Anesthesia, Resuscitation, and ICU: Q&A
in Health ·
urbanscout50 said:Most of the time, we’re looking at an anesthesiologist totally miscalculating the dose of the hypnotic needed to keep someone under properly. If they throw in a muscle relaxant—you know, the stuff that paralyzes everything except your heart and your gut muscles—you end up with a patient who’s completely paralyzed, can't move a single muscle, but they're wide awake and hearing every damn thing. It's a nightmare for the patient. Now, if they got enough analgesics (heavy-duty opioids), they won't feel pain. But if the opioid dose is too low? Then they feel the pain, which is just horrific for the patient... and honestly, pretty traumatic for the anesthesiologist afterward, too. Why does this happen? 1) You've got "cheapskate" anesthesiologists who try to skimp on the drugs, failing to monitor the anesthesia or the surgery closely enough, or they just forget to top up the dose (look, just avoid those types of doctors at all costs). 2) Some people just metabolize drugs incredibly fast, so you can't seem to get them to stay under—especially alcoholics or patients on chronic meds where their livers chew through the drugs way faster than average. 3) The patient's baseline health before going under... say, someone with massive blood loss, trauma, or elderly, frail patients. They actually need much *lower* doses just to keep things stable without crashing their vitals. Or, things shift mid-surgery—like a huge hemorrhage requiring massive blood and fluid replacement, which basically "washes" the anesthetic out of the system. You have to adjust on the fly, and it's never a sure thing. 4) Equipment failure or technical glitches...
As it turns out, being an anesthesiologist is high-stakes, dynamic work. You have to watch the patient constantly and react instantly. Most people think it doesn't matter who's handling the anesthesia as long as the surgeon is good, but they don't realize they're handing their life over to a stranger... literally. They are trusting this person with their consciousness and, more importantly, their actual BREATHING... and yet they act like it's secondary.
Bottom line: 1) For general anesthesia: usually, a woman gets one shot of the hypnotic and the relaxant, and then they deepen the anesthesia by adding analgesics only after the baby is out. If the OBGYN can't get the baby out quickly enough, anything can happen... usually waking up and feeling pain.
2) For regional anesthesia (spinal or epidural): the patient is awake, but the lower abdomen and legs are numb, so they can't move and they don't feel pain. This lets the surgery happen while Mom gets to see the baby and do skin-to-skin immediately. When the local anesthetic is administered and before it fully "takes," people feel warmth, tingling, or pins and needles in their legs and lower body. That isn't a bad dose; it's just a normal reaction as the drug spreads. Of course, sometimes the block doesn't "take," or it doesn't spread right, or for some reason regional isn't even possible—in those cases, they switch to general.
Choosing between general or regional depends on how urgent things are, the health of the mom and baby, the anesthesiologist's experience, and what the mother, the anesthesiologist, and the OBGYN all agree on.
That's the gist of it, anyway... 🙂
Basically, it’s all about making sure those surgeons get to walk away with all the glory.
And one more thing... if you ever find yourself dealing with the anesthesiologists over at the Mayo Clinic... watch your back...👎