't understand that she was just feeling the injection. Unfortunately, there is no way to know if the drugs are going to be enough until you try. You can start with what you think someone needs based on age and weight (as you seem to understand by providing this info), but cannot really give more than that to start as it would be dangerous since these drugs cause heart rate, blood pressure and breathing decreases.

I can't really say what happened without being there as there are many variables, so please don't feel insulted if I say something that indicates that I don't quite understand the situation.

Olojo Oluwasegun profile image

Olojo Oluwasegun 5 years ago from Lagos Nigeria

This is great. Wanted to ask what anesthesiologist is but i can see it already. Good job again

TahoeDoc profile image

TahoeDoc 5 years ago from Lake Tahoe, California Author

Thank you very much. :)

imagrandma8 4 years ago

This is an awesome article. Very informative. I am having trouble finding any articles as to how many times you can have general anesthesia in 1 month. I am having oral surgery on Feb 8 and back surgery on Feb 15. Trying to find out if this is safe?

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi imagrandma8,

This should be safe for most healthy people. If you are having general anesthesia for both, you could be at increased risk for complications that relate to underlying medical conditions. Surgery and anesthesia are stresses on the body and so organ systems that are already not functioning well can take longer to recover after each anesthetic.

Having said that, we do sometimes have to give general anesthesia to people several times in the course of a week (burn dressing changes, irrigations and debridements of infected tissue, etc) and most people do very well. Talk to the doctor doing the back surgery and make sure they and the anesthesiologist will be ok with you doing these (after reviewing you medical history) close together. My guess is that they will say it's fine, but do bring it to their attention.

If the oral surgery is going to impede being able to open your mouth, the anesthesiologist for the back surgery will not be able to safely place the breathing tube so will DEFINITELY need to know. You should discuss this ahead of time with the anesthesia dept where you are planning to have these things done.

The other thing I can think of and it's more surgery related than anesthesia related... the back surgeon may have a minimum amount of time they need to wait after you have dental surgery. Surgery in the mouth (especially if it's for infected tissue or teeth) can release bacteria into the blood which may increase the likelihood of an infection at the back surgery site.

Again, this may very well be safe in your case (and it usually would be), but there are some things you should discuss with the doctors involved in your care. It's hard to find articles because there really isn't a standard answer that fits. Thank you for bringing your question here.

Good luck and I hope everything works out :)

amy123 4 years ago

Im having oral surgery, day after tomorrow, & scared out of my wits, I take methadone, no more than 10 mg a day, & cannot tell my oral surgeon, I really need to have this done, what should I do????

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

You REALLY need to tell your docs. They need to know for a variety of reasons including being able to treat your pain adequately and plan your anesthetic and post op course. What is the reason you can't tell your surgeon? The anesthesia provider? Methadone is something we deal with a lot in our patients and it doesn't usually cause problems if we know about it. the biggest risk is interference with or inappropriate management of your anesthetic or pain. If we are giving you anesthesia- including narcotics at the usual doses and you don't seem to be responding, the docs might think something else is wrong and start treating you for a problem you don't even have. Please disclose this info to your surgeon and anesthesiologist. They will most likely be relieved to know about it rather than judging you.

dlopp88 profile image

dlopp88 4 years ago from Georgia

Very informative hub. Thank-you! I do have a question that I am having a hard time finding an answer to anywhere though. I had an elective surgery Last Friday, had a hematoma complication and had to have an emergency surgery that Sunday. Now- 1 week post-op, im still feeling very nauseous and vomiting at least once per day. I was first prescribed percocet, and I thought they were making me sick- so dr. switched me to norco- and i thought THAT was making me sick- but now Im only taking advil and still getting sick- even very light headed and dizzy . Is this a possible side effect from the anesthesia?? Im very concerned b/c I do have 3 daughters to take care of, and I hate feeling so out of sorts- is there anything I can do?

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi dlopp- Sorry it took so long to answer...

I would also have guessed it was the narcotic pain meds making you sick. Since you are off of them, it is more likely that the dizziness, light-headedness and nausea are now a result of dehydration or low volume status from the blood loss after the hematoma.

It is unlikely this far out to be from the anesthesia, itself, but the physical stress of surgery, having received the anesthetics and the hematoma can certainly make you feel the way you describe, especially if you lost a fair amount of blood. Please make sure you are taking in a lot of fluids if you can keep them down. Your body is working hard to make more red blood cells to replace the ones you lost, in addition to trying to heal from your surgeries. That is a lot of physiologic stress on your body and it will take time to happen.

Either way, call your surgeon and tell him/her that you are light-headed and ask if you should have your blood count checked again (it doesn't hit its bottom number until a few days after the bleeding sometimes) and if it is or they suspect it is low, ask if you could possibly need to get some IV fluids (especially if you can't keep fluids down).

If you have a fever, swelling or warmth around the surgical site, you should also call right away as infection can also make you feel sick.

Hope you feel better soon. I know what it's like to have to care for others when you should be taken care of yourself! You must get some rest, though, so if you have any help or offers for help- use them! Good luck to you~

Misty Blue 4 years ago

I have experienced waking from surgery feeling great, alert, relaxed and calm. When waking from anaesthesia two out of three of my last surgeries I experienced none of the above. One was a day surgery. Dis ease then uncontrollable shaking. Returned to hospital. Maxeran was suspected to be the cause. Given Ativan and antihistamine. Second experience was when coming out of anaesthesia. Shakes, spasms (jerking arms and legs), put on antihystamine I.V..

Anaesthsitist was called. He said not an allergic reaction. Another surgery in a month and making sure all know my concerns. Please, anything you might add to what I have experienced would be appreciated.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Misty. The shaking after surgery can be an anesthesia reaction (NOT an allergy or concerning reaction) that just happens to a certain subset of patients. We don't really know why, but often it will be treated with meperidine (Demerol) if there are no contraindications to it.

Maxeran (metoclopromide) is often given to prevent or treat nausea. It causes a different kind of abnormal movement-including a type of spasm, and is treated differently.

I'm not sure what kind of movements they saw (although your descriptions are good) or if they were the same both times, but do let them know that the metoclopramide (Maxeran) may cause these reactions in you. If you have the shaking this time and they don't give you that medicine, then it is probably a general anesthesia reaction that they may be able to treat with meperidine before you leave the hospital.

I hope this upcoming surgery is smoother for you. Make sure you get to talk to the anesthesiologist BEFORE they start giving you medicines like the Maxeran so you can relay all this info. Write the events/sequence/suspected meds down. As you know, your time with the anesthesiologist is short before surgery and there is a lot going on. It would be really easy to forget something that you want them to know.

Good luck!

Misty Blue 4 years ago

Thank you. My son exhibited spasms in recovery after back surgery a few years back. We shared the lack of control and degree of arm/leg jerking. His reactions seemed more pronounced and unsettling and mine were quite scary.

I did speak to anesthesiologist before last surgery. I will be sure to share my concerns well in advance of "going under" this time.

Thank you again. Hopefully I will be blissfully waking from this surgery forearmed with knowledge that if I must undergo another in future ......all will be good.

Ally 4 years ago

Thank you very much for your straight forward information, a great read.

Does the risk of anesthesia lessen after repeat surgery?

I am 26 years old and have had 15 surgeries under general anesthesia (shunts, can't live with them - can't live without them!) I still get affair amount of anxiety about "going under" but since I'm a frequent flyer no one seems to bother asking any more. They just assume I don't have any questions or concerns because I've seen it all. Other than puking my guts out after surgery I've never had a complication, what are the chances that number 16 might give me trouble?

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Ally,

You may be correct, the team may think that you have had all your questions answered in the past or that you are 'comfortable' with the process now and that you just want to get on with it. Not saying this is the way they should approach you, but it may be.

Please do express your apprehension and ask questions even if they don't seem to think you need this. I sometimes ask patients if the process gets easier or harder with more procedures. I get both answers. So do bring it to their attention, you may be helping other patients too. :)

Each anesthetic carries its own risks, BUT by now it seems you ...

1) don't have malignant hyperthermia or other life-threatening reactions to anesthesia

2) have an 'easy' or manageable airway

3) tolerate anesthesia fairly well (except the puking)

So, the team already knows a lot about you and feel comfortable. You should be able to feel comfortable, too. Speak up even if they don't ask. Like I said, it will be a good education for them too, not to assume you don't have anxiety or questions just because you have been through it before.

Sorry about all the surgeries and issues. I hope you stay out of the OR as much as possible. :) Good luck to you.

Ally 4 years ago

Thank you very much for your quick response to my question. Its nice to know there is someone as informative as you, keeping us informed. When you only get a few minutes with the figure at the other end of you IV, sometimes your left with more questions than answers.

CM 4 years ago

...???? Post op kidney surgery 2 1/2 wks--no pain med for 2 wks. Lightheaded and nauseous feeling---?normal? Thanks

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi CM,

Nothing related to the anesthesia should last that long. It's possible that there is normal healing that could be still making you feel that way, but it can also be a sign of infections, dehydration, issues related to underlying medical problems.

For this, given that it was kidney surgery, follow up with your doctor. He/she may want to do a physical or order some blood tests to check your hydration level or electrolytes and other things as these can be disrupted with kidney disease or kidney surgery.

Hope you feel better soon!

lauren 4 years ago

I had extreme pain before surgery, feeling like i was going ro have a baby pains, from endometriosis and adheadsions, but the nursing staff when trying to find out if i could have something from the anesthesiologist said I couldn't have anything as this would effect the pain meds i could have after surgery. So i was left in extreme pain for two hours. I dont know if this is correct, as I have had this surgery before and was given 10mg morphine the last time before surgery with only medium pain. what do you think?

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Lauren. I'm sorry you were in pain prior to your surgery. Unfortunately, different anesthesiologists handle this differently. Some of us will allow the pain meds prior to surgery to keep the pain (and heart rate and blood pressure) to tolerable levels. I usually fall into this category.

Other anesthesiologists handle this differently. Some will not give pain meds because they feel it makes it harder to figure out what medications to use to get you to sleep. Others still, feel that giving pain meds before they meet your or before the nurses or surgeons have done your full assessment prevents you from giving full informed consent because the meds can make you 'cloudy' and sleepy. They may cause you to forget later that you really did give INFORMED consent if you don't remember what was discussed with you right before surgery. Personally, I think being in pain creates the same issue and I give meds in MOST, but not all cases like yours. Sometimes, though, there are still some medical considerations that will prevent me from doing so.

I cannot say, however, that another anesthesiologist is right or wrong in their decision without knowing all the facts and their reasoning, but it seems that you should not have been left with so much pain and again, I'm so sorry you had to go through that.

Robert 4 years ago

I had a question.I'm having inguinal hernia surgery Friday.Everybody tells me i'm gonna be fine and I know I will but I worry about everything.I don't think it's the actually surgery it's the anesthesia I think I fear the most.Now I've never had surgery before but I've been under twice with General anesthesia(I assume i was unconscious)before when I was 15-16 I'm 31 now.I have no obvious health problems plus my mom and dad had the same procedure done at one time.Does it sound like I should stop worrying and that I have nothing to fear.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Robert, I think it's pretty common to fear the anesthesia more than the surgery- even for me as a patient. The fear, I think, often stems from the lack of control. When you are unconscious, your safety really is in the hands of a stranger and you can't make decisions or contribute to your care. it is understandable to be a bit apprehensive.

Having said that, for perspective, tens of thousands of anesthetics are given every single day -millions per year- and serious complications are quite rare. It's actually quite amazing when you think about how far we've come and how safe anesthesia really is. It is pretty common to have a side effect or two, but rare to have a complication that requires further care. Anesthesia is not perfect, and there are still things we are learning, but we should really be grateful that we live in a time where we can undergo surgery without pain or a high risk of problems.

You have a personal history of tolerating anesthesia (why did you have anesthesia without surgery?), your family history does not suggest a problem and you sound healthy. You have everything going for you to do well with your procedure!! You are the type of patient that I LOVE to see on my roster for the day. We can never make any guarantees (don't I sound like a typical doctor there?), but statistically, you should do well. Even people who have serious medical issues or other problems do well most of the time- you I wouldn't worry about. :) Practice deep-breathing or relaxation techniques between now and the surgery. I definitely notice that your attitude going into anesthesia affects your whole experience and how you feel coming out of anesthesia.

Good luck and let me know how it goes or if you have any more questions before or after your surgery.

Robert 4 years ago

Thanks that makes me feel a little better now.When I was 15 they thought I had a hole in my heart I went in for surgery and they said their wasn't one, and prior to that they went down my throat to see my heart i guess, thus that explains my adventure being under twice.

pete 4 years ago

Very informative site. I need to have arthroscopic surgery on my knee, and from my research it appears that this can definitely be done with local anesthesia plus sedation if necessary, but so far I am unable to find a surgeon in my area who will do anything but general anesthesia. I would like to avoid that if possible due to a history of a heart attack and intermittent atrial fibrillation, as well as general problems with fatigue and pain, and I suppose to be fair fear of the unknown having never had general. Any advice would be welcomed.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

HI Pete- I get where you are coming from and I agree. IF this can be done with local, then it would likely be better. However, there are several things that determine whether arthroscopic surgery can actually be done with local.

If it is just a diagnostic scope without a lot of work being done, then most of the time, it is amenable to local. BUT, if the surgeons are actually doing some work- especially on the inside or outside of the knee, many will not do local. It just isn't possible to get the local to cover those areas and there is a maximum dose that can be safely used. These are the factors that surgeons consider before agreeing to local anesthesia. There may be other issues as well, and I try not to second-guess the surgeons. And, also, to be honest, some surgeons just aren't that good at doing these with local. Either they haven't done a lot of it in their training or they have become accustomed to general anesthesia on their patients. Either way, you don't want them to do something they aren't comfortable with.

When local can't safely or adequately be used, general might actually be the better choice, even in light of cardiac issues and here is why: If the local isn't adequately covering the painful procedure, you will be uncomfortable or in pain. Pain causes heart rate and blood pressure to go up and 'stress' hormones to be released. Cardiac risks are increased and preexisting issues are exacerbated by these stress-induced changes. Anesthesiologists are aware of this, and it may play into the decision as to whether or not to recommend local anesthesia vs. general.

Epidurals and spinals can also be used, but are falling out of favor a little bit because in many cases, general is as safe or safer for many patients (and it cannot be done if you take blood thinners for the a-fib). They also take longer to 'wear off' than general anesthesia and cause more problems with things like urinary retention that can keep you in the hospital unexpectedly.

Here is what I recommend: If you can find a surgeon who thinks local is ok, then great.

If not: See your primary doctor or cardiologist to get a 'medical clearance' (I don't like the word 'clearance as it sometimes implies that there are no issues, rather than indicating that issues have been addressed and optimized which is our goal) or evaluation prior to your procedure. Make sure the doctor is aware of your cardiac issues and tell them about any new or ongoing symptoms you have - chest pain, shortness of breath -with exertion or during sleep, lightheadedness, palpitations, etc. Ask if you need a new EKG, echo, stress test or whatever if you haven't had one in a while. If you are on blood-thinners, ask your surgeon and primary/cardio how to handle that approaching surgery. Make sure whoever is doing the pre-op medical eval knows you are having surgery and that you need to be 'optimized' before the procedure.

If these things are done, then general should be as safe as possible for you and the anesthesiologist will have the info they need to monitor and treat you as needed.

As to the fear of the unknown- this is one of the hardest things to conquer. All I can tell you is that we give general anesthesia for very long, complicated procedures to people with a history of multiple heart attacks, congestive heart failure, etc and people do really tend to do well if they are 'optimized' and the anesthesiologist is aware of the current state of health, beforehand. Of course, I can offer no guarantees, but that general statement is true- even very sick people most often do just fine with general anesthesia.

Good luck to you - you already have the fact that you are quite educated about your medical status on your side! That really is huge. You wouldn't believe how many people come in and don't know much about their medical history.

Let me know how it goes.

Supriya 4 years ago

Its appx. 1 and a half yrs of my marriage and we have been trying for baby for past 1 year but i am not being able to concieve. Docs have asked me to undergo ultra sounds and few injections and all. I have gone through the complete cycle but my egg did not rapture. Now i have been asked for laprascopy. What do you suggest for the same?

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Supriya. This is a good question and I'm sorry you are having difficulties. Unfortunately, this is not the area of my expertise. If you have a doctor you trust, they probably know what will give you the best chance of having a baby. If you aren't sure, it may be necessary to try another doctor for another opinion.

I'm guessing the laparoscopy is to look at the internal organs and see if there is any visible reason for your difficulty. Please ask your doctor if there is any other test you could have first before surgery if you are nervous about it. Good luck.

Trudy 4 years ago

I would like to know why my oxygen saturation dropsn and oxygen has to be used while waking from anasthesia?. I keep being told to breath and so forth. What is going on?

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Trudy,

Both anesthetics and pain medicines decrease the rate and depth of your breathing. In addition, any surgery around the torso or abdomen will cause pain and further decrease breathing depth.

Sometimes during general anesthesia, a ventilator has been assisting your breathing. As you wake up, you take over this function on your own. As your body adjusts to this, you sometimes need to be reminded to breathe deeply.

So, the combination of transitioning to being awake, any pain from surgery near the lungs or breathing muscles, the leftover anesthetics and the pain medicines that you get as you wake up all contribute to decreasing breathing rate and depth. When your respiration decreases, so does your oxygen level. Usually, with an occasional reminder to take a deep breath and the temporary use of oxygen, this corrects quite quickly.

Hope that answers your question. :)

tinapnyc 4 years ago

Hi TahoeDoc:

My son will be having an orchidopexy shortly (he will be 15 months old). Despite being a very rational person, I am extremely scared of putting him under general anesthesia (I am constantly thinking of worst case scenarios) and generally driving myself crazy. I have been reading everything I can find to understand the risks and found your hubpages. Have a few questions: If this was your baby, would you be concerned and what would be your biggest concern? What should I ask the pediatric anesthesiologist pre-surgery? Can you explain what the factors are in deciding whether a baby needs to be intubated or not? Also, my secondary concern is the potential impact on my baby's developing mind particularly given new APA release on this subject (understand this applies to multiple instances of general anesthesia). Any views on that? Look forward to your reply.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Tina,

As luck would have it, my son had general anesthesia with a breathing tube at 19 months old for bilateral inguinal hernia repairs.

Believe me, no matter how much you know, it is NOT easy to turn your baby over to someone for anesthesia and surgery, so I TOTALLY get your apprehension.

I comforted myself with the thought that little ones do very, very well with anesthesia if they don't have other health problems and if they aren't ill (fever, productive cough, etc).

As far as the development issues, I don't have a lot of guidance beyond what you've said. It's unlikely that one short anesthetic will cause problems. It's a valid concern, but if he need surgery, there's not much you can do, except know that it's unlikely to cause problems with this procedure and the short length of anesthetic.

I wish I could reassure you further. General anesthesia with a breathing tube is most likely for this (it's how I've done them) and what my son had for a similar procedure. In babies, it is difficult to provide sedation, maintain spontaneous ventilation AND keep them still for the surgery without general anesthesia. I wouldn't have had them try it any other way for my boy's operation. It is just safer to have everything under control from the beginning. If they have developed a way to do this without general or a tube (or laryngeal mask airway-which some people like for babies, and some don't, all for valid reasons), then great. If not, then you want them to do what they usually do and are comfortable with. I find that problems happen when you stray from what you already know to work. Does that make sense?

I think the best thing you can do is look at the big picture (it's what I had to keep reminding myself). Many kids have longer anesthetics for more complex surgeries and do just fine (in fact, while my kid was having his procedure, the little girl of one of my friends was under for a 4+ hour open heart procedure. She did great).

Really, the biggest thing is just getting through it. It will be traumatic for you, but he will have no memory of it. I sought out a center that had a pediatric anesthesiologist instead of anesthesiologists who also do anesthesia on little ones, because they are more experienced with little kiddos. So I guess that was my biggest concern.

The waiting for this, and getting him ready the morning of the surgery will really be the hardest part. I know how relieved you will be when this is behind you. I barely remember it now.

I really do feel your fear and worry. It's normal and means you are a good parent. Wishing you the best and peace for your mind and heart.

Kim 4 years ago

I had surgery today and was under general anethesia. Feeling great other than having lots of anxiety. So much that it is hard for me to sit still. It feels like I am on a caffeine high and unable to rest or sleep. Do you know what would cause this feeling?

Thanks, Kim

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

It is quite possible that this is a side-effect of medication. Sometimes, we give medicines to counter-act the negative effects of the anesthetics. For example, the beginning of anesthesia may cause heart rate and blood pressure to decrease. If we anticipate or see this, we may give medicines to slightly increase them (ephedrine or glycopyrrolate are commonly used, as examples). Some of these medicines can make you feel jittery for a while.

Other people just seem to have a bit of jitteriness and anxiety after surgery and anesthesia.

If you have a fever, or if you check your pulse and it is seems very fast, or you have shortness of breath or other concerning symptoms, call or go to your urgent care.

The good news is that if it is a medication side effect, it should start getting better shortly.

Good luck and let me know if I can help further :)

Kim 4 years ago

They put Demerol in my IV during surgery because I always wake up with shakes. They had to give me another dose when I woke up because I was shaking really bad. Could this also be the cause of the anxiety? 11 hours have past since my surgery, should still be feeling like this?

Thanks so much! Kim

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Demerol is one of those medications that speed up the heart rate and raise blood pressure and may contribute to feeling the way you are. Eleven hours seems like a long time and it may be a combination of medications that are doing this. If you have a history of nausea, they may have used a steroid in your IV to help prevent this. Steroids are longer acting and may keep you feeling exactly the way you describe for a longer time. Steroids are also sometimes used to help prevent inflammation, especially for surgeries around the airway (tonsils, for example). There could be other things contributing (type of surgery, etc) to this feeling as well.

It is also possible that there are other contributing factors. For example, some surgeries cause hormone release that can contribute (thyroid surgery, as an example). So, of course, I'm speculating only. I can't begin to make an actual diagnosis or pinpoint the cause without knowing everything that happened/was given.

I hope you are able to get some sleep tonight and that you feel better soon. If you are really uncomfortable, feel like you heart is racing or anything else, please do call/go the ER.

Kim 4 years ago

Thanks so much for you help and time. I really appreciate it! What a great site!! I had the Leep procedure done today. Hopefully I can get some rest tonight and I know I will feel much better tommorow.

Thanks Again,


TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

I should also mention that if the doc uses local anesthesia (which they do for lots of different surgeries), there is adrenaline (epinephrine) added to the local anesthesia to make it last longer. That's another possibility for 'that' feeling.

Night-night and pleasant dreams!

Kim 4 years ago

Hope you have a great night and thanks again!

tinapnyc 4 years ago

Thanks for your prompt response regarding my son's upcoming surgery/anesthesia concerns. It was very helpful. He will be having his surgery at a children's hospital and will have a pediatric anesthesiologist so I guess that is good. A couple of additional questions for you: (1)does the anesthesiologist usually perform pre-surgery check or is it some other attending doc/nurse? (2)I assume they will be using some anti-anxiety medication (Versed?) prior to surgery? Is that standard practice to your knowledge for kids? Any potential side effects of that? (3) Now for the crazy mom question-I know its very uncommon but have you ever had or heard of a patient experiencing malignant hyperthermia? How low are the chances?

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Tina- Good questions!

1). In most places, both the prep nurse and the anesthesiologist will talk to you and examine your baby prior to surgery.

2). Sometimes on little ones, they do not use Versed or other anti-anxiety meds. This is really decided by the individual preferences of the provider and there are very good and equally valid reasons for either one (not needed=anxiety or separation reaction are so brief because anesthesia is induced rapidly, so avoid extra medications VS. needed to decrease crying, anxiety and maybe risk of vomiting post op, etc and worth the minute risk and extra time spent in recovery). The biggest thing I've seen with these meds is a paradoxical reaction where some kids actually get 'revved up' instead of sedated with them.

3). In my career of 14 years and thousands of patients, I have seen MH once and it wasn't in my patient. By most estimates, each anesthesiologist will have an MH reaction once in their career. I have had a few patients come with either a personal or family history of MH and then adjusted the anesthesia accordingly for them. None of them had any bad reactions to anesthesia in this situation. It happens, but is extremely unlikely without a known history in the family. If anyone in your family has had fevers, organ failure, etc after anesthesia, do alert the anesthesiologist to this (actually alert EVERYONE remotely connected to the surgery). Otherwise, this is probably one of the least likely events.

Most negative experiences after anesthesia are side effects rather than complications. Even when complications do occur, they tend to be minor and short-lived. My baby had a little laryngospasm (narrowed airway that made a little extra oxygen necessary) as he was waking up. There were no repercussions of this at all. I did not consider this a problem as these little things are just par for the course sometimes and pediatric anesthesiologists are used to taking care of them.

tinapnyc 4 years ago

thanks so much for your reply.

Luisa 4 years ago

Hi dr,

My 3 year old daughter got her Tonsils & Adenoids removed a month ago since having this fine she has been waking up screaming through the night, having really itchy skin around thighs and bub checks. She is also waking up in pain struggling to walk in morning, and also hand sometimes falls asleep during the night and she wakes screaming my arm my arm. They have told me that it may be inflammatory arthritis but I'm not convinced, she was a perfectly normal bubbly girl before the opp. They have put her on endomethacin 5 Mls morning and night this helps with the pain but now having tantrums and saying very silly things. What should I do can you please help me?.

picklesmommy 4 years ago

My 6 month-old is having surgery under general on Monday. He is healthy as far as we know (just went for his 6 month check-up last week and all was well) but what "unexpected complications" can arise in children who appear otherwise healthy, and how are those managed? I'm told by my doctors that the only risk is really his age, which really scares me. Is he more likely to have problems with anesthesia because of his age, or is the risk associated more with not having an adequate medical history? Thank you!

Cat 4 years ago

I just had a scheduled laparoscopic gallbladder surgery done that was supposed to be an outpatient procedure.(This was approx my 13th surgery total in my life.) They ended up keeping me overnight because I was not responding after being in phase 1 post op for 4 hours. I was told they ended up doing blood gasses, a ct scan and called in a neurologist to make sure I was ok. I don't remember any of this. Once I did start remembering things, I remember my heart rate was low(39) and my blood pressure was 86/56.(abnormal for me).This was 12+ hours after the surgery. I went into surgery very dehydrated and malnourished. I had recently had a NJ tube placed to help, a few days prior. I have never had this amount of difficulty with anesthesia. Could this have been a reaction from the anesthesia because my state of health before surgery? I am afraid to ever go through surgery again thinking this might happen again.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Luisa- this is tough to answer. The honest answer is that I know of nothing that would cause this reaction that would be related specifically to the anesthesia.

It sounds like the timing of this was pretty clearly after the surgery. The most likely answer you will get is that this is coincidence. This is because we don't have a better explanation for you. I know that is frustrating.

Having said that, there are many diseases/disorders/conditions that have both a genetic component and an environmental trigger. For example, I had ulcerative colitis. It is generally believed that a person inherits the gene that makes it more likely to develop the disease. Then, some environmental factor (virus, bacteria, pollution, food additive...who knows) triggers the expression of the gene. That is, the person begins experiencing sypmtoms/develops the disease.

I will never know what the environmental trigger was that set off my colitis. Likewise, you may never know for sure if there was something about the surgery, anesthesia, stress, tonsillitis, etc. that set off your daughters symptoms.

I am so sorry, though. As a mother, I can imagine how hard it is to see your daughter in pain and then to not even really know what's going on.

Has your daughter been seen by a pediatric rheumatologist? Or any specialist, rather than just a general pediatrician? That would be my next move...ask if there is some specialist you could get a referral for, to see if they have any other ideas.

Good luck and ((((hugs)))). I really feel for you.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi there picklesmommy. I'm sure you are getting very anxious. It's so hard to turn your baby over to have surgery and anesthesia. I had to do it, so I know it's scary.

Healthy babies do very well with anesthesia. Of course, there can always be 'unexpected complications' and as the mommas, we can't help but think of those "what ifs". These would be things like slowed heart rate, low blood pressure, allergic reaction or malignant hyperthermia, etc. These are rare. The more serious they are, the more rare they are too.

One of the reasons anesthesiologists train so hard for so long is to be able to handle little bumps in the road (or giant bumps, if necessary) during the course of the anesthetic. Most of the time, these special skills aren't needed as most anesthetics end up being routine. But, the training is there if any issues should arise.

His age puts him in a category of 'increased risk', but 'increased' just means more than baseline. Baseline is low risk, so statistically, the risk of anything serious going wrong is still very, very small.

Knowing he is healthy and having a recent physical exam do help so much! The worst scenario is when you don't know a patient's medical status and something goes wrong and you are trying to diagnose and treat it all at the same time. Having the medical history and physical ahead of time is really helpful!

Good luck to you and your little guy. These are the worst days just waiting for it to be over. Hang in there.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Cat. Sorry you've been having such a rough time.

It does sound like your state of health probably did influence your reaction and seeming slow metabolism of the drugs.

Dehydration and malnourishment really do affect your anesthetic. We can give IV fluids pretty easily, but the nutrition can't be addressed very well in the short-term. So if, for example, your protein, calcium, potassium, magnesium, etc were low or altered, your ability to clear the medicines will be affected. Also, all of those blood chemicals are involved in regulation of blood pressure and heart rate. Yes, this could very well explain what happened.

I hope you don't need another anesthetic,but know that the pattern of 'no problems' after is more likely.

Take care!

Steve 4 years ago

Getting ready to go for my ninth abdominal surgery. I am using a surgeon that has done the last 4 and knows my history. IV drug user for years then in a methadone clinic on 120+ mg of methadone for 6-7 years. The last surgery I woke up hurting pretty bad it was 4 years ago, and I told the nurse but the anesthesiologist said I have given u enough fentanyl to knock down a horse, and wouldn't give me anything. Finally the surgeon came out and gave me dilaudid and ketamine which was oh so nice (lol I'm not gonna lie) and did the trick. For this next surgery the surgeon knows ur should I inform the anestheologist of my high tolerance? I wear fentanyl patch now 75mcg every 48hours no iv drug use in years but I seem to soak opiates up like I'm 250lbs. I'm only 150lbs. And I always seem to wake up shaking like hell every time seems like a normal thing to me not sure though. And as for versed that stuff makEs me mean as hell and I don't forget anything just get mean my first surgery with this doc I tried to tell the nurse I guess she didn't believe and gave it to me anyway, I woke up in the recovery room strapped to a bed and mad as hell still they finally in strapped me and I ripped out the 3 rd iv all the monitors and Walked out wouldn't let them wheel me out I walked, so I have been more vocal since about the versed or any benzo they alll seem to make me really mean. But I have noticed without the versed I don't seem to have the shakes as long when I wake up.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Steve. That's good that the surgeon knows your history. But, still, tell the nurses, the anesthesiologist, ...anyone who will listen or is otherwise within earshot. Approach it very matter-of-fact like, but make sure you give the examples of what has happened to you in the past with pain meds, what they had to do and the experience with the benzos.

I'm sure you understand the complex issues you have with sedative and narcotic medications. Be as kind and calm, but as direct as you can about your history and previous experiences. If you ask for no benzo, they should not give you one. The pain meds are going to be tougher, but telling the anesthesiologist ahead of time (with previous examples) is VERY helpful. If we know that we have an uphill battle against your pain, we can get a head start while you are still sleeping/waking up and sometimes do better in recovery.

GOOD LUCK to you! I'm sure you don't look forward to all of this. You are quite brave!

Kites n Sky profile image

Kites n Sky 4 years ago

I never had anasthesia.So no personal experience. I never knew that we couldn't eat anything the night before. A very useful hub.

janne 4 years ago

Hi, ive got really bad hayfever and have allergies to cats and dogs. i just wondered if i went under general anasthtic..would i have more of a chance have having an alleric reaction to it??than someone who hadn't got allergies. i want a breast reduction but the storys ive read about GA are scaring me! thanks

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Janne.

It's hard to say, but people who are more 'allergic' in general are more likely to have allergies to medications and so on.

Having said that, I see people every day who have seasonal and animal allergies. I don't think I've ever seen any of them with a bad allergic reaction to anesthesia. Every once in a great while, I've had to give someone a dose of benedryl because they got hives after certain meds. But, I haven't seen a bad allergic reaction.

Breast reduction is a big surgery, and any surgery requiring anesthesia should be considered carefully, but I don't fear of general anesthesia should necessarily stop you from finding out about this surgery. Every single person I know who has had it has been incredibly happy with their results and their decision.

Good luck!

janne 4 years ago

thanks.. just GA scares me so much incase i dont wake up

jen 4 years ago


I have a delayed type iv sensitivity to PABA, and preservatives in local anestethics. My reactions usually appear a few days after the injection, and include hives and uticatia. After learning this, my Allergist and Dentist decided using single dose mepivicaine would be best. No topicals, no estherhello,

I have a delayed type iv sensitivity to PABA, and preservatives in local anestethics. My reactions usually appear a few days after the injection, and include hives and uticatia. After learning this, my Allergist and Dentist decided using single dose mepivicaine would be best. No topicals, no esthers can be used. I had a positive skin test to Lidocaine 2%. I had a C-section done in 2009, before I found out about all of this. During that labor, I was given a spinal erpidural. All seemed to be fine, except the huge rash that developed on my core after surgery. First question is, do you think the original epidural could have triggered my allergy, and my second question is, how will I be able to hsve a future surgery knowing I now have this allergy to presetvatives in locals as well as Lidocaine?

Kate 4 years ago

Great hub! I had laparoscopy surgery a little over a month ago and about to have another one in 2 weeks. I wish I had found this before my first was exactly how you explained it. Thank you for taking the time to help all of us who have questions!


TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Jen. That must be frustrating for you (and the docs)! That's tough being allergic to almost all types of local anesthesia. Sorry.

So if the records are available, I would start by finding out what locals (exactly) were used. When I do them, I use lidocaine 2% to numb the skin, then I use bupivicaine IN the actual spinal fluid. Have you been skin-tested for bupivicaine? If not, you should be. There aren't many choices, so it would be good to know which ones, if any, can be used.

For some reason, you are allergic to these things. I think the spinal/epidural was the demonstration of this allergy, not the cause of it. Not sure if that is what you were asking.

Also, from the insider's point of view. A lot of patients think they are allergic to local anesthetics. We have many who had elevated heart rate after a dental procedure and call that an allergy, when it's really just a normal side effect of the epinephrine in the local anesthetic.

I tell you this because you have REAL allergies. It's important that you make sure everyone 'gets' that. So tell them what you told me. Tell them the reactions you have had, and tell them or show them the results of any skin testing you have had done. It helps everyone realize that your reactions are truly an allergy.

Good luck! and let me know if you have other questions.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Aww, thanks Kate- let me know if there's anything else you would like to know about. Good luck to you!

Jen 4 years ago

Oh! Thankyou for your informative and speedy reply. Im not sure if I had a skin test to bupivicain but I will be sure to double check. Also, my C-section was over two years ago, will I be able to gather info from then on what was used? It was very scary going through, trying to find reasons for my symptoms. Everyone was clueless at some poin. We put it together after a year of continued injections. Like I said before, no esters, no preservatives, no epi or vasoconstrictors and Im good to go. Thanks again for your hub. Its helped a great deal!

jen 4 years ago

Im sorry, I forgot to ask. What would be considered a precautionary "work up" to prepare allergic patients for surgery if needed. I heard of this but am not clear on it. Thanks again!

CJ-14 4 years ago

Hi, I'm considering going for surgery on my eustachian tube in the ear as it is causing my hearing to be lost. The surgery should last 15 mins max. I was just wondering what risks I will have to be aware of.

I'm a 16 year old female with no previous health problems.

The only thing holding me back from the surgery is fear of the anesthesia. (is it more dangerous that the surgery itself?)

How long will I have to stay in the hospital after the operation?


ElizabethH 4 years ago

Hello, I have a fairly sensitive question, and was wondering if there were any similar cases to mine with anesthesia or surgery. I got my wisdom teeth removed two years ago. I was put under with an IV and everything went well except I had terrible shaking and it took a long time for me to wake up. Bur the main thing I'm concerned about is that I developed an eating disorder following my surgery. It seems far fetched, but it was such a coincidence, and I don't have any history of mental or physical disorders.

Titan 4 years ago

I had my labrum repaired and remember waking up screaming from the pain.It felt like someone cut a nerve the size of a pencil in half with a pair of bolt cutters.I remember it like it was yesterday.I'm guessing I wasn't put out all the way.Now I need basal thumb joint surgery and I'm scared I'll wake up again or be awake.Not to mention my modesty issues I'm very nervous going under again.I like to be in control of situations.Any advice

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

I'm sorry everyone! I usually try to answer questions quickly, but these either didn't show up consistently or I missed this for some reason.

I will be back to answer soon. Apologies.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Titan- Are you saying you think you woke up during the surgery? If so, that is awful. If you had a nerve block and sedation, it would not be unusual to remember BUT you should not have been feeling pain, in any case- no matter what kind of anesthesia you had. I don't know if this will help, but check this article out...

If you haven't had your thumb surgery yet, you should make sure your surgeon and anesthesiologist are aware of this problem. You really can have post-traumatic stress reactions to this type of event (if you had actual intraoperative awareness) and it should be addressed as soon as possible.

Good luck to you!!

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Actually, your allergist would be able to figure out what to test for, although they may need to speak to an anesthesiologist to know what drugs may actually be used.

Sometimes, allergic patients are given precautionary benedryl and/or steroids before other medications are given to prevent or minimize any allergic reaction. It's probably best to be tested, though, so that the allergies are better clarified.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Charlotte. Many times these surgeries are done with short-acting general anesthesia. I don't know if they still do them with sedation or not. In any case, a healthy person your age should have minimal risk.

Find out if you can talk to an anesthesiologist beforehand to have your questions answered or if they can explain exactly what they will need to do. You will likely feel much better after a talk like this.

The time you spend in recovery will depend on the type and amount of anesthesia you get, but should not be very long.

Good luck to you!

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Elizabeth. I certainly don't know of any cases of eating disorder developing as a direct result of surgery or anesthesia. I don't know if anything associated with the event was traumatic enough to trigger mental changes.

I'm sorry I don't have a good answer for you. The shaking is a common side effect of anesthesia, though.

Hope you are getting better!

Polly 4 years ago

I had a very traumatic experience a few years ago with conscious sedation (midazolam & fentanyl) for an outpatient procedure. I was merely told I would be given a "sedative", with no mention of the amnesia, which in my case, lasted ten times longer than the procedure did. I "became aware" in mid-sentence, and freaked out. I was also not told I would be given narcotic pain medication (which I cannot tolerate), and had extreme vertigo & nausea following the procedure. TWO QUESTIONS: Why is the amnesia not always explained to the patient in advance, and do I have the absolute right to refuse an amnestic in the future ? (I find it profoundly disturbing, and would rather be completely "out")

I had major surgery 20+ years ago without Versed, was allowed to see (& remember) the OR, and I "went under" peacefully when asked to count backwards...and I was treated with compassion by EVERY medical person I encountered...)

FYI: My consent form (of which I have a copy) does not name or explain the drugs I would be receiving.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Polly.

First, I am sorry you had an unsettling and less than acceptable experience.

I think that most people prefer NOT to have memories of being in the operating room and most people who have had amnesia of the experience don't have a problem with it. Not to say that your feelings of being disturbed by it are wrong- they are not - but they may be the exception and not the rule. I'm guessing that's probably why it has never become 'tradition' or standard of care to mention that you won't remember.

It would be quite difficult to give you a sedation OR an anesthetic without using an amnestic OR a narcotic. In fact, both of these things are part of most sedations, and definitely part of general anesthesia.

So, to answer your first question, I think we don't always think to stress that amnesia is part of sedation because most people either don't care or welcome it. If you prefer, you can ask to not have amnestic for sedation, but to be honest, it might be very, very difficult for the anesthesiologist to fulfill that request. The drugs that aren't amnestic tend to be narcotics, which it sounds like you also don't want.

If you have general anesthesia, you can absolutely ask to NOT be given versed before induction of anesthesia. I get this request from time to time. It's not usually a problem. But, obviously, the general anesthesia will be amnestic. Also, narcotics are almost always used as part of the anesthesia. I like to use narcotics during anesthesia for lots of reasons, including allowing a smoother wakeup if my patient isn't in pain as they wake up.

I hope that answers your questions. The best thing to do would probably to explain to your next (if there is a next) anesthesiologist what you did and didn't like about your past experiences. Ask what is and isn't possible in these areas and come up with a plan together that is acceptable.

For their part, they may need to understand that you don't necessarily want, like or need what other patients do. For your part, you may need to realize that some things are not possible and some of these medications will need to be used.

I have never seen a consent form that lists all the possible drugs that may be used. Anesthesia is a dynamic practice, meaning that what works for one person may not work for another. If we didn't have the option to change plans midstream and do what needs to be done to keep our patients safe and comfortable because the drug we need wasn't listed on the consent, it would be nearly impossible to do our job well. I'd say there are a couple dozen possibile medications we use fairly regularly for a general anesthetic. Trying to list all of these and anything else we might need would be confusing at best.

Does any of that help at all? I hope it didn't make the whole thing more confusing!

Let me know if you have other questions.

Polly 4 years ago

Thank you for giving me a thorough explanation from the "doctor's" perspective. I think the fact that the amnesia was not explained to me was more upsetting than the amnesia itself. From the "patient's" perspective, not warning the patient about the memory loss makes the doctor/anesthesiologist look sneaky. We patients do not approach surgery with the same expectations, just as we do not all have the same medical histories. We don't even know what questions to ask, and put our total trust in you. Causing a loss of trust is just as harmful as causing physical harm. And there are many more people who feel like I do than you know, we just aren't acknowledged. Take a few minutes to talk to the patient, please. Thank you again.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Thanks Polly. Actually, my lack of time with patients to discuss these types of things is one of the reasons I get frustrated with my job. I've had more than one surgeon completely lose it with me because I was spending too much time talking to the patient. In fact, one even said to me "What do you have to talk about, it's not like they'll remember any of it". Nice, huh? Luckily most doctors are really not that nasty. Many don't realize, however, that what we don't tell patients can be as important as what we do say.

My pre-anesthesia talk mentions that "you will likely not remember much after I give you the sedative here in preop." I know not all of my colleagues do this. I am certainly not defending the lack of communication. I was more trying to figure out or explain why that may have come to be. I will definitely remember what you have said here and keep in mind that this IS a big deal and it is not to be taken for granted that all patients WANT to be amnestic before having anesthesia.

I hope this at least helps a little as you have helped me see your point of view. I certainly would not withhold information to trick a patient or be cruel and I don't know of anyone who would, for what it's worth. We practioners definitely need to be more careful not to have omission of information make us seem that way! Thanks again for your insight- it will help me for sure and I will remind my colleagues, as well!

skarnick1 4 years ago

It looks like I may need my gallbladder removed, and after having an emergency appendectomy, an ectopic preganacy surgery due to a ruptured tube, and a hysterectomy, I'm really bummed to be needing surgery again. I have asthma and allergies, and after the hysterectomy, I noticed some chest tightness and worsening of my asthma when I got home the next day. I remember the anesthesiologist telling me that he would be "irritating my bronchial tubes" with the breathing tube before the surgery. I had not had the asthma issue with the other surgeries that I've had previously, and I remember the anesthesiologist for the ruptured ectopic surgery telling me that she would keep me "sleepy" a little longer because of my asthma, and I never had an issue with it. I should also say that I don't use albuteral due to heart rhythm issues. I use atrovent for a rescue inhaler. I am just super upset that I will probably be needing this surgery and I am wondering what can be done to minimize any problems with my asthma? Do different anesthesiologists use different size breathing tubes? I just thought the comment about irritating my bronchial tubes was kind of strange, and I really don't want them irritated!!!!

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Skarnick- I certainly understand your apprehension.

The phrasing about irritating the bronchial tubes seems odd. I usually say "Sometimes, the breathing tube that is necessary for your surgery and the anesthesia gases, along with the cool, dry oxygen can irritate the airways and cause airway reactivity. Sometimes, this just causes a little coughing, but people with asthma can have an asthma attack or notice their sypmptoms worsening for a few days after surgery."

Sometimes, the breathing tube irritates the airways, and sometimes it does not. As gentle as we are when we place it and as improved as our medications and treatments are, the airways can just be so sensitive. The size of the breathing tube may not matter much either.

Unfortunately, there is no good way to predict when this irritation will happen and when it won't. Let the anesthesia doc know that you had issues before. This tells them that you are more likely to have bronchospasm, and they should do whatever they can to prevent it. No guarantees, obviously.

Probably, if at all possible, you and the anesthesiologist should discuss you puffing your atrovent just before surgery. This seems to help in a lot of cases, even if you usually only use it for rescue.

As hard as it will be, you will have to do your breathing exercises after surgery. Your gallbladder, as you know, is in the upper right quadrant of the abdomen. The fact that the surgery is near the chest, and that it will likely be laparoscopic (compresses the lungs a bit more) may make this more of a challenge, but will help you a lot if you can do this (have they given you an incentive spirometer in the past?) Take deep breaths, hold them for just a second, then blow out slowly. This helps keep the lungs expanded.

Also, don't know if you saw this, but I wrote specifically about asthma. There may not be much in there that you don't already know, but maybe something can help you.

Good luck to you and stop back here if you have other questions.

Million n 1 4 years ago

Hi. I've had had many surgeries (approximately 55 if not more) since I was seven years old, I'm 20 now. I haven't really had much problems, most of my surgeries have been done under general accept for this year where I had a few done just with local. The only issue I have is the fact I'm such a hard stick for IVs that I've actually had to have a few surgeries rescheduled simply because the anesthologist didn't know how to deal with this issue and simply refused to do anything about it, such as possibly sedate me as other past anesthologist have so they can poke as "much" as they'd like without me being in pain for it. I have had times where literally I would be poked for three hrs straight by like five different people. My question is, what can I do to maybe make getting my IVs easier since not every anesthologist out there seems to have a crasp on what to do?


TPHd21 4 years ago

Hi! I am having a TAH with my ovaries being removed on may 23rd. Two questions.

1- what is the likely hood of being under and actually feeling and hearing everything that is going on?

2- after surgery will they give me something to reverse the anesthesia or will I just be waking up on my own?

Any insight would be fantastic, because for some reason one of my biggest fear is feeling everything and hearing everything and not beagle to do anything about it, silly I know but I am scared about it:/

Oh and another thing I am concerned about, in 2009 I had surgery under GA and from what I understand they had to keep me under longer because my blood pressure dropped scary low, this is what they told my husband, so for this surgery I went and got the surgery paperwork from the surgery in '09 to bring to this surgery and the surgeon wrote nothing about the blood pressure just said I handled everything great. This also has me very concerned.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Million- The difficult IV stick is frustrating for everyone (and painful for you!) and I'm sorry that's been an issue.

There isn't much you can do, unfortunately. You must stop eating and drinking at the designated time, but make sure you are well-hydrated until then.

I'm wondering how they sedate you adequately without an IV? Do they give you oral medication? There are definitely pitfalls and dangers to this, so I can see why they wouldn't make this a routine. This is going to be at the discretion of the individual that day. Unfortunately, if he or she feels it is unsafe, they aren't going to do it. It's hard to say what the issues could be without knowing your whole history, etc.

The best thing you can do is to ask to talk to the head of anesthesia well in advance of any procedure. Sometimes, a little pow-wow and a plan of action that the anesthesiologists can agree on will help. They may be able to assign someone who has cared for you before or brainstorm some ideas about the best plan. They might have you come in early to have an IV placed under X-ray if they are equipped to do that (most places don't, but they also could refer you to a hospital, perhaps an academic center, where this is available).

I don't know your history, so I am absolutely not saying that any of these things SHOULD or COULD happen- just trying to think of potential things for you to ask about before you go through the frustration of being canceled again. That's really aggravating, I'm sure!

Good luck and if you know where your surgery is schedule, ask to be put in touch with the anesthesiologist in charge, or ask if someone could talk to them for you about this issue in advance of your surgery.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author


Hope you have a very smooth surgery and recovery!

Your answers (as best I can do in a "generic" setting, anyway.

1). The likelihood of having some intraoperative recall has been quoted at 1 or 2 in 1000 general anesthetics. Other studies have put this number at 1:10,000 or higher. There is some discrepancy due to study methods and definitions. I have personally given thousand and thousands of anesthetics and don't know of this (legitimately) ever happening. I say it that way because some patients have thought they had recall, but really they had a sedation anesthesia and didn't understand that some memories are within normal limits for that type of anesthesia. Even people who do have recall don't usually feel anything, even if they hear. The brain can process and perhaps remember sounds when every other sense is 'deadened'.

It seems to me that real intraoperative awareness or recall is pretty rare (see my hub about this), although possible and devastating when it *really happens.

2). At the end of surgery, the anesthesiologist turns off the anesthesia gas or infusion they are using. The anesthesia is allowed to 'wear off'. In addition, sometimes, reversal agents are used for certain medications (muscle relaxants, benzodiazepines and opioid pain medicines can be reversed if needed) if they aren't wearing off on their own.

So... the answer is the anesthesia is ALWAYS allowed to dissipate or wear off and SOMETIMES, reversal agents are used, if needed.

3). You did the right thing by getting the operative note from the surgeon. Unfortunately, their notes are focused on the surgical procedure. Your anesthesia record should have any intraoperative events (if they were significant or prolonged). Contact medical records at the surgery facility and get a copy of the "intraoperative anesthesia record and any anesthesia notes" if you can. Take this to the surgeon, and bring a copy to the anesthesiologist, as well. It may not even be noted on there if it was a brief event. Even if you don't find any specific notation, tell the anesthesiologist about this to the best of your (husband's) recollection.

The best bit of preparation we get as anesthesiologists is information! Anything you tell them or show them will be very helpful! Let me know how it goes :)

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

OOps, here's the link for you to the hub about intraoperative awareness in case you want more info..

Million n 1 4 years ago

Usually they poke me till they get my IV, sometimes after they've poked me for about an hr or so they realize it's not going to be easy so they either give me a shot of ketamine or nitrous through the mask. For the past like five years thats been pretty rare. I simply suck it up till they've found a vein that works. 

That time they  canceled my surgery (it was to be done in an ambulatory center) they rescheduled it to be done in a hospital facility because there they would be able to use an ultra-sound. Sadly, I went there and they poked me for an hr THAN used the ultra-sound and they were only able to find veins for a central line which was also not easy to get in because of my burn scars. But thankfully they did get it and finally knocked me out. 

My original place where my main doc is they know me and my situation so usually they sedate me without questioning it if they feel the need to. The place I had that surgery where it was canceled I had one previous surgery and they poked me for about 45 minutes to an hr and they finally decided on nitrous gas because they said it expands the veins. But when I went in for my second surgery, I had a different anesthesiologist who when the nurse suggested doing the nitrous again, she said no which I didn't understand why not. Third surgery in that place I ended up having to do the surgery under just local because that same  anesthesiologist that refused previosly was there and refused to even try to get my iv in for conscious sedation.  which ended up to a not so pleasant experience which has made me a little reluctant to even going back there. Unfortunately I have a surgery there in a few weeks, they're saying it will be done under conscious sedation but I don't really know if that's true or not, since what happened last time. All I know I've done it under local three times and I don't plan I doing it again that way. 

One question: if they do end up doing conscious sedation, what should I expect? I'm a little nervous it won't work or I end up saying something embarrassing or mean. 


TPHd21 4 years ago

Thank you so much for your words. I feel much better than my first message. I am still nervous, but starting to feel better about it.:)

Deb 4 years ago

Hi there, great site thanks so much for taking the time it's very comforting for us patients. Wondering I have huge pain after laparoscopy due to gas is there any way that can be avoided? My anesthetist asked if I get reflux which normally I don't should I say yes next time? Would that help prevent?

Hf13 4 years ago

Wow this has been very informative! But I'm still terrified.

I'm having my first ever surgery in 2 weeks, in getting knee surgery.. I don't know what the surgery is called I live in French Quebec and I'm English so all information is told to my boyfriend.

They are strapping ligaments across my knee cap to stop it dislocating and then putting screws in the bone to hold it in place.

But I am terrified of going to "sleep" and still feeling something or getting sick after or even acting stupid when on the drugs what can I do to calm my nerves??

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Hf13 - I'm sorry you don't even get to have a real discussion with your doctors. They don't provide English translation? We are required to provide translators for our patients if they ask. Just make sure you understand one way or another what the potential issues are with the surgery, ok?

I think the best thing to do for the fear of anesthesia is to remind yourself that very, very few people have problems in spite of the millions of anesthetics given world-wide each day. Even really sick people in not-so-medically advanced countries do just fine. Statistically, you have no reason to worry.

It might help to start practicing relaxing or breathing exercises now. Practice calming your nerves when you feel yourself getting anxious. Take deep breaths and think calming thoughts or focus on relaxing your tense muscles. The worst part is the anticipation, the waiting.

Good luck!

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Sorry, I missed your question in there...

Conscious sedation, MAC anesthesia, twilight sleep or whatever they call it is the addition of sedative and IV pain meds to the local used by the surgeon. Usually, you get sleepy and relaxed. They can adjust the meds to your comfort (as long as breathing and vital signs are ok) and you may have partial or no memory of the procedure afterwards.

It's unlikely that you will say anything nasty. Usually, you just fall into a light or even deep, sleep. Tell them ahead of time that you fear you will do this and they will reassure you that even if you do, they know it's the drugs!

Let me know how it goes, ok?

Hf13 4 years ago

Thank you so much for your fast response! This thread has helped put my mind at ease a little bit.

I will report back in 2 weeks :)

Thank you for the job you do and taking so much care of us we need it most.


Million n 1 4 years ago

It didn't reall go as I was told. I went there thinking I would be getting IV sedation. My doc told them not to put an IV and to just give me diazepam orally and that they'd just do it with local. The meds didn't kick in till after I got into the car and than they really could do the surgery cause there were unforeseen circumstances and he said I wasn't sedated enough to get it done. So really was just a waste of time.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Million n...

I'm so sorry- you really do have a rough time and A LOT of aggravation with your health/surgical care. I wish there was a way to make it easier or to help you and the docs figure out an approach that would just work.

Take care & let me know if you have other questions.

Million n 1 4 years ago

Thank you so much for all your help!

Liz 4 years ago

I am having general anesthesia and have a lot of dental crowns and several bridges. A nurse told me that teeth were sometimes chipped during administration of general anesthesia. How often does this occur and what complications can it cause?

Kat 4 years ago

I have always had a low blood pressure. However when I went into Group Health yesterday to check out my elbow (which we found out to be broken) the nurses found it to be alarmingly low. After we found out that my elbow was broken, my doctor informed me that I would need surgery.

I've heard that a low blood pressure or low heart rate can increases ones risks for under going cardiac arrest while under anesthesia. Is this true? Am I more at a risk for this than others?

Amanda Taylor 4 years ago

My brother has Fabrys disease, which is he's missing an enzyme. Recently, they have started him on a new medicine which is the missing enzyme. The new medicine is by I.v and last about an hour and a half but, it causes him a lot of pain during the infusion. The doctors have give him lots of different pain med's that have not helped. My question is would a medicine such as Versed be an option? He has to have the infusion twice a month. Would that be too often to be put under sedation?

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Amanda- I'm sorry for your brother and his health issues- that's really hard. I have not worked at a place where sedation is used for infusions, but I can understand the need if it's painful! Versed (midazolam) is a great medicine. But, it does not have any pain relieving qualities and it's very short-acting. It wouldn't last near long enough. Repeated doses increase side effects, but still probably wouldn't be as effective as needed. I'm sorry the pain meds haven't worked.

Being sedated twice a month should not be a problem, but they need to find something that will work. I'm not how old your brother is, or what type of medical facility administers his care. The successful regimen will also depend on whether the pain is localized to the IV site, the arm where it goes in (have they tried different sites) or generalized body pain. These things would all influence what can be done to help him through these treatments. Some places may have strict policies about who can administer sedation, where they can give it (certain monitors have to be available), and for what procedures. There might only be certain meds that the docs are allowed to prescribe in certain situations.

I would try to call them before his next infusion and ask if they have other suggestions, stating that nothing has helped so far. I don't know if they could ask around if other people have issues with this med, and what can be done. If you are at an academic medical center, you may have more luck asking the doctors to seek input from other doctors or patients at other centers.

I hope they find a regimen that can help.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Kat,

Low blood pressure and heart rate may or may not increase risk of anesthesia. It depends on the reasons for it, really. Was any further questioning pursued? For example, did they ask questions about other symptoms (light-headed, chest pain, palpitations, weight gain or loss, dry skin, constipation, etc)? The first thing to be done (if there is time before surgery) is to make sure this is just "your normal' and not related to a thyroid or other hormonal disorder. I love my surgeon colleagues, but they don't always think to do these things and there may not be time to do so, anyway.

Even if you don't have this done, btw, the nurses will check your blood pressure in the preop area. You should also make sure you get to talk to the anesthesiologist and tell them your concerns. We have ways to make sure your heart rate and blood pressure don't get too low under anesthesia, but it helps a lot if we know there's a potential issue ahead of time.

So...if you surgery is scheduled immediately, try to call your regular doc and ask if they have ever worried about a cause for your blood pressure/heart rate to be low. Report anything you find to the anesthesia doc.

If your surgery is planned in the future, call your primary doc and ask for an evaluation for the low blood pressure and heart rate, making sure to tell them what it was during the most recent visit.

Again, either way, provide as much info as you can (including any symptoms listed above or any others) to the anesthesiologist. If you can, call the anesthesia or preop office beforehand and alert them to the issue. Sometimes, that can give them the head-start they need to decide if you need further testing in advance of your surgery.

Information is our friend and the more planning and preparation, the better.

Good luck! Let me know how it goes :)

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Liz- It is a risk that a tooth (most often an upper front one) could be chipped during anesthesia when a breathing tube is placed. This happens relatively rarely considering how many patients are intubated each day. It is more common when the 'airway' is difficult (obesity, serious jaw or face abnormalities, neck issues, etc). They can be chipped as the breathing tube goes in from the metal light we use to place the tube, or on the way out if the patient bites down on the tube or bite block. This hub explains the issues a little better. For dental work, an ET tube would most certainly be used with GA.

Good luck- remember most people have no issues with this at all.

Scared 4 years ago

Im having plastic surgery. I got my h&p done today my EKG showed a fib but my de said that I wasn't after he listen to me. He said its hard to explain but the test was in correct. I do have high blood pressure which is controlled however all my bloodworm came back fine & he cleard me for my surgery. Should I be worried about the a fib if he said that I'm ok to have surgery.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Scared!

The EKG prints out the strip that shows your heart rhythm. In addition, many EKG machines provide an initial interpretation of the EKG and print it in words on top of the paper. For example, yours might show your rhythm (the pattern of the line, points and blips across the page) and might read "irregular rhythm, atrial fibrillation, rate=85 or something to that effect (example only, obviously).

Sometimes there is some reason that the computer misinterprets the rhythm, such as movement or other artifact. Usually, they do a decent job, but minor errors are pretty common.

If this was your surgeon who said you weren't in a fib when he listened, you can ask for another opinion. Ask for a copy of your EKG and request to be seen by your primary MD for official 'clearance' before your operation.

This is your health and you deserve to feel comfortable before proceeding.

If this WAS your primary MD, this is more likely to be their area of expertise. Feel free to ask for clarification as to why there is a discrepancy between what the EKG says or shows and what he sees or hears.

You can also call the preop office and alert them to a potential issue. They may put a note on your chart to get a repeat EKG immediately prior to surgery OR to make the anesthesiologist aware to listen to your heart carefully before anesthesia.

It sounds like you had bloodwork. I'm not sure what tests you had, but if they checked your blood chemistry (sodium, potassium and so on), this is a good test to do to make sure you don't have abnormal heart rhythm because of an electrolyte problem (one of the most common reasons).

In any case, it sounds like you need a better explanation at the very least. Ask if you could kindly get a bit more information.

Good luck to you!!

Tbear1013 4 years ago

Hi I found this page to be very informative I have got to have oral surgery under ga to remove 17 teeth scared to death because 1 I have read horror stories about dying during surgery for teeth removal and 2 I have been on oxycodone 10/650 for the pain for 2 months what are the dangers of having oral surgery under ga and also I being on the meds for do long thank you so much for response I am really scared to death thank you tbear1013

Virginia7 4 years ago

I had my gallbladder removed in Jan. 2012 In April I had a spell where my vision was blury, was confussed, and my speech was slured. It lasted about 30 minutes. I went to the ER and had several test done and they couldn't find anything. Could this have anything to do with being put to sleep months ago? I had the same thing happen about 10 years ago with another surgery.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Tbear- Sorry I didn't get to this sooner. I saw there was a question from you too, but for some reason, it only shows up on my mobile account and not my computer??

Anyway, first- take a deep breath. If you are having general anesthesia, that is actually a good thing. That means that a qualified anesthesia provider will be there administering the medication and monitoring your vital signs. That should provide some comfort.

Dental extraction does not fall into the high risk for anesthesia death category. I'm not sure where you are reading these horror stories, but the best I can tell, it would be an exceedingly rare occurrence. I've never, ever seen it or heard of it from my colleagues. It may happen rarely, but the odds are WAY in your favor. I hope that helps. The anesthesia doc continuously monitors your heart rate, blood pressure, oxygen level, breathing, anesthesia needs... And that's their only job. They are not also the same person that is doing the procedure - that's an extra level of safety that you get when you have general anesthesia (or have an anesthesiologist present during sedation).

Second, the anesthesia doc will need to know about the oxycodone. Be honest with them if you take more than the prescribed doses. There is no more danger to the anesthesia because of this medication. It may just make pain relief afterwards take longer to achieve. We give anesthesia very frequently to people who have been on astronomical doses of narcotic pain meds for years and years. The anesthesiologist will be able to do this.

If it will help, on the day of surgery, be sure to talk to your anesthesia provider before you go into the operating room. Tell them about your fears and let them answer any questions. I would consider your situation to be 'routine' unless you have a lot of serious medical problems that you haven't mentioned. Even the sickest of the sick patients almost always get through the anesthesia though. We work hard to keep you safe.

If you do have significant medical problems, you can always request to be evaluated by your primary doctor before surgery to make sure you are in as good shape as you can be as far as problems and medications. We call it being 'optimized' for surgery. If you have only minor or well-controlled medical problems, they may tell you this is unnecessary, though.

Good luck to you! The worst part is the waiting and anticipation.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Virginia- There is no known medical reason that this spell you describe should be caused by surgery or anesthesia 3 months after the fact.

You did the right thing by going to the ER. Obviously, they needed to rule out strokes, mini-strokes and so on. Believe it or not, migraines can manifest this way and they might diagnose you with that after they have ruled out more serious diagnoses.

I have no idea what that spell was (disclaimer: the above migraine is just an example of something that can cause those symptoms and is NOT meant to diagnose you). But, again, I can't think of any reason that it would be related to the surgery or anesthesia. I also can't find reports of anything similar happening.

I hope it doesn't happen again- that has to be really scary!

glenda sutton 4 years ago

Twice I have had general anesthesia and have stopped breathing and they had to work with me to get me breathing again. What could be causing this? I am scared to have anethesia again. What do I do?

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Glenda- It is often part of the anesthesia process that you will stop breathing on your own and be assisted by the anesthesia team or the ventilator.

It sounds like you mean that it was more difficult than usual to get you started breathing again after surgery. Is that correct?

There are some things that can contribute to this.

Among these are obesity, sleep apnea (central or obstructive), smoking history, other lung disease, excess sensitivity to anesthesia or narcotic medications used during or after surgery.

If you have not been evaluated by your primary doctor in a while, that would be a good place to start. You may need to have your blood chemistries and thyroid checked.

Sleep apnea is a very common cause of this, as is lung disease, like emphysema.

For sleep apnea, usually, the initial screening just involves a series of questions to evaluate the liklihood that you have it. Then a sleep study can be performed if sleep apnea is suspected.

If you are overweight or smoke (or both), you can ask your regular doctor to help with these issues.

Once these things are evaluated, if no likely cause is found, discuss the issue with the anesthesiologist beforehand. Make sure they understand that this happened more than once and give them as much info as you can.

If possible, ask to get (or ask if they can get) copies of your previous records related to the events. There may be no clues at all in there, but it may help. It can help them understand if the issue is related to your metabolism of medication, your brain's processing of signals to breathe, your lungs... or other issues.

Honestly, knowledge is power. The more info you and they have ahead of time, the less likely there is to be a problem and the more likely they will be prepared for it if there is. It should make (hopefully) you feel better too to know that this is something they can deal with.

Good luck and let me know what you find out. There are too many unknowns for me to guess at the cause of this, but regardless, a physical by your doctor and a discussion with the anesthesia provider should help a lot.

When they know there isn't some other reason, they may be able to adjust the medications

susanp 4 years ago

I have pseudocholine esterase deficiency and just had lap gallbladder surgery. I have only had anesthesia twice and both times they give me the alternate to the regular anesthesia because of the deficiency. My question is the long term effects of the anesthesia on someone that has this deficiency? I am now on day 11 after surgery and am having some slight pain when taking deep breaths. This has been going on for 2 days. I just wondered if this could be some of the lasting effects of the GA. My surgeon said it takes a couple of weeks for the med/GA to get out of your body. I am a fairly healthy 44 year old in pretty good shape so am puzzled that I have not bounced back as quick as some other people.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Susan. Pseudocholinesterase deficiency really only causes us to change one of our main drugs, the muscle relaxant, succinylcholine.

Succinylcholine is a muscle relaxant and is metabolized by the enzyme, pseudocholinesterase.

You have a deficiency of this enzyme and therefore, if you receive succinylcholine, you would be very weak and need help from a ventilator for breathing for up to 6 hours after your surgery. Usually, this medicine is gone in half hour or less.

For you, they would just not use succinylcholine, which is often, but not always used anyway. They would use another muscle relaxant to start the anesthesia (like rocuronium or vecuronium). But, just so you know, this other muscle relaxant is usually used during the anesthetic anyway, just not always at the beginning. Succinylcholine is almost always used ONLY at the beginning of surgery.

So, they likely didn't use anything they wouldn't use anyway. Probably, they just used one of the other muscle relaxants at the start of anesthesia, in addition to during anesthesia, when they would likely have used it anyway.

Muscle relaxants necessarily have to be 'gone' by the end of surgery or you would not resume breathing on your own.

If succinlycholine is not used, there is no reason to think that you would have any long-lasting effects from anesthesia, more than anyone else.

There are some other drugs that are metabolized by this enzyme, but for most, the metabolism is not completely dependent on pseudocholinesterase. In other words, there are other pathways of elimination from the body and usually, you should not experience long-term effects from this, either.

If you are having pain when you take a deep breath, there could be a variety of causes. Most commonly, this is either from the surgical changes inside your upper abdomen, the incision or from irritation of part of the lung or its lining. Sometimes, if you have pain, you don't breathe as deeply as usual and part of a lung can collapse (called atelectasis). Also and very importantly, if the pain is bothering you, you should ask your surgeon if you should be evaluated for blood clots (especially if you have any shortness-of-breath or trouble breathing or leg swelling).

Each person has a different experience recovering from surgery. Usually a healthy, young person like yourself will bounce back fairly quickly, but sometimes it just takes extra time, rest, hydration and care.

Hopefully, instead of just saying "oh, it's the anesthesia" as is very common, your doctor will make sure you don't have any serious reasons for the pain, like infection, incision problems or blood clots. Sometimes, they can make this determination just by talking to you. Sometimes, they will want to see you and do an exam.

This is not a diagnosis or suggestion of one. Only your doctor, who can see examine and talk to you can determine your relative risk of those things. All I can tell you is that I know of no reason why the anesthesia would be causing pain when you breath, starting almost 2 weeks after surgery.

In any case, I hope you are already feeling a little better. Take it easy- I know it's not easy to be patient when you are more than ready to feel well (I've been there so I get it)!!

susanp 4 years ago

Thank you so much for responding. I just got off the phone with my surgeons nurse and since I am not having shortness of breath or any sharp pains they do not think it could be a blood clot since I don't have any other swelling. They told me to take tylenol and to give it more time. The incision that is at the top of my abdomen has been the most painful of the 4 and it is still slightly swollen. Even though the incision looks good on the outside, clearly there is more going on under the skin. Surely, if there was an infection inside, I would have other symptoms. Thank you too for explaining the deficiency to me and how the anesthesia is administered. It seems to throw up a lot of red flags when I flash that card and they had to do this in the hospital instead of the outpatient facility because of it.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Laparoscopic surgery produces less pain than traditional incisions BUT, the higher the incision for the ports, the more pain they seem to cause. A lot of people actually say it takes weeks for the gallbladder port incisions to feel better. It may be that, as you started feeling better, you moved around more and aggravated that incision. I've had surgery and did that exact thing, so just another guess as to why it would start farther out from surgery.

Good luck and I'm glad you called and talked to them. Sounds like you got good advice and as hard as it is, patience is your friend. Good luck to you!! Thanks for visiting!

Tiffani T 4 years ago

Thank you for taking your time to answer people's questions even when they are not your patients.

I am one week today post op appendectomy/abdominal wall repair/explore. I have had GA in the past with no ill effects. I saw my surgeon today and was discharged from his care, as everything looked good incision wise and such. Unfortunately he did tell me as a result of his surgical findings I need to be seen by my Gyn doc for TAH..

I'm so concerned about having GA again, so soon, but know that I've never had problems.

My concern Is how I'm feeling NOW. I feel very shaky, weak, and short of breath. I just assumed it was A. Maybe still the anesthesia, or B. just still part of the recovery phase. For those reasons I didn't mention it to my surgeon.

Could this be anesthesia related, or should I be concerned?

After my last c section I did develop bilateral pneumonia and remained hospitalized for 7 days, however no GA was involved.

I've also had some concentration issues, and have been quite weepy..

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Tiffani-

The shakiness and weakness can be part of normal recovery. Usually, you are feeling a little better by a week out. Are you able to eat and hydrate properly? If you aren't better in a couple more days, you may want to give the surgeon's office a quick call, or see your regular doctor.

The fact that you had postop pneumonia in the past, and you say you are short of breath, makes me think you should follow up with that before moving onto the next step of your surgical care. If the TAH is urgent, ask to be seen by a primary medical doctor about any potential lung issues before your surgery. It's possible you are just still recovering, but given the history of pneumonia, you need to take preventive measures to make sure it doesn't happen again. Even if you don't have or get pneumonia, you may need someone to follow up with you regarding lung recovery after surgery.

Regardless of the type of anesthesia, the anesthetic and especially having abdominal surgery make it harder for your lungs to fully expand afterwards. You should be doing deep breathing exercises and walking (unless you have some reason why you can't) to expand all those little airways deep down in your lungs. Often, they will give you the little plastic breathing apparatus when you are discharged from the hospital called an incentive spirometer. This is the device that has a straw for you to inhale against to try to raise a ball or plunger up inside the canister. Did you get one of those? If so, continue to use it until you are seen or are feeling better and moving around a lot.

Hope you feel better soon. You will do fine having another general anesthetic as long as you and your lungs are recovered from this surgery first, so just have that checked out if you are still feeling short of breath. :)

Justin 4 years ago

Had inguin hernia surgery yesterday,im honestly just wondering if the anesetic is ojt of my body and can it still effect me somehow negatively or am i good now? It's been over 30 hours,and how good is mesh repair for an inguinal hernia.

Jennifer 4 years ago

Hi I have recently been put under twice with general anesthesia. Once to have a stint put in me and the other to have lipotripsy done to break up kidney stones. Everything went fine but I am now getting a really bad burning sensation in my chest. What could that be? Is it normal after having these procedures done for this to happen? If someone could give me some information I would totally appreciate it I am freaking out.

Rebecca2904 profile image

Rebecca2904 4 years ago

This is a really great hub! It's really scary having to be put under, knowing that things will be happening to you and that you'll have no way to stop them. I was put under once when I was a child to have an operation on my mouth which didn't really scare me at all, both my parents came with me and all the hospital staff were obviously really nice since I was so young. The second time I went under was terrifying though. I was all alone when I went to hospital because my uni is hours away from my home, my parents only came when I woke up again, and this time hardly anything was explained to me. I wasn't even told until after the operation that they kind of tie a kind of bag around your gall bladder and pull it out? I thought they'd just cut it out the side. I think reading hubs like this really help people to feel more in control of what's happening, it's so much better knowing exactly what's going to happen to you rather than just going in blind.

I don't know if they're are different kinds of anesthetic? I have kind of fuzzy memories of mine, but the nurses put something in my hand and told me it would make me feel drunk and then I'd just pass out. I remember thinking that wasn't going to happen to me, I'd just pass out straight away, but the next thing I knew I was laughing hysterically telling them how hysterical the light was. Perhaps you could include something about how you feel in the few seconds between being given the medication and passing out? I know that was something I was quite concerned about.

Polly 4 years ago

I had a completely opposite reaction than the previous poster. I was relaxed and calm pre-procedure, not concerned at all, and was expecting a good experience. Instead, I was overcome by extreme anxiety and fear when the medication entered my system. If it was supposed to make me feel relaxed, it had the opposite effect. Doctor, can you explain why each of us reacted differently ? Thank you.

ria360 4 years ago

Is it too dangerous to have one general anesthesia and 2 local spinal anesthesia with in one month, My dad is going through so much with in the last 30 days He's having last surgery tomorrow with spinal anesthesia and he's 79 years old. I am very concerned about he's health and at the same time worried if he's going to be ok.

Any advice? Thanks

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

@Ria- Hi there. I understand your concern. It sounds like the surgeries are necessary or it's unlikely they would do them in such a short time. There isn't much info on repeated anesthetics in elderly patients. I know the stress of illness and surgery and anesthesia on the body can certainly be cumulative. Much of how he does will be related to what kind of shape his is in going into the surgeries.

I would follow the doctors recommendations and ask if there is specific rehab available for afterwards (occupational or physical therapy) that can help him maintain his physical and mental functioning.

Good luck and he's lucky to have you caring for him.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Justin- sorry I don't always get to this page every day or even every week when I am busy at the hospital. I hope you are feeling better by now. It's often hard to tell what effects are left over from anesthesia and surgery and what is just the effects of inflammation and the body trying to heal. The anesthesia should mostly be gone within a day or two.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Aww, Jennifer. I'm sorry I wasn't here when you were worried. I can't always be here when I want or need to be.

I hope you are feeling better. It's hard to say what would be causing that without more information. I hope you have talked to your doctor by now and you are on your way to doing great!

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Rebecca- Thank you so much for reading and taking the time to comment. I do so appreciate that. That initial "happy medicine" is the last thing that most people remember. Maybe, I will write a future hub on that. :)

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Polly. That is known as a "paradoxical reaction". We see this most with children. It can happen with them with the same medicine you got. Also, some parents will tell you that even benedryl (diphenhydramine) causes some kids to go bonkers rather than making them sleepy.

It doesn't happen as often in adults and we don't really know why it happens, but it is just an occasional effect that we see. Sorry it happened to you, but I appreciate your comment.

Kenneth 4 years ago

Hi,im suppose to have a partly thyroid removal surgery which im so afraid of that i delayed it,my concerns are not waking up from the general anesthesia or sudden complications may arise while during under,eg:blood pressure or heart rate abnormal?what will you do to?and does valium realy send me half asleep as the surgeon describe even before i reach the operation theatre?im having some difficult time here as im suffering from severe anxiety.thank you

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Hi Kenneth. If it helps at all, I've had my entire thyroid removed under general anesthesia.

The relaxing medicine used before going to the OR really do help. You will feel relaxed and may not remember much after getting the medicine.

During anesthesia, the anesthetist is there the whole time. We monitor your heart rate and rhythm. On the continuous EKG that we have, we are able to see any changes that also indicate that oxygen isn't being delivered adequately to the heart. That is a very, very unusual occurrence, even in people known to have artery blockages around the heart or other heart problems.

We monitor blood pressure, usually checking every 2 to 5 minutes via an automated cuff that measures and records the value automatically. Anesthesiologists are extensively trained to respond quickly, decisively and skillfully to any change in vital signs that may mean the patient is in danger. And while we spend a great deal of time and thought learning and preparing for that eventuality, it almost never happens. When it does, it usually isn't unexpected- there are usually risk factors that tell us what the dangers are for a particular patient.

Of course there is some risk to anesthesia, but honestly, it has gotten safe enough that I have had five general anesthetics and two epidurals, myself. My 20 month old baby had anesthesia and my 90 year old grandmother did as well. I would not allow that to happen if I didn't believe what I was telling you about safety. Can't make any guarantees, but usually the anticipation and worry is worse than the actual experience. Eventually, you cross the point where the problem you need surgery for is more dangerous than the surgery and anesthesia!

Good luck and I hope you can find a way to be at peace with what you need to do and get through it. (hugs)

Johnny 4 years ago

Hi dr,theres a question i would like to know,isit possible to to have a hemithyroidectomy on local anesthesia with twilight sedation means i would not need general anesthesia where all those machines and wires hooked on to me,i am a very anxious person suffering from panic disorder

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Probably not. There are some centers that are experimenting with, or doing these with nerve blocks and sedation. But, that type of anesthesia may end up making you more anxious in the end.

Here's the problem(s).

In order for you to have thyroid surgery, your face will be covered (or partly so) with a drape. The surgeons will be pressing on your neck. Even if you have numbing medicine, you will still feel the pressure and the tugging and pulling. It would potentially make you feel like you can't breathe. I suspect that the anxious patient would not do well in this situation.

Further, the surgery is very delicate and slight movement on your part could be quite dangerous because of the blood vessels and nerves in the area. If you are anxious, it is unlikely that the anesthesiologist will be able to sedate you deeply enough to ensure no movement.

If they sedate you enough that you don't respond to any stimuli, then that is, by definition, general anesthesia. At anything close to this level of sedation, it is likely that you wouldn't get enough oxygen. Then, the anesthesiologist will be forced to try to intervene to secure your airway. This is quite nearly impossible while they are working on the front of your neck.

With sedation, the more deeply sedated the patient is, the less able they are to voluntarily cooperate.

Your head and neck are positioned in a manner that would likely not be well tolerated by an awake or sedated person, with a roll under your shoulders to help expose the surgical area.

It would be much more dangerous and would interfere with the success of your surgery to have you awake. It would be a rare patient, I would think that could tolerate this with safe levels of sedation, unless it is done at a hospital with personnel (surgeons, anesthesiologists, nurses, etc) who are trained and equipped to do so.

The monitoring and thus, the wires and machines are essentially the same whether you have sedation with local, or general anesthesia. Your safety is much easier to secure under general anesthesia for this surgery in most cases.

So, it is unlikely this will be an option for you unless you are at a center that is set up to do them this way AND you can assure them that you would not panic while the sedation is adjusted to the right level AND you can tolerate needles that are used to place the nerve blocks and/or local anesthesia AND the nodule you are having removed is very small and superficial (easy to get to). Not trying to make you feel bad, but want to tell the truth. I'm sorry this is stressful and anxiety-provoking for you. I had a total thyroidectomy under general anesthesia and did just fine. Actually, it was the easiest of all of the surgeries that I have had. Good luck.

Kim 4 years ago

Hi,is it possible to answer this soon? I had endometrial cells in my pap,need a D and C at a surgical center.i have stenosis so have to do the biopsy this way.i have a phobia about being "under". The Dr and surgical center said they use Propafol,and I read that it is dangerous because it is NOT reversible. I asked for a spinal,and they are trying not to do that . My question is why can't they sedate me partially,and why not another reversible drug,and is Propafol safe from ur experience? Do people sometimes not ever wake up from it? I am terrified to be put UNDER. What would they do if I had problems while under,if it is not reversible!???? Please advise,I may cancel if I keep feeling so scared . Thanks so much!

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Propofol is QUITE safe when used by qualified providers at an appropriate facility. This means that an anesthesiologist should be present. At the very least, someone who is experienced with propofol should be giving it. It should not be given by the same person doing the procedure, in my opinion.

I give propofol to every single patient that goes under general anesthesia and it is my PREFERRED drug for sedation. Honestly, I think spinals have more risk than a propofol sedation in qualified hands. Most of the drugs we use aren't necessarily reversible. And even if they are reversible, the reversal agents usually aren't used or needed. So, the fact that it isn't "reversible" doesn't mean anything. Most sedatives and anesthetics aren't reversed. They just are metabolized by the body and their effect wears off over time. So, propofol isn't different as far as that goes.

It sounds like you are saying that you will have a sedation anesthetic. This means "semi-conscious" or not completely unconscious.

Sedation (with propofol or any other medication) anesthesia is titrated- meaning, the dose is adjusted based on your need. Propofol is one of the shortest acting drugs we have so if you do get too much for a short time, it will be that- a short time because it wears off so quickly after a sedation. The anesthesiologist or anesthetist will be monitoring you for the right level of anesthesia and will take care to keep you safe.

I've even done general anesthetics (complete unconsciousness, placed a breathing tube, etc) with propofol as the main agent (rather than the usual anesthesia gas) because I think it's so easy to adjust and get rid of at the end of surgery (by lowering and then stopping the infusion). The side effects are predictable for most people and patients say they had a "good rest" and don't get nauseated from it. In fact, it helps to prevent nausea.

Compared to spinal anesthesia, propofol is easier to adjust. With a spinal, the medication is injected and you get what you get.

Either the spinal is adequate OR it's not. You can't add more medicine after it's been done. If it doesn't last long enough, you get general anesthesia anyway. If it lasts too long, you end up in recovery for HOURS trying to pee and move your legs. The blood pressure drops from a spinal can be more pronounced too. AND, most people need sedation with their spinal anyway to be comfortable in the operating room or not care what's going on around them.

Don't get me wrong, spinals are great anesthetics for the right surgeries. I, personally, would prefer a propofol sedation over a spinal for outpatient surgery anyday, both as a patient and as an anesthesiologist who has to give each.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Kim, I really hope that helps you feel better. The reason propofol gets a bad rap has to do with 1) Michael Jackson's doctor trying to use it for a sleep aid- completely inappropriate and dangerous without oxygen and monitoring available. 2) the use in health care certain settings without qualified people there to give and monitor it. This isn't as common anymore since the standard of care is to have separate providers- one giving the sedation with propofol and a separate person doing the procedure.

Good luck- you will feel so much better after this is over.

Lisa 4 years ago

I'm so glad to have found you, with such clear and compassionate responses, I feel safe asking you about my 15 month old's upcoming GA. We have an alternative to the GA for dental work - to simply have his 4 top front teeth extracted, in which case the permanent teeth won't come in til he's ~7 years old. We decided on the GA, due to the myriad very good reasons to avoid extraction. I had prepared myself with knowledge of the very low risks, and secure in that it would be done at the Children's Hospital of Eastern Ontario, Canada. A dentist at my son's clinic was able to get him in on his surgery date a month from now, which means that we don't have to wait potentially another 8-10 months on the waiting list for the general anesthetic, by which time the teeth might not be able to be saved as the cavities may be too big. We know that we're very fortunate, and being at CHEO for the consult this week, we were ever-mindful of the more serious circumstances that other children were there for. However, at the consult, they told us that the surgery wouldn't be til 12pm. Which means of course, no breastmilk or food or non-clear liquids after midnight the night before, and no water or anything at all after 9am. My son is and always has been a big feeder. I know all babies are, but I know other babies well, and he just seems to have a fast metabolism. He's pretty good-natured and calm. He even lets the dentist look in his mouth sometimes without resistance. However, when it comes to going without food for so long, I know from experience that he'll be screaming, heaving crying, and inconsolable that morning for hours before going in. I've read that a little stress can even be healthy pre-surgery? But I know that this will be A LOT of stress. I know it may seem trivial. The nurse at the consult didn't exactly gloss over him going without food or drink that morning, but she said a more compromised patient had to go first that morning. I just can't believe that I am doing right by my son to put him in this situation. He'll go into the surgery completely spent and exhausted, angry & upset for hours. I mean, really screaming at the top of his lungs, turning purple, angry and upset. This can't be good for his body, already going into the stresses of surgery. I asked the nurse what is included in 'clear liquids' which he can have from midnight to 9am that day, and she said only apple juice, water, and gingerale. I asked if I could give him beef broth, for some more sustenance, if I made it from only lean meat, carrots, parsnips, and ginger (nothing too gassy to upset his stomach), but then strained it a hundred times with the finest mesh I could to get all of the particulate out. She advised against this, as she said it's not on the list. I read here on your site and I understand the risks of him throwing up and it entering his lungs. I certainly don't want to do anything that would be dangerous. Is it particulate matter of even the finest size that is of concern? Anyways, the clear beef broth question is a side question. The bigger one is about the effects of such stress of not eating or drinking til noon on a baby his age before the surgery. I know it seems trivial, but I can't believe that it is. Should I not be trying as hard as I can to get him an 8am surgery time? Or is it wrong to vie for this, when there are so many other children with more compromised situations? Thank you very much. Your comments will be extremely appreciated. As a parent, and as a parent of a child who's had GA, and as an anesthesiologist, would you simply have your child's teeth pulled rather than put his little body through all of this?

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Lisa- have you seen the hub I have on pediatric anesthesia? It might help you a bit too (

But to answer the questions from above…

1) I know this is stressful. My child had surgery when he was 19 months old, so I get it from the mommy's point of view too. BUT, the most important thing for you to remember is that this will be a passing event in your baby's life that he will not remember. It is waaaay more traumatic for you than him. Deep breaths and keep in mind that your stress level will affect his behavior.

2) None of your concerns seem trivial. This is your baby and your instinct is to protect him from anything unpleasant. Good job. Having said that, please follow the instructions as given. Even if it's not harmful, and there may be some debate, it will add stress to the operating room team. It makes them wonder if there were other rules that were broken or bent. I know some anesthesiologists because of this doubt would consider canceling the surgery that day if you showed up and told them he had beef broth or something else not pre-approved. Trust in the doctor-patient relationship works both ways.

3) It is not going to be the best day of either of your lives. Just accept that this is going to be a hard day. Accept it, be tough and get through it. I don't mean that to be callous, but it will pass. If this is the best decision (and it sounds like it is), the hardships of one day are usually worth the payoff. Does that make sense? I hope that comes across with the tone of caring that I mean for it to. You already know, as a parent, that enduring unpleasantness is just part of our deal.

He will not remember this. My child was exactly back to normal by the next day.

What I would do: Give him his juice, water, ginger ale up to 9am as indicated. If the surgery is at noon, they will likely want you at the hospital between 10 and 11am. That gives you just an hour or two to kill before all the helpful distractions of the hospital. Take him to a park or movie or just drive around- whatever is unusual and new to distract him. Many kids can get lost in a show on a computer or iPhone or iPad while driving around. The key will be to get him out of the house where he normally has access to food and distract, distract, distract. Some parents keep the kids up later the night before so they may nap and pass some time until the surgery. Other parents know this makes their child too cranky- your call on that one.

You WILL get through this ((hug)), really, you will. If this is going to be better in the long-term (and that's between you and the dentist), then just soldier through the short-term unpleasantness. You can do it!

Oh, and one more thing. If it were my child, I'd rather have them anesthetized by a pediatric anesthesiologist at a Children's hospital, than sedated in a dental chair to have 4 teeth extracted. He'd probably need a lot of sedation to get through that anyway. The risks may be higher. Just my opinion and no offense to the dentists, but if given the choice, I'd take the hospital with a designated (pediatric) anesthesiologist.

Please keep in touch. Let me know if you have other questions and let me what you decide and how it goes. Good luck sweetie.

Lisa 4 years ago

Thank you very much for those strong words of encouragement and reassurance of the best practice.

He normally wakes around 7am, immediately nurses for 30min, then breakfast at 8am (oatmeal, yoghurt, hardboiled egg, applesauce), then nurses before morning nap at 10:30am for 15 min, then wakes at noon and has a big lunch at 12:30p! So we know this is going to be very hard as not only will he be hungry, but he'll also probably be exhausted as I'm not sure that we'll be able to get him to nap without having nursed or fed.

I like your ideas for distraction, I was also thinking to get him a kid's laptop computer (he goes bonkers for electronics despite his parents owning a wooden toy store, go figure ; ) for the hospital wants us to be there at 9am.

If you don't mind, just one more question, based on that he'll likely also miss his morning nap, and be so hungry (we're just plain not able to get him to sleep when he's hungry, he's always been like that), if he becomes so upset that he's screaming, crying, purple for hours, then is there a level of stress on his part where it becomes harmful to go into surgery so worked up?

I agree with you that he will need me to be a calm collected reassuring touchpoint that morning. Thanks for that.

I just still wonder if I should persevere at the hospital to try and find some way for us to get this done at an 8am surgery time. It may be the case that I can but with a different dental surgeon.

Sorry for long post again! I really did appreciate every word in your reply! Many, many Thanks! Lisa

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

You are welcome, Lisa. If it was my child, I would certainly prefer an earlier time. So, if you can get it, that's great. Don't cancel the spot you have until you see if you can be moved earlier.

If not, though, then could you see how he's doing that morning? If you get concerned that he is too distraught, then you can reevaluate at that point. Since you will be at the hospital early, you will have nurses and the anesthesia staff that can help you decide if his level of distress is too much to proceed with surgery. I have never seen a child be so upset that we couldn't proceed, but I don't work with a high volume of children or at a Children's hospital, either so I may not be a good measure.

I totally get what you are saying and your concerns are certainly valid. He's just too young to understand the "rules" or why he can't eat, I understand how that can be with a little one. I wish I could help more and hope this works out for you.

I try to check this page every day or two so don't hesitate to come back if you have other questions or concerns.

Kathryn L Hill profile image

Kathryn L Hill 4 years ago from LA

You are a brave and patient person! I am in awe of anyone willing to be an anesthesiologist! How does one happen to have the dedication and guts??? I would be so afraid of miscalculating and making a mistake. I would be ner- ner- n e r v o u s.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

little patients with heart rate too low, youngsters with blood pressure too high, patients who are closer to 100 years old than 90 with failing hearts, teenagers with adult problems…. I busted my a$$ and it's all in a (stressful) day's work… I do have a headache and a glass of wine in hand now, though. And hugs from my boys before bed...

Kathryn L Hill profile image

Kathryn L Hill 4 years ago from LA

And a mom as well. Thank you for sharing with us.

experienced patient 4 years ago

Good and helpful article. Anesthesia care has reached a point where it is no longer safe or in any way routine. I have great insurance (plus a medical degree) and it's not the science of anesthesia that scares me, it's the medical economics that puts profit ahead of patient safety..I'm speaking of the ACT care model (anesthesia care team)...basically a patient's anesthesia is done by a CRNA- a nurse with maybe 20 months of nursing school "anesthetist" training; note that they are not an anesthesiologist in any way, shape of form. but to maximize profits, many institutions allow these nurses, and they are nurses, to be sure,to attempt to function as anesthesiologists......sure, one anesthesiologist may (or may not) be present to manage up to 4 of these nurse/CRNA's, but basically a patient's anesthesia is done by a CRNA (a nurse, not an anesthesiologist)..this is unsafe......hey, if you want safets, insist that an anesthesiologist actually personally perform your case, not supervising multiple CRNA..what happens whn 2 (or more emergencies occur when 1 anesthesiologist is supervising 4 nurses?CRNA? answer: one patient gets the services of the anesthesiologist and the other gets a nurse...for hevan's sake, I never want to be the poor patient depending on a nurse (yes, all CRNA are nurses, nothing more or less) to handle my anesthetic emergency.

a retired doc who is scared of today's ACT model 4 years ago

Experienced patient's comments are spot on. I have a D.O. degree, vrefentialed in anesthesia and I want a physician administering any and all of my "anesthesia care"

returning vet needs surgery 4 years ago

I have learned a lot just reading this site. I'm a 40-year old guy who just returned from the middle east; unfortunatelly I returned with a few extra grams of metal (fragments of anti-aircraft artillery) that were lodged in my arm during my last big deal, just some metal slivers that need to be removed and I wanted to have them removed back in the USA, not at a field hospital thousands of miles from home. I'm a pilot, not a doctor, so my comments are not medically degree is in aeronautical engineering, not medicine. Anyway, upon returing to the good old USA, I seek out a surgeon to remove the copper/steel splinters from my problem, she's a great surgeon and I trust her judgement when she says that a general anesthetic is necessary; I certianly would prefer to avoid GA, but she assures me that the anesthesiologist that she works with is experienecd and safe. On the day of surgery, I am interviewed bt several "providers", none of which are an anesthesiologist. I get prepped and the IV is started etc, and I'm asked to sign a blanket consent for "anesthesia care providers" to perform my anesthesia and a friendly nurse-anesthetist keeps telling me that she will "take great care of me, just sign this consent and I'll kepp you comfortable, safe and warm". She has a fit when I tell her that my GA will be administered by an anesthesiologist, not a nurse (CRNA) as promised by my surgeon. This CRNA has a meltdown and tells me that she's "equivilent" to any anesthesiologist, etc and suggests that I sign the consent immediately. I decline; Ihave never refused to do anything that any of my doctors have asked me to do, but this is plain stupid: I was told that an anesthesiologist would perform my case and now I'm expected to accept a nurse CRNA at the last minute, and I politely decline. As I'm getting dressed, the CRNA is still arguing with me, until she notices my wounds, then she starts to apologize and starts to tell me that she supports "America's heros who defend us"..I tell her that I'm no hero, just an airline pilot who was temporarily assigned to combat duty "over there"....after all that I went thru, I don;t want to return to the USA for surgery and die on the table because I didn't have an anesthesiologist performing my case. The CRNA left the room but soon retuened with the much-promised anesthesiologist, who seemed unhappy that she had brought him in to talk to me. I asked him if he would be personally be performing my case as promised by my surgeon; he spent 20 minuted not answering that question, but finally agreed that he would personally do my case. Fine. But when I specified this on the anesthesia consent and asked him to sign it, he balked: " everyone gets a CRNA, I'll be supervising your case, don't worry". At this point, my surgeon and the CRNA spoke and said: "he was promised an anesthesiologist performing his case 1:1. why are trying to get him to accept anything less"? At this point I gave up and got dressed. When did anesthesia become a nurse's job? The kicker: "you have to sign a consent so that the CRNA and everone else will get paid"..I'm glad that I didn't sign anything. I'll never consent to anesthesia of any kind unless it's administered by an anesthesiologist The copper fragments in my arm are turning s pretty green; I'm sure that this woukd be funny to the CRNA .

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Not perfect, but vigilant and conscientious. I try anyway. Thank you.

Manhattanbeach3 4 years ago

Hi, great information here, thank u! I'm a nurse and really appreciate your feedback! So I'm going to have back surgery in a couple months, an anterior lumbar fusion at L5S1. Degenerative disc and herniation. I've been taking pain meds for a year now: nucynta er 50-150 mg bid, currently 150mg bid, Tylenol 500 mg bc I get headaches from the nucynta ER, Percocet 5-325 mg as needed for pain, flexeril 10mg prn, neurotin 200-300mg tid. Now my dr is telling me I have to detox off all of my pain meds before surgery. He said that I will have a higher success rate with the surgery if I am off my pain meds. Can you explain the reasoning in detail for this? What are the benefits of being off all my meds? Leading up to surgery, I will be in a lot of pain and won't be able to take anything. I'm willing to do whatever I need to to have the best chance of a successful fusion, I would just like to know the "why"? So right now, as dr ordered, I've increased my neurotin dose to 400mg tid, and decreased nucynta to 100mg bid, Tylenol 500mg daily, and added Celebrex 200mg daily. Then he said I can take Norco 10-325mg prn, max of 3 doses in a day. What are the reasons why norco is a better pain med to take before having surgery than Percocet? He does not want me taking any more Percocet. Please explain. Then after 2 weeks I will decrease nucynta to 100mg day then 50 mg at night, and slowly keep decreasing pain meds until surgery date. If I have taken pain meds for a year, does it make GA more difficult? I'm 27 and healthy otherwise, healthy wt. Have you done GA for ALIF's? Difficult procedure? Thanks for your feedback! Really appreciate it! My main concerns are to know the benefits of being off pain meds before surgery, will it make the surgery and recovery more successful, why norco over Percocet, and does taking a higher dose of neurotin have any effect on GA/surgery, and any other comments you have about my situation. Thanks so much!

Scardy kat 3 years ago

Thank you for this informative site! I am terrified of getting my gall bladder removed! It sounds silly but I've put up with gallstone pain since 2008 and one of the biggest reasons I am terrified is because I have been dependent on OTC nasal sprays for about 16 years. Is there any risk with GA and the length I've been dependent on the nasal spray? Thank you much for your kindness and time. :)

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

Hi Scardykat. The OTC nasal sprays (I'm guessing you mean the ones with phenylephrine and not the saline ones) cause constriction of blood vessels and thereby decrease mucous congestion.

They can cause some systemic effects, but usually not enough to cause problems under anesthesia. In fact, we use phenylephrine nasal spray in patients when we have to place the breathing tube in the nose instead of the mouth (the usual entry) to constrict blood vessels and decrease the risk of bleeding.

Incidentally, stopping those sprays cause a rebound congestion. That is why so many people become dependent on them.

All you really need to do is tell the preop nurses and anesthesiologist that you have been using these. If possible, do this when you do your initial preop interview. The anesthesia providers should be aware that there may be some effects on the mucous membranes of the nose and maybe (although not so likely to be significant) on the mouth and throat. Rarely, someone is sensitive enough and absorbs enough to cause an increase in blood pressure, but this too, is usually not a major issue unless you have other health problems or take lots of other medications.

It's not enough of a concern to stop you from having surgery. Sorry to take away your excuse, eh, I mean reason, LOL. :)

Seriously, if you tell them, that's usually all the preparation required.

hsmom 3 years ago

Hello TahoeDoc, thank you so much for making yourself available in the comments section for questions. I am preparing to schedule an elective lap cholecystectomy. I have little fear of going under anesthesia or of any recovery complications. Unfortunately, I am a lifelong emetophobic. I would prefer to wake up in recovery and hear "Well, we accidentally lopped off a hand," than to wake up nauseated and/or vomiting. I'm sure you must hear this concern from every patient, but my fears go well beyond the standard worry. It's actually making me hesitate to have the surgery done.

I've been reading like crazy and I understand I have quite a high risk of PONV (female, non-smoker, lap surgery, suffer from motion sickness) up to nearly 80%. I also understand that the causes of PONV are multifactorial and even the most skilled anesthesiologist can't cover every possibility. My question is this:

I received what was called "general" anesthesia for wisdom tooth removal when I was 20 (25 years ago) but I'm sure it was actually conscious sedation since no oxygen support was required, etc. When I awakened, the nurse asked me if I felt nauseated and I said, "nope" and then heaved into a trash can. I honestly didn't have a sensation of nausea - it was more of a dizziness and "motion sickness" feeling. I threw up again after coming back home and then I was fine. Are the effects of GA similar and is there anything at all that can be done to help prevent this?

Thank you so, so much. Of course I will talk to whoever is doing my anesthesia, but with only a few minutes to talk beforehand, I'm not sure I will be able to adequately explain my outright terror without it seeming to be just preop nerves. It would be great to be able to speak intelligently about what measures could possibly be taken.

Thanks again.

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

Hi HSMom. You are articulate and knowledgeable and that will come through when you talk to the anesthesiologist. Explain that not only do you have a history of postoperative nausea and vomiting, but that you are also emetophobic (just the use of that word will get their attention- in a good way).

Hydrate well up until the point that you are to take nothing by mouth. Tell everyone you talk to (surgeon, anesthesia office, preop nurse, anesthesiologist, etc) that you need meds to help prevent nausea.

Scopolamine patches can be very, very helpful, especially if you have a history of motion sickness. Usually, the nurse in preop will apply this before you go to surgery since it takes a couple hours to kick in. This is good for people who are going home. By the time the IV meds are wearing off, this thing is kicking in. There can be some rebound nausea for some people when it is removed a couple days later, but no where near the anesthesia and surgery related nausea and vomiting.

The other meds are IV while you are at the hospital. Before or during surgery, the anesthesiologist can give you metoclopramide (Reglan), ondansetron or decadron (a steroid) to help prevent post op nausea and vomiting.

Most useful intraop or in recovery are phenergan and ondansetron (in my experience as a patient and doctor).

There is an orally dissolving tablet (ODT) of ondansetron (Zofran) that can be helpful. If you take it with pain meds, it can prevent nausea that comes from them too.

As a patient, I usually get prescriptions for both the Zofran ODT and pherergan. One or the other, or the combo tends to work very well. I also recommend that patients ask their surgeons to prescribe those things along with any pain meds or antibiotics. They are usually happy to oblige as it may prevent them from trying to figure out how to treat your nausea in the middle of the night.

Good luck and check out if you haven't already.

And of course, all of these meds have side effects and potential interactions with other meds or medical conditions, so your anesthesiologist will make the decision about which are most appropriate after reviewing your history.

hsmom 3 years ago

Thank you so much for such an informative answer and so quickly, too! I feel more confident discussing this issue and my options now. I hope I won't run into the preop area and start yelling for them to load me up with everything in the arsenal. Too much could be counterproductive.

I also checked out your other excellent page. Thank you for not simply replying, "go read this so I don't have to repeat myself." It may not seem like a huge deal to you, but this has helped me tremendously.

nancynurse profile image

nancynurse 3 years ago from Southeast USA

Great Hub. I am an RN and enjoyed this a great deal. Voted up.

scardy kat 3 years ago

Thank you so much for your kind words. It has put my mind at ease and I really do feel that this will be the year I get some guts to follow through. You truely are an Angel to me! :)

Manhattanbeach3 3 years ago

Hi, just wondering if you would have time to respond to my post about back surgery from 3 months ago. Thanks!!

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

Hey Manhattan- Sorry, didn't realize I'd missed that. Let me go take a look...

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

@Manhattanbeach3==Hey there- sorry I missed this. I have done GA for these surgeries. The neurontin will be fine at the dosages you mention.

The other changes in narcotic pain meds seems like personal preference or practice of the surgeon? maybe. Unfortunately, I don't know what is routinely done in the months up to the surgery. I cannot say I specifically have heard about these types of reductions or changes, but I only see what patients are taking right before the surgery.

It seems (although I have no idea if I am correct) that the surgeon or whoever is managing this is trying to get you on the lowest effective dose of narcotics so that pain medications will be effective for you postoperatively.

Norco is less potent than percoset, although they are both narcotic/acetominophen combos. The nucynta is another narcotic. If you are on strong pain meds before surgery, pain management (and to a smaller degree, your GA) will be MUCH more challenging. This is a big surgery with a significant recovery. Postoperatively, there will be fewer choices and less likelihood of success in treating your pain if your body is already accustomed to or dependent on, the strong narcotics that are routinely used for postoperative pain.

That's my best guess as to why this is being done- to minimize the preop amount and strength of narcotics, to maximize success of pain relief after the surgery.. I'm surprised your doctor did not give you an explanation for such changes in your regimen.

And, again, I'm sorry I missed this post before. Some times are much busier with hospital work and I can't always guarantee an answer at all or in a timely manner. Thanks for the reminder to get back to this! Good luck to you and if you have other questions, I will do my best to respond.

Mur7ay 3 years ago

Hello, I'm soon to have my appendicitis taken out and was kinda nervous because I've had svt since I was 19 (now 26.). And I'm curious will the ga affect anything. Have you done ga on someone that had a history of svt? Thanks in advance

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

As with most things, knowledge is power. If the anesthesiologist knows you have that history, they can prepare for it. I've had 2 patients in the last 2 weeks with a history of SVT. One had a brief, self-limted run under anesthesia and the other was already on medication and had heart rates that stayed under 80 the whole time.

The stress of surgery on the body, the physiologic changes of the pre-existing illness and the general anesthetic can trigger rounds of SVT. It is usually pretty easily controlled or treated though and almost never causes a problem, especially in a younger person who doesn't have other heart disease.

Just be sure to tell the anesthesiologist. They can decide, based on your vital signs at the time and other factors, whether to pre-treat or just be on the lookout for it. You are on a heart (and other) monitor the whole time and the anesthesiologist is there the whole time, so if there is an indication of SVT, they can and will respond quickly.

Good luck! I bet you do great.

nailsbyniki 3 years ago

tahoedoc, hope you're still around...I have a question about how many times within 6 months is it safe to go under anesthesia? I have had bariatric surgery with complications and have had to have several procedures and possibly surgery again on Tuesday...this will be a total of 6 times in less than 6 months!

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

Hi nailsbyniki,

Usually the necessity of surgery overrides any potential issues with repeated general anesthesia. Most adults are ok with anesthesia as you describe. Older people, people with serious health problems or pre-existing dementia and children may have more issues with frequent, repeated anesthetics. I bet you are going to feel tired and worn out for a while as your body tries to recover from all that, though!

Keisha 3 years ago

I have endometriosis and am undergoing exploratory surgery in 11 days. My doctor told me not to mess with my hormones and I assumed it was because it will mess with the general anesthesia. Unfortunately, I had to take a Plan B pill today which I just read is significantly throwing off my hormone levels. Should I be concerned? Should I tell my doctor that I took Plan B or will my hormones reset by my surgery?

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author


You need to tell your doctor and right away. The issue may be more surgical than anesthetic. This isn't my area of expertise but, the changes in hormones can change things like your risk of bleeding and affect your healing. But the GYN doctor will know if this is still going to affect you at the time of your surgery.

I'm sorry you are having a hard time, but tell your doctor right away! Don't wait till the day of surgery. Call the office in the morning.

Good luck to you with everything.

CZebo 3 years ago

I had lower back surgery on May 6th and when I was put to sleep under general anesthesia the pain in my IV and up my arm was excruciatingly painful. I screamed bloody murder and I have never done that before. Thank God it was only momentarily and the next thing I remember was waking up in the recovery room. I have had 10 + surgeries in my lifetime and never had that happen before. As a matter of act I am always so relaxed that the doctors usually comment and joke with me prior to putting me to sleep. This is the first time I have had a surgery at this facility and I spoke to a friend who also just had surgery there and had the same painful experience. What would cause that? Unfortunately, I will be scared to death the next time I have to be put under or anything!

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

Usually, that is the propofol (occasionally another induction drug) that burns if it happened right as you were going to sleep. Tell them next time that you had severe pain and you remember it and see if they can put some medicine in before the propofol to numb the vein or make it so you don't stay awake long enough to feel it. Some places/anesthesiologists can do that and some can't/don't for a variety of reasons.

Good luck- hope you don't need more surgery, but if you do, I hope this helps.

Patty Ortega 3 years ago

When you are put to sleep for surgery, do you still cough? I have allgergies

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

Hi Patty, if you are under general anesthesia, your cough reflex is suppressed and you do not cough from allergies. It is possible to cough when going to sleep and waking up and there might be an exacerbation of coughing for a short time after the surgery.

Patty Ortega 3 years ago

Thank you so much, i feel so much better, I didnt want to cough while she is doing the surgery, I am having a Abdominal sacrocolpopexy, very close to the bladder

Patty Ortega 3 years ago

What if the cough is not from allergies, but i am not sick! Maybe headcold

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

The cough reflex is suppressed while under general anesthesia. Again, it is possible to cough while going to sleep and waking up, so tell your anesthesiologist if you are having cough. Usually, the meds will prevent this, as well. Smokers tend to cough more during these times than others.

If you have allergies/post-nasal drip or something like that, it usually isn't an issue at all, even before and after anesthesia/surgery. Asthma and smoking are more likely to cause coughing, wheezing and low oxygen levels. Even in these populations, it is rare for it to be enough of an issue to warrant intervention beyond maybe an inhaled treatment or a little extra oxygen for a while in recovery.

Good luck and don't worry about coughing under general anesthesia. If they offer you a spinal or epidural instead of going to sleep, then please mention that you might cough if you are awake. They would like to know this ahead of time. :)

Patty Ortega 3 years ago

Thank you so much, put my mind at ease, iv'e waited a long time for this surgery and i dont want to cancel, nor do i want to cough! Do you think i should go take a chest xray, for them?

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

If you have a fever, a history of asthma, are coughing up any sputum or have other medical problems, then they may very well want an xray. But, since all institutions doctors are different, please call your surgeon's office and ask. If you have an anesthesia preop clinic, that would be an even better place to get the answer. Express your concern and that you are just trying to make sure you won't have any issues the day of surgery that might risk cancelation.

Good job trying to be ahead of the game. It's good to be proactive.

Experienced Patient 3 years ago

I was recently diagnosed with GERDs and a hiatal hernia. I was wondering what are the risks with these two conditions and general anesthesia. Just would like to be prepared for when my next surgery gets scheduled (unrelated to these two conditions).

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

Hi there- There are some precautions the anesthesiologist will take as long as you make sure they are aware of your history. Lucky for you, I wrote a whole hub on the topic... :)

Experienced Patient 3 years ago

Another quick question: Is there any risk correlated with being anemic (caused by low iron) and general anesthesia?

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

One of the big outcomes studies/databases ACS-NSQIP (American College of Surgeons-National Surgical Quality Improvement Program) did find a correlation between preoperative anemia and postop complications. This was more pronounced in patients with anemia and comorbid conditions such as heart or lung disease.

Unfortunately, I don't know what all of the confounding variables were and whether it had to do with receiving intraop blood products because of a lower threshold to transfuse or whether all surgical types were included.

I approach anemia like this. If there is time before your surgery, make sure your primary doctor and surgeon know. Adjust iron supplements or take other measures to increase the red blood cell number prior to surgery.

If the surgery is major and blood loss potentially requiring transfusion is likely, I will be more aggressive in my preoperative stance that anemia needs attention prior to surgery.

If the surgery is not expected to require transfusion or if other medical conditions are not present, or the level of anemia is mild or if there is no time to get medical attention for the problem (urgent or emergent surgery), then I make sure the patient and surgeon understand the risk and proceed with caution.

*disclaimer* This is general information only and is not meant to represent medical advice on how to proceed in your (or anyone else's) individual case. Only a physician who can interview and exam you and your past medical history can do that. Thanks

Experienced Patient 3 years ago

Thanks again :)

Alheise 3 years ago

After having two surgeries I noticed once I'm in recovering I start getting rapid heart beat that last for about a minute or so. This happens for a few hours. I've been thing about getting a tummy tuck but afraid of this happening again.

Kathryn L Hill profile image

Kathryn L Hill 3 years ago from LA

don't do it then!~

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

Have you had it worked up? If not, mention it to your doctor. They can evaluate whether or not you need further testing. Is it a feeling you have or have the nurses mentioned it to you? Does it happen any other time or only after surgery?

There are a couple medicines that anesthesiologists use that can speed up your heart rate. One is a med we use to keep your blood pressure from dropping or to treat it if it does. Another is medicine that goes along with the med we use to reverse the muscle relaxation. In addition, demerol, a medicine used for pain and shivering can cause increased heart rate in recovery. Pain, the excitatory phase of waking up and medicines can cause this. Knowing what meds you take, your medical history, whether it happens any other time, any other symptoms, and so on and so on are only a few bits of the history it would take to know for sure why this has happened.

Your regular medical doctor should be able to use some of this info to help you sort it out and obviously, without a history and exam, I am unable to even guess the cause or recommend further steps. Sorry :(

See your doctor for a full exam and bring this up. If nothing is found, see if the records of your surgery or anesthesia or recovery time make mention of it (good to get this info if you can before you see your doc)

A tummy tuck is actually a pretty big surgery with a significant recovery, so you want to sort this out first.

Good luck

Abcmom66 3 years ago

QUESTION- why would my mother who has skin cancer of her nose be denied general anesthesia, when this surgery due to the depth of cancer and cosmetic repair needed after? She is refusing to have it done w local and they're concerned with her health (current medical and mental state) and refusing anesthesia. Without my mom getting clear answers everything's come to a halt which concerns me. The cancer has already tore her nostril in two which she experiences Constant bleeding and uses toilet paper to hold and cover nostril. This is ridiculous. She was diagnosed w beginnings of dementia however not incompetent. She can refuse surgery although if they deem her unable to make this decision it'll fall on me, next of kin, as our mom is not married. She also has cirrhosis of the liver. However her GI doctor has claimed she has a normal endoscopy, her varicies (spelling) found last upper endo are now gone (questionable. Read they move but don't disappear). Nevertheless not concerned and claims blood work normal. Mom hearing this and us too would therefore be confused than why surgeons are not willing to put her under knowing how firm she stands be this request believing its her right as well. Does not wanna be awake for this kind of surgery which first is removing the cancer from nose and they won't know how much but do know by visual damage now, they'll need to Repair nose cosmetically using cheek skin ? Can anyone medically educated tell me who they refuse or why they'd refuse to put someone under knowing this is a surgery they have and normally would put one under for? Help me understand as I was not able to join her at the consult. But surgeons won't budge. Local only and she's insisting we keep looking till we find a surgeon that'll put her out. She's 67. My grandmom had surgery under anesthesia at age 86 so I know it's not because of her age.

Thanks for any insight as they have been vague. Simply are not happy with her general health mentally or physically. No specifics.

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

My best guess (and it IS a guess ONLY, not a diagnosis, recommendation or knowledge of this specific case) based on what you told me is the cirrhosis of the liver. The death rate for people who have advanced cirrhosis and anesthesia/surgery is very, very high. It can be in the 20 to 25% percent range shortly after surgery and much higher ultimately as a result of related complications. If she has cirrhosis badly enough to have varices and bleed easily, she has advanced liver disease and she would be at extremely high risk- a one in five to one in four chance of dying and would almost certainly have other complications short of that. says this...

"Identification of the surgical risk is imperative in the care of any patient, especially as patients develop an increasing number of chronic comorbid medical conditions. Patients with liver disease are at particularly high risk for morbidity and mortality in the postoperative period due to both the stress of surgery and the effects of general anesthesia. del Olmo et al compared 135 patients with cirrhosis with 86 patients without cirrhosis, all undergoing nonhepatic general surgery.[2] At 1 month, mortality rates were 16.3% for patients with cirrhosis compared with 3.5% in the control group. What is further evident in the literature is that decompensated liver disease increases the risk of postoperative complications (eg, acute hepatic failure, infections including sepsis, bleeding, poor wound healing, and renal dysfunction). Assessing risk in these patients is a challenging but important endeavor."

also see...

So... the only thing you can do is ask for a surgeon and anesthesiologist's opinion at an academic or large medical center where they have high-level liver specialists and excellent ICU care if she really has advanced liver disease. If she has other conditions like kidney problems, heart issues and so on, it's going to be even more difficult to find someone willing to put her through this risk when the surgeons say they can do this with local anesthesia.

Good luck. It's a tough situation for sure. I hope that you at least get a better explanation and another opinion. But, you will need to seek out a medical center with the right expertise to even give you the best assessment.

Jane 2 years ago

Hi very informative page. I'm going to have a surgery. am in my fifties and suffer from hot flushes. I was wondering what happens if I get a hot flush during the surgery. Would it confuse the monitor/ vitals while I get hot and sweat etc ?

TahoeDoc profile image

TahoeDoc 2 years ago from Lake Tahoe, California Author

Anesthesiologists often give anesthesia to perimenopausal women. Just tell your anesthesia provider your concerns beforehand. It will almost certainly not be a problem.

Good luck.

Jane 2 years ago

Thanks for quick response. Your answer "will almost certainly not be a problem" makes me more concerned.. Does it mean the anesthesia is more challenging hance more prone to complication? I hope you can give me a more "reassuring" explanation. Thanks a bunch!

TahoeDoc profile image

TahoeDoc 2 years ago from Lake Tahoe, California Author

Doctors- especially those who cannot examine and talk with you- simply cannot make guarantees. In my experience, in tens of thousands of patients, I have never had a patient have a problem under anesthesia that was caused solely by menopausal hot flashes, so assuming the hot flashes are menopause, it won't likely cause a problem. It is a normal physiologic change that we are aware of. That's the best I can do without knowing/seeing/talking with/examining you. Please express your concerns to your doctor for further reassurance.

Shane Coombridge 2 years ago

hello just would like to know if I should have been op on 8 hours on a shoulder dislarcation because I had a sezier from going cold turkey from sanex 4mg a day had the sezier after 7 nights could not sleep drink or eat how high are the changes of having another sezier on the table cheers

TahoeDoc profile image

TahoeDoc 2 years ago from Lake Tahoe, California Author

I'm not sure I understand the timing of the events. I think you are saying that you had a seizure 7 days after surgery? In that case, it wouldn't likely be related unless you never went back on your xanax and you were taking that for seizure suppression?

I'm sorry I cannot help, but I don't understand what you are asking.

Colleen 2 years ago

I had thorasic surgery to repair my esophagus after suffering from Barrets Esophagus! They took half of my stomach to make a new esophagus. I have had pain ever since my surgery, They took me off of my fentenyl Patch that I was on for cluster headaches. I am now on Luricol! That isn't working for the pain. They put a shunt in the bottom of my stomach thinking if the food can get to the bowel quicker then the pain would stop! it hasn't and now I have to go under again to have shunt taken out!!! Do you have any idea on what to do about the pain??

DJ 2 years ago

Hi, I have a somewhat elective surgery coming up and my baseline labs came back normal except my blood sugar was 104 after fasting. This is kind of typical for me to be right over the cut-off of 100. Will this prevent me from having surger in 3 days?

TahoeDoc profile image

TahoeDoc 2 years ago from Lake Tahoe, California Author

An isolated blood sugar near the high end of normal should not be a problem. If other issues are discovered or suspected, that could be an issue, but unlikely. Of course, without reviewing your history thoroughly, knowing the details of the surgery you are having, and the reason for it, doing a physical exam and seeing other results (like EKG or other labs), I cannot possibly say what will happen.

Amommy 2 years ago

Hi I am scheduled to have a laparoscopy sterilization in about a month. I was told I will need GA for it and the operation should not take long. I have never had surgery or needed to be put under and it's scaring me to think something will go wrong like feeling everything and being in pain and not being able to let people know the state of pain I am in. Also the thought of not coming back from it is scary mostly cause I have children to care for. So my question is how safe is GA? And would an epidural be a better option? Cause I had an epidural for my last birth and I tolerated it well I think.

I feel there would be less complications with an epidural for this particular surgery. But I'm no expert. Thank you for taking the time to answer questions.

TahoeDoc profile image

TahoeDoc 2 years ago from Lake Tahoe, California Author

Hi Amommy.

I have been both a patient and a doctor with anesthesia. I honestly believe the best thing is usually to go with the 'norm'- what the doctors and nurses are most used to doing for a particular procedure. In this case, that is going to be general anesthesia.

Laparoscopy has been done with epidural on very rare occasions when there was an overwhelming reason (like medical issues that made general anesthesia unsafe) BUT it is NOT ideal. It is very difficult to get the epidural to cover / prevent pain in all of the areas needed for a laparoscopic surgery. I would not advise it as a doctor, nor would I accept it as a patient. While the surgery will not take long, it would still be quite uncomfortable due to the gas that has to be put into the abdomen and the position in which you have to lay while they are operating. General anesthesia does a much better job of this.

You can ask to speak to someone from the Anesthesia department there long before your surgery to get more info. It will likely help you feel better.

General anesthesia is more scary because you have to give up control to become unconscious- you are not aware of what is going on, but in this case, I believe the discomfort and the risk to you and the level of difficulty for the surgeons are all minimized by general anesthesia.

You could ask your doctor about the possibility of doing something to avoid general anesthesia, but I imagine you will get a similar answer.

I have had 5 surgeries, all with general anesthesia. I also have young children (I had a 4 month old baby when I had my 1st surgery) and it's a protective momma instinct to fear that you won't be able to care for them, but if you are otherwise healthy, general anesthesia should be very safe.

*standard disclaimer- no guarantees are made or implied and this comment nor any information contained on this site or any other should be a substitute for personal medical interaction with a qualified professional medical provider*

Amommy 2 years ago

Thank you so much for your reply. I did ask if an epidural or other local anesthesia would be an option for me and the answer was no. The surgery requires GA. Uncomfortable and I will need breathing tube. I am still apprehensive about it all but I am slowly coming around to the idea that all will be well. Will keep you and your readers posted! The fear of general anesthesia is not easy to overcome. So I know I am not alone in this. Again Thank you.

Sara 2 years ago

Thank you so much for posting this blog. I'm getting ready to have my very first surgery ( a tonsillectomy) at the age of 25 and I am petrified. I know in the grand scheme of things, it's a very simple procedure, but like you mentioned, it's the fear of the anesthesia that gets to me. I don't like the fact that for those 45 ish minutes, I will be giving all control up to a stranger (a very very educated and smart stranger, but still a stranger). I do get panic attacks prior to anything very there something they could give me to calm me down before surgery and/or make me not aware that I'm going into the OR? I'm perfectly healthy (the sickest I've ever been in my life was just the stomach virus). Everyone in my family has had some kind of surgery with some type of anesthesia and no one has ever had any problems. Based on that, are the chances pretty good that I too won't have any problems with the anesthesia? Sorry for all of the questions- I'm just really nervous and am trying to get as much information as possible.

Amommy 2 years ago

Yesterday was my surgey! I am doing well resting at home. I just wanted to say thank you for your response and all your information. I was given versed, I guess something to take the edge off, right before heading into the operating room. Once there I guess I was given proforol through an IV and I could hear someone say you will get very sleepy soon and next thing I knew I was being awaken by a nurse asking me if I was in any pain. The surgery was over! It was as though I had closed my eyes for 5 seconds! Again Thank you!

Clyon 2 years ago

Very good information! About ten years ago I had a cesarean under anesthesia. My husband did not tell me until later (he forgot in the excitement of the baby) that they had been very scared for a while because a nurse came out and told my family they were having a hard time getting me out of anesthesia. I remember waking up in extreme pain and the staff seemed very frantic... The staff never explained what happened & I have always wondered if I should get my medical records from that hospital (I have since moved states) in case I have to go under again & they should know about the possible? Complications. Is this common & what are the possible causes?

India Collins 2 years ago

I'm getting ready to under general anthesia for the 4th time I'm having laporscoptic assisted vaginal hysterectomy since this surgery takes so long do they have to give me more of the anesthesia to keep under I have had gall bladder removal bladder procedure and dental surgery in OR and usually what is the time frame for this surgery very nervous thank you for your time

babs74 2 years ago

Is thrashing around a side effect of Propoful...I had a follow up colonoscopy and was told by nurse after awakening from anesthesia.

I did not have this reaction 3 months earlier under the same anesthetic.

Is this a common reaction.

Lynda Derks 2 years ago

I have to have a complete hysterectomy 8-30. I just had a D@C and was put to sleep the middle of last month. I have Meniere's disease and since the last surgery my dizziness has gotten worse. Do you think the next surgery will add to this? How save is it to have 2 in a month and half?

shreekanth 2 years ago

my wife had an cesarean delivery and some times she feel some fear in her mind and not get sleep and also not talk smooth and not have food and I need reason and answer to come out from this complications

shreekanth 2 years ago

my wife had an cesarean delivery and some times she feel some fear in her mind and not get sleep and also not talk smooth and not have food and I need reason and answer to come out from this complications and u can help me by mail

sharon dass 24 months ago

Hello I had surgery 2 days ago and quite traumatised by it first conscious memory was the nurse advising me I need oxygen through my nose as my oxygen levels were low. .also my blood pressure..they took me to the ward after recovery ward and I still was out to it..some 6 hours later the nurse tried to take me to the toilet but i could barely walk and felt so dizzy I felt like I was going to pass out..I didnt wake up properly till 1am that morning and my surgery had been 1pm that day my blood pressure was still down the whole day..ive had surgeries before and it never took me that long before.

shoaibkhatri 23 months ago

This is a wonderful article, Given so much info in it, These type of articles keeps the users interest in the website, and keep on sharing more ... good

kuma508 23 months ago

Should they able to tell if water is around lungs and heart in pre op day before surgery

Feeonavictoria 23 months ago

So I had a lump removed from my breast under General anaesthetic four days ago, not sure what pain killers I had but I know they put some in me before they put the anaesthetic in. Ever since I have random spurts of itching which is mostly down the arm that I had the anaesthetic put in and my legs (still wearing the stockings they give you for blood clots) and also my face. I was wondering when will this stop it is very irritating.

I have also got this mucus cough after I eat :/ never had it before but I have to cough til the mucus has gone for it to stop. Is this normal? 21 months ago

To be a soccer mom is equivalent to having some sort of part-time job that has a demanding program. My top ten soccer mama ideas will probably hopefully be useful for finding balance that you saw and while doing so help improve your son or daughter's soccer ability.

sakinah profile image

sakinah 15 months ago from Minneapolis, Minnesota, USA

Very informative hub. I liked how you explained why laparascopies are done under general anesthesia, even for surgeries performed below the belly button. I cannot say I feel at ease about general anesthesia, and will probably do whatever I can to avoid it, but it certainly helps to have an idea as to what to expect, coming from a professional.

thomas 11 months ago

Three months ago I had a pace maker implanted,now I am experiencing ,an odor in my hair,on my breath ,and my skin has this smell of medicine coming from the pores of my skin.Is this a side effect from anesthesia?

redhed 10 months ago

I had a partial nephrectomy 6 weeks ago to remove a large ( thankfully benign ) tumour ( angiomyolipoma ). I have me/cfs ( chronic fatigue syndrom ) which the anesthetist was aware of . I had a lot of anxiety before the surgery, so the anaesthetist prescribed an ativan tablet pre surgery. I went into the surgery aproximately 8 am and the surgeon tried to call my spouse at aproximately 1:00 ( he'd forgotten to turn his cell back on as not to have on in hospital ). I did not get to my room in the ward until 5:15 pm. My husband kept asking why the delay and nursing staff just said, not to worry she'll be up soon. On my follow up visit to my surgeon I was so worried about the results of pathology I didn't even think to ask about why I was in recovery so long. ( is 4 hours excessively long ? ) I'm wondering if anything went wrong or if there is anything I should be aware of in case of needing anaesthesia in the future. I have suffered shortness of breath but seems to be improving since doing breathing exercises.

Meri 2 months ago

Hello. I have a big concern. Please, help me. After 9 days is my operation with full anesthesia, but I started to cough. Some months ago when I went to checking, my doctor said that if I cough they can't do the operation. It was over, but now suddenly I got cold and started to cough. I have to do the operation abroad and at this moment I can't get in touch with the doctor and my flight is in 4 days. Please, help me and advise me what if my cough lightens, as now I take a lot of medicine for recovery, will it be possible to do the operation. And if no, what can be the risks?

Thanks a lot in advance.

Karen Bal-e Eduarde 2 months ago

Why it is important to a doctor or nurse to know the percentage of an anesthethic before performing an surgery?

noplaybarbie 8 weeks ago

Hi...I recently had my second hip replacement in less than 3 months time. My first hip replacement was done under general anesthesia because they said in the OR that I couldn't have spinal anesthesia because of multi-level spinal stenosis. Now for my second surgery, different anesthesiologist he insisted that he can give me a spinal anesthesia with a nerve block. This time approximately 17 hours after my surgery time I awoke in ICU on a ventilator. I was told that I aspirated at the end of my surgery and that I had to be put on a ventilator and that they also had to do a bronchoscopic procedure to suck the contents out of my lungs. I had to stay on the vent the rest of the night with no sedation because they said they could not sedate me as my blood pressure was way to low. It was one horrible night. I also caught aspiration pneumonia. I did not eat or drink anything for over 12 hours prior to surgery with the exception of a small sip of water to take my blood pressure medication the morning of surgery. I am curious to what could have caused this. One doctor said maybe I am diabetic and it takes diabetic people longer to digest food. My blood sugar level is good, so that is not it. I just want to know what happened to me and wonder why I was completely out for so many hours. I have no recollection of anything that went on until I awoke at almost midnight that night, my surgery was at 7:30am....Thanks....Just curious....

Linda 8 days ago

Can you be my anesthesiologist next Wednesday?

    Sign in or sign up and post using a HubPages Network account.

    0 of 8192 characters used
    Post Comment

    No HTML is allowed in comments, but URLs will be hyperlinked. Comments are not for promoting your articles or other sites.

    Click to Rate This Article