What would happen if someone were to wake-up during anesthesia?… by QT Patu
Would they feel everything?
Best Answer:
It depends on how much anesthetic they have already received. Most people, when they undergo general anesthesia, first receive several other drugs before they are intubated and under the influence of the volatile anesthetic (the inhaled gases). Generally induction is obtained with
1. Fentanyl - This is a fast acting opiate given before attempting to intubate the patient. It, like other opiates, gives you a relaxed feeling. It's basically very clean, very quick acting heroin…without the drawbacks of having bought drugs off the street.
2. Midazolam - This is a short acting benzodiazapine (same class of drugs as Valium). It induces axiolysis (causes relaxation) as well as causes amnesia. People who are given this drug rarely remember much from the time preceding the administration until several hours later. Patients often do not remember anything from their procedure, or even talking to the physician in the recovery room - it is most likely due to the action of the benzodiazapine they were given during induction.
3. Propofol - This white, milk-like substance, cause a rapid induction of anesthesia. This stuff burns going into your veins, but by the time you complain about it to the anesthesiologist you are asleep. This is what “knocks you out”, and then the anesthesiologist or anesthetist will intubate you (put a tube down your throat), and then give you the inhaled agents (which are unpleasant to breath in if you are awake). Some surgeries are done with only Propofol, and it is given as a drip rather than a bolus (or large single dose).
4. Succynilcholine - This is a depolarizing paralytic agent. It is much easier to intubate someone if all their muscles are relaxed. It is also easier to manipulate someones body if they are relaxed. This paralytic agent is fast acting, so it is given with the Propofol to allow the anesthesiologist to place the tube down your throat for breathing with less difficulty. Other, longer acting paralytic agents such as vecuronium or rocuronium are used to maintain paralysis for a longer period of time once an airway has been established. While you are under the influence of a paralytic agent you cannot move. Every muscle in your body is paralyzed. This includes your diaphragm (thus the importance of a breathing tube while under anesthesia). The horror stories that you hear of people waking up (i.e. not getting enough of the inhaled agent, but still having the paralytic agent) but not being able to move are from this drug.
Generally the anesthesiologist has an array of tools to measure how sedated someone is. A person, even sedated, will be able to respond to pain with an increase in their heart rate and blood pressure - and this is monitored by the anesthesiologist along with other vital signs throughout the procedure. Generally, if the doctor feels that you might be in some discomfort they will modify your level of anesthesia, either by administering more opiates, benzos, or inhaled agents until your vitals are more normal. Almost all patients are never even aware of these variations in heart rate or blood pressure. Some anesthesiologist monitor the brain function of the patient through a device placed on the forehead for an even more accurate reading of the patients level of sedation.
It is highly unlikely that a patient would be able to wake up during anesthesia unless there was some malfunction of the equipment or negligence on the part of the anesthesiologist. They would be able to feel things, and depending on if they had been administered a paralytic agent, may or may not be able to move. Again, the media like to sensationalize things, so the rare (<.1%) of times that people do "wake up" are seized upon rather than the 99.9% of times that people experience no pain. Of course there are other, more concerning, reasons to avoid anesthesia - but failure of induction or remission of induction is not one of them.
Powered by Yahoo Answers
Comments
Leave a Reply