Anesthesia, Resuscitation, and ICU: Q&A

I don't know, I can't really get behind that whole "every anesthesia takes five years off your life" thing🙂 It sounds a bit morbid to me, kind of like saying if you break a mirror you're cursed with seven years of bad luck or something.🤣Scott Bennett4, since I read somewhere that you've actually gone through eight different surgeries...😢 Anyway, staying on topic here—and I truly hope this is the last surgery you ever need and everything goes perfectly—but have you ever had any weird experiences with anesthesia? Like, was it ever hard to wake up, or did you struggle to drift off, or was it just smooth sailing every single time? Tell me more, since you've clearly been through the ringer.

Forgive my sudden intrusion into this space, as it has been quite some time since I last contributed...

To get straight to the point, I had a dental appointment recently, and after they administered the local anesthetic, it took effect almost instantly. It immediately brought back a memory of how things used to be—I would be relegated to a waiting room for at least twenty minutes just to ensure the numbness set in, and even then, they’d frequently miss the vein or the site five times over just to treat a single tooth.

I couldn't help but wonder if these modern standards have finally perfected the efficacy of the numbing agents, because a friend of mine, who was seeing a resident at a teaching hospital, had an experience where the anesthesia was delayed by twenty minutes, failed entirely, and left her in absolute agony.

So, perhaps someone here can enlighten me—is it safe to assume that the quality of the anesthetic depends entirely on the specific dentist and the particular supplies they choose to stock? Is the price discrepancy truly significant enough to justify the wait, or to mitigate the risk of a procedure failing miserably? I ask because I have personally endured the horror of having two permanent molars extracted while practically feeling every ounce of the trauma without proper sensation. What are your thoughts on this matter?

It doesn't really matter which medication you choose; the prices aren't significantly different, and they aren't expensive anyway...

electricpanther82, unfortunately, the saga of these surgeries isn't over yet, and there’s no clear timeline for what comes next. It’s an endless cycle of orthopedic procedures; I'm dealing with such advanced osteoarthritis that there is always some new complication requiring immediate intervention. On a brighter note, I’ve never actually had issues with anesthesia—neither going under nor waking up. Everything has been remarkably smooth in that regard, and I owe a debt of gratitude to the anesthesiologists for their skill. However, the spinal block remains a persistent nightmare when it comes to my first attempt at using the restroom. It is an agonizing experience; I feel as though my bladder is moments away from total failure, yet nothing happens. The whole system only seems to function properly once I am able to sit down and finally find relief.

Sam Hall15 said:it really has nothing to do with the specific type of medication, since the price points aren't significantly different and they aren't particularly expensive anyway...

Then what exactly is the cause?

Kimberly Edwards38 said:Hey everyone. So, I’ve got a question for the group. I’m starting to wonder about the long-term effects of having frequent surgeries and, you know, dealing with all the different types of anesthesia. I actually just got home about a week ago from my eighth surgery—this one was done under spinal anesthesia. Looking back at the whole tally, I’ve been through general anesthesia twice, spinal twice, an axillary nerve block once, and I think I’ve had local anesthesia a couple of times too. Honestly, I haven’t really run into any major issues so far (aside from that annoying struggle with peeing right after the spinal, if you know what I mean), but I can't help feeling a little anxious about what this might be doing to my body in the long run. It’s especially weighing on me since I’ve already got at least two more procedures on the calendar. Any thoughts?

Look, I’m just saying—you really ought to sit down and have a heart-to-heart with your surgeon about all this. You need to get the full lowdown on the potential fallout, any weird complications that might pop up, and the actual risks involved. Every procedure is its own beast, you know? Don't just wing it based on some random internet thread; make sure you know exactly what to expect before you go under the knife.

When it comes to anesthesia, look—every single time you go under, there’s a unique set of risks involved. Honestly, every new round feels a bit like the first one when you consider the potential for acute, immediate complications. It's just how it works. Then you've got the chronic side of things, where long-term issues can stem from how the drugs actually function, how your body breaks them down, or how they eventually clear out of your system. But anyway, let's try to break this down logically:
Look, I’m no doctor, but when you start talking about IV setups, things can get a little dicey if they aren't handled perfectly. Even just the initial poke can go sideways—you might end up with a burst vein that needs a redo, or just those annoying bruises and inflamed spots where the needle went in. It's one of those "small thing, big headache" situations. Then there’s the whole issue of paravenous administration. Basically, if a vein pops during anesthesia, all that fluid and medication leaks out into the surrounding tissue instead of staying in the bloodstream. That can cause some nasty swelling, irritation, or inflammation. In really bad cases, it can even lead to necrosis, which is just a fancy way of saying the tissue starts dying off. And man, the absolute worst-case scenario? If a med accidentally gets injected into an artery instead of a vein, it can cut off circulation entirely. We're talking potential necrosis for the whole area that the artery feeds—like, your entire hand could be at risk. Definitely not something you want happening in an OR.
So, here’s the thing about that pre-medication phase—you know, when they give you those chill-out meds to help you relax before they wheel you off to the OR? There’s always this tiny, nagging chance of a nasty allergic reaction hitting right then. It’s one of those things you don't really think about until it's mentioned. And honestly, even once they start the actual anesthesia, things can get a little unpredictable. Since most of these drugs are stuff you’ve probably never encountered in your life, it’s super tough for doctors to predict how your body might react. Sometimes, your system just decides to throw a curveball with an unexpected reaction to a medication you've never even touched before. It's just one of those weird medical wildcards, I guess.
So, when you’re dealing with intubation—you know, sliding that breathing tube down into the trachea—things can get messy fast. Sometimes it’s just a "difficult airway" situation where you can't get the tube in, which isn't actually the end of the world if you can pivot. Like, if you can just switch over to bag-mask ventilation or pop in a laryngeal mask, everyone stays breathing and we move on with our lives. No biggie. BUT—and this is a massive *but*—if the patient has already been given a paralytic, and then you realize you can't intubate them, AND you can't get a mask on them, AND you can't ventilate them with the bag? Yeah, that is a nightmare scenario. If you can't quickly reverse that muscle block, you're looking at an emergency tracheotomy or a cricothyrotomy—basically having to go through the neck to create an airway right then and there. In a best-case scenario, if things go sideways, you're looking at severe brain damage or even a permanent vegetative state. It’s heavy stuff. And don't even get me started on trying to intubate someone with a full stomach. I mean, obviously, I'm talking about the patient's stomach, not the anesthesiologist's! That whole situation is its own special kind of disaster. You risk them vomiting and inhaling all that acidic stomach contents straight into the lungs, which leads to aspiration pneumonia. And that can be just as fatal as the airway issues themselves. Just one of those high-stakes parts of the job that keeps you on your toes.
You know, I was reading up on some medical stuff earlier, and it’s kind of wild how much can go wrong with something as standard as intubation. Like, it's not just about getting the breathing right; you could actually end up causing damage to the lips, teeth, or even the tongue. They can even mess with your vocal cords or cause issues down in the trachea. It's definitely one of those things where you realize how delicate everything really is.
So, here’s the thing about anesthesia—it’s definitely not always a smooth ride. Sometimes things just don't go exactly according to plan, and you can end up with some pretty unpredictable reactions to the meds. Like, you might deal with "light" anesthesia where you aren't quite under enough and start drifting back toward consciousness, which is super weird. Or, on the flip side, you could go too deep, and that's when things get a bit dicey with your vitals—usually resulting in your blood pressure taking a sudden dive. It's one of those "anything can happen" situations, even when everything seems totally fine.
Waking someone up from anesthesia is honestly one of those high-stakes moments where you really have to trust your gut. You’re basically playing a game of timing—trying to figure out exactly when the drugs have worn off enough that it's safe to pull the breathing tube and move them over to a recovery room or a PACU. It's all about finding that sweet spot where they're stable enough to handle it.
You could also end up throwing up here, too. Honestly, it’s definitely something to keep in mind if you're planning on heading that way.
So, look, even if everything seems totally fine in the OR or the recovery room right after you wake up, things can get a little dicey later on. It’s all that weird biology stuff—metabolism, how your body breaks down meds, how it flushes them out, and those active metabolites that hang around longer than they should. Basically, the drug might have a "delayed reaction." The most common way this hits is with extreme drowsiness, shallow breathing, or even worse, someone accidentally stopping breathing altogether. Now, honestly? Not a huge deal if you're still right next to the anesthesia crew where they can jump on you instantly. But if you've been moved away and you're flying solo? Yeah, that's when things get pretty sketchy. We've already chatted about the whole situation with pain management and stuff not quite hitting the mark, but this side of things is just as important to keep in mind.

Look, what I just laid out can happen with pretty much any anesthesia, whether it’s your first time under or your fiftieth. Even if someone says they have decades of "anesthesia experience," there's honestly no guarantee that things won't go sideways.

I could go on about the long-term effects of anesthesia, but let me try to keep this brief.
Basically, anesthetics are drugs that mostly get processed by your liver and then cleared out through your liver or kidneys. Just like any medication, when you're dealing with massive amounts, it can put a real strain on the liver and kidneys. To make matters worse, during anesthesia, blood flow to those organs can drop, leaving them struggling with a lack of oxygen while they're working overtime to break down the drugs. This can lead to cellular damage. Now, if those organs are already dealing with other issues—say, if you're regularly taking stuff like Advil, Aleve, or Motrin, which we know can be tough on the kidneys—they might not be able to handle the extra load from the anesthesia. They end up accumulating tiny bits of damage that can eventually snowball into something permanent. Plus, some of the metabolic byproducts created when the body breaks down these drugs are known to be toxic to the liver and kidneys.
This risk is higher with frequent, back-to-back procedures that last a long time, or if someone is undergoing surgery while their vitals are already unstable (like a young patient dealing with major trauma).
If things take a turn—like a sudden drop in blood pressure from bleeding or acute heart failure—doctors might have to use vasopressors to bring the pressure up. These drugs constrict blood vessels quite aggressively, which can cause ischemia (basically, a lack of blood flow) in parts of the body supplied by smaller vessels. That can lead to tissue death (necrosis) in areas like the intestines or limbs.
Then there's the brain. Because of how anesthetics affect the central nervous system, you can run into cognitive dysfunction—essentially, issues with mental processing. This ranges from being barely noticeable to serious personality changes, especially in older patients or after heavy-duty surgeries like cardiac, neurosurgery, or organ transplants.

Alright, all that was regarding general anesthesia.

Regional anesthesia—things like a spinal block or a nerve block (like in the armpit)—has its own set of potential headaches too.
With both techniques, there's always a small chance of accidentally hitting a nerve, which can cause paresthesia (weird sensations in the area controlled by that nerve) that usually fades away pretty quickly. However, if the anesthetic actually gets injected directly into the nerve, it can cause permanent damage.
There's also the risk of accidentally nicking a blood vessel. If a large amount of local anesthetic gets into the bloodstream, it can trigger neurological issues or even heart arrhythmias and cardiac arrest.
With spinal anesthesia, you might deal with temporary urinary retention (not being able to pee) while the drug is active, which usually just requires a quick catheterization to fix. You might also get those nasty post-puncture headaches. To help prevent those, doctors often suggest lying flat for 24 hours after the procedure and staying super hydrated. Drinking things with caffeine, like coffee or tea, has also been shown to help reduce the frequency of those headaches.
The most serious complication would be an epidural or spinal hematoma—where a blood vessel is accidentally nicked near the spinal cord. If that blood builds up and starts pressing on the spinal cord or nerves, and it isn't caught and treated surgically right away, it can lead to paralysis or permanent disability.

So, yeah, that's the short version of regional anesthesia.

As for that whole theory about losing five years of your life after general anesthesia... honestly, I don't know anything about that. If it were true, I guess we'd have to tack on another three years just for reading all this stuff I just wrote! Seriously though, I'm not sure that "five-year rule" holds any water. It reminds me of the late Michael Jackson—by that logic, he should have lost decades of his life, but in the end, it wasn't the anesthesia that got him, it was the poor choice of medical oversight.👎

I hope this helps answer your question at least a little bit. Wishing you the best of luck with your treatment—hopefully, you can avoid any more surgeries or anesthesia altogether. Good luck.

stormymaker24 said:Wait, what do you mean it worked so fast?

Honestly, your dentist might just be that good—maybe they hit a spot right near the nerve, which would explain why the numbness kicked in almost instantly. If their work is solid and they’re actually talented at fixing teeth as well as they are at numbing them, I wouldn't dream of switching dentists anytime soon. Just stick with the pro if they get the job done.
Best,

Hi everyone. I’m new here and looking for some guidance from experienced anesthesiologists because I’m feeling a bit lost. Briefly, on March 30, I had vein surgery at a hospital in Washington, D.C. It was originally scheduled three weeks earlier—when I had my pre-op assessment and everything seemed fine—but I came down with what felt like a sudden cold. It lasted two days, followed by a weakened immune system and mouth ulcers, which ultimately forced the postponement. By March 30, the ulcers were still there but fading, so the anesthesiologist decided I could proceed, though they opted for spinal anesthesia instead of the general anesthesia the surgeon preferred. In the OR, they tried for a spinal, but they couldn't get my legs numb (or so I was told when I woke up; I don't recall the exact moment we switched to general). They ended up using a mask. When I woke up, my breathing felt labored and shallow, especially during exhalation—I heard later that I was already complaining about it as I was regaining consciousness. At first, I just chalked it up to a normal post-op recovery. Then, a week later, the shortness of breath started hitting me hard, always in the late afternoons and evenings. My first trip to the ER turned up nothing; X-rays, blood work, and EKGs were all clear. The second time, even my surgeon looked worried, so they sent me for a CT scan and a venous Doppler. Those results were also fine. While the acute attacks have calmed down, that heavy breathing in the evenings persists, along with chest tightness and a pulsing sensation in my veins. My blood pressure stays normal, which is odd since I had zero respiratory issues before the surgery. I’m waiting on more pulmonary tests (spirometry was okay) and cardiology workups. A pulmonologist briefly considered myasthenia gravis, though they doubt it since there's no significant muscle weakness. I want to know: is it possible this is an anesthetic complication? What are the possibilities from an anesthesia standpoint, and where should I head next? I hope you can help. P.S. I ended up back in the ER yesterday because my chest felt tight, my blood pressure spiked, and I struggled to breathe again. An internist suspected myasthenia, so they sent me to a neurologist who also thinks it's unlikely, but more testing is underway. Could general anesthesia have triggered potential myasthenia? Has anyone dealt with this?

My sincere thanks to urbanscout50 for such an exhaustive and thorough explanation. If I had you as my physician in the real world, I suspect I’d feel significantly less trepidation regarding everything that lies ahead. Best regards.

Hello everyone
My father finally underwent heart surgery after waiting nearly a decade for it.
Specifically, he had an implantable cardioverter-defibrillator (ICD) installed because his arrhythmias were so severe that the only thing capable of bringing him back to life was immediate emergency intervention from doctors using external paddles.
It happened three times—he even experienced what they call clinical death once—and I am only mentioning this to convey the sheer gravity of the situation, the trauma, and the shock he has been living through since childhood due to a rare and insufficiently researched heart muscle disease.
After years of being the subject of various medical "experiments"—there have actually been books written about cases like his—and enduring countless unsuccessful treatments and attempts,
that day finally arrived; the device meant to solve his greatest lifelong struggle was ready for implantation.
Everything would have been simple if our family hadn't spent two months essentially badgering him to agree to the procedure... and then, in a state of disbelief, he grabbed his pajamas and belongings and headed to the hospital, frustrated as ever.
Since the surgery was high-risk, we sat there waiting for the doctor's call like we were sitting on needles, half-driven mad by the suspense.
The call finally came, and the doctor said the surgery lasted 2.5 hours and everything went fine—we all wept with relief at that moment.
But later that same afternoon, after having visited his room to kiss him and check in, his very first words to us were, "If I had known it would feel like this, I never would have agreed; I would have rather just died."
What on earth happened?
Before the procedure, they strapped him to the table and gave him some local anesthetic that only seemed to hold its effect for about 20 minutes. For the rest of the time ("roughly 2 hours"), the surgeon was essentially working on him while he was conscious, reaching through the scalpel incision to thread the leads to the heart and eventually tucking the device under the skin.
There were complications during the operation and while extracting the leads—which have anchor-like tips—meaning when they go in, they are difficult to pull back out, leading to more issues because of a surgical error.
I could hardly listen to him anymore; I felt a profound sense of guilt because I was one of the people who pressured him into undergoing this operation.
To make matters worse, several months have passed, and the wound isn't healing, and the site where the device sits remains painful—just another layer of frustration!
A few days ago, we finally convinced him to go back for a follow-up with the surgeon who performed the procedure.
He barely managed to get there, only for the doctor to tell him that the device was implanted too shallowly and that everything must be redone immediately!
So, people, please help me: is it acceptable for a man in his condition to demand general anesthesia instead of just local, and does he even have the right to request that? The doctor isn't exactly communicative, so what are his actual rights in this entire mess?
Beyond that, we are seeing deep frustration, nervousness, and a genuine loathing and fear toward hospitals manifesting in him.
Any perspective you can offer would be greatly appreciated.

I'm opening this thread up to everyone on the forum. Hopefully the mods don't mind me doing this.
So yeah, feel free to ask whatever you want, I'll try my best to answer.
My background is basically cardiology and ER medicine. I'm actually in the middle of my residency right now.
It'd be cool if some other doctors joined in too, I think there's plenty of them listed in this PDF.🙂🙂

Nicole Jones12 said:I wanted to open this up to everyone on the forum, so I really hope the mods don't mind me starting a new thread here.
So, fire away with whatever questions you have—I'm more than happy to help out.
My main focus is cardiology and emergency medicine, and I'm actually right in the middle of my residency at the moment.
It would be awesome if some of my other colleagues joined in too; looking at this PDF, I think there are plenty of them around here.🙂🙂

Oh, they definitely won't mind... though they might just keep this as its own standalone thing. Honestly, when it comes to emergency medicine in the US—especially those cardiac-related calls—the anesthesiology department usually holds the most expertise. Since we already have an anesthesiology topic that basically covers all that ground as a sticky, I'll just link this one to that.
Hope you dont mind....🙂

cosmicowl64, I’ve honestly never heard of someone getting heart surgery under local anesthesia before. I always just assumed that was physically impossible. Is this doctor actually sane? Did he even bother explaining what kind of procedure we're talking about or how they actually pull it off 🤷???

Nicole Jones12 said:I’d like to open this thread up to everyone on the forum. I hope the moderators won't mind...
So, please feel free to ask anything; I am more than happy to help.
My expertise lies in cardiology and emergency medicine. I am currently completing my residency.
It would be great if other colleagues joined in as well. Looking at this PDF, there should be plenty of them here.🙂🙂

Are you doing your residency in anesthesiology?

cosmicowl64 said:Hey everyone,
My dad finally had heart surgery after waiting about ten years for it.
He needed an ICD (implantable cardioverter-defibrillator) because his arrhythmias were so bad that the only thing that could jumpstart him was emergency intervention from doctors using manual paddles.
It happened about three times—he even experienced clinical death once... I’m just mentioning this to show how heavy this whole situation is and the trauma he's been carrying since he was a kid due to this rare, poorly understood heart muscle disease.
After years of various medical "attempts"—there were even books written about cases like his—and a bunch of unsuccessful treatments and trials,
the day finally arrived. The device meant to fix his biggest struggle in life was ready for implantation.
Everything would have been smooth if we hadn't spent two months basically badgering him to go through with it... He eventually went to the hospital in a state of disbelief, just grabbing his pajamas and stuff, looking totally frustrated.
Since the surgery was high-risk, we were sitting on pins and needles waiting for the doctor to call us. We were losing our minds.
The call finally came, saying the procedure took 2.5 hours and everything went fine—we all broke down crying tears of joy.
But later that same afternoon, once we visited his room and gave him some love, his very first words to us were, "If I knew it was going to feel like this, I never would have agreed to it. I would've rather died."
So, what happened?
Before the surgery, they had him strapped to the table and gave him some local anesthesia that only seemed to last about 20 minutes. For the rest of the time ("about 2h"), the surgeon was essentially working on him while he was awake, using a scalpel to make the incision and manually threading the leads to the heart before tucking the device under the skin.
There were issues during the operation too, specifically when pulling the leads out of the heart—they have these anchor-like ends, so once they're in, they're hard to get out, and they had to redo parts of it because of a surgical error.
I honestly couldn't listen to him complain anymore—I felt a huge amount of guilt because I was one of the people pushing him to get the surgery in the first place.
Long story short, it's been a few months now, and the wound isn't healing properly, and the site where the device is located is still painful. Just more frustration.
A few days ago, we finally convinced him to go back for a follow-up with the surgeon who did the procedure.
He barely made it there, and the doctor told him the device was implanted too shallowly and that he needs to go back in for a corrective surgery immediately!
So, folks, I need some advice. Is it okay for someone in his condition to be given general anesthesia instead of just local? And can he actually demand that? The doctor isn't being very communicative, so I'm wondering what his rights are in this whole mess.
On top of that, he's clearly dealing with massive frustration, nerves, and a total aversion and fear toward hospitals.
Any insight would be much appreciated.

If there aren't any contraindications for general anesthesia, he should talk to the surgeon and insist on being put under. He absolutely needs to tell them about the nightmare experience he had with the local anesthesia and how the procedure was handled.

electricpanther82 said:cosmicowl64, I honestly had no idea heart surgery could even be done under local anesthesia; I always thought that was totally off the table. Is that doctor actually sane? Did he even bother explaining what kind of procedure this is and how they pull it off?🤷???

Installing a pacemaker-defibrillator isn't really considered major cardiac surgery anyway.
But even "real" heart surgeries—you know, the heavy stuff where they saw through your sternum and do bypasses—can technically be performed using regional anesthesia.
Of course, there are almost no actual reasons to do it that way, so it’s mostly just a niche thing for specific cases, but it is possible.
They set up an epidural catheter, similar to what you'd see for a painless labor, but they go higher up into the epidural space, which basically numbs everything from your neck and shoulders down... and then the surgery starts...😲....honestly, it sounds a little twisted; you'd have to be some kind of hardcore masochist to handle someone sawing through your breastbone and spreading your ribs while you just lie there, paralyzed from the neck down, blinking your eyes...😍....don't get me wrong, the anesthesiologist will give you sedation so you aren't fully conscious, but once they finish closing up the wound and stabilizing the patient's vitals (I once saw a training video from a major US cardiac center showing this), they wheel the patient out in a gurney straight to the shock room...😍....it's pretty wild...😍...

Anyway, I heard that urbanscout50 is actually looking into pulling off one of these crazy anesthetic stunts...👋....

urbanscout50 said:If there aren't any medical reasons to avoid general anesthesia, she should sit down with the surgeon and insist on going under. It’s vital that she explicitly mentions that previous nightmare with local anesthesia and how they handled the entire procedure while she was still awake.

But isn't this the exact same surgeon who performed the first operation? 😱He went back to the same guy, and honestly, I don't think there's much point in explaining things again when he already had to listen to my father shouting at him for two hours straight during the last one.
I doubt there are any other options left on the table; I'll tell her to push for it, though she already tried asking, only to be told that it would be too risky.😕

thanks, urbanscout50

Alright, so urbanscout50 can certainly insist on his way, but does the surgeon actually have any obligation to go along with it?
Are there specific patient rights regarding this situation—if the doctor refuses to sign off on a general consent, what exactly is the patient entitled to know so they aren't left flying blind?
And is it even possible to request a different surgeon at this stage, or is it already too late since the hospital admission is happening today?
😕

cosmicowl64 said:alright. urbanscout50 can push all they want, but does the surgeon actually have to say yes?
Are there any patient rights regarding this if someone won't agree to general anesthesia—like, what can they actually point to in terms of legal standing?
And is it even possible to switch surgeons at this stage, since they're heading into the hospital today?
😕

Look, the surgeon really ought to honor the patient's request to skip local anesthesia, or at least work it out with the anesthesiologist to do some kind of "light" general anesthesia combo. Especially for a procedure that drags on this long and was already incredibly painful last time.
If a patient is fully conscious and lucid, they have the right to refuse any medical intervention—especially one that could be done in a much more "comfortable" way!
The absolute dealbreaker here is if the patient simply refuses local or regional anesthesia. That’s where they draw the line.
Plus, if the device they had implanted before is working fine, then the risks associated with anesthesia this time around should be lower than they were previously.
But hey, I'm just a surgeon, right? What do I know?
Of course, they can always ask for a different doctor, though honestly, they probably should've done that sooner. The only catch is if this specific surgeon is the only specialist in the area who handles these kinds of implants. If that's the case, they might be stuck with them.

urbanscout50 said:A surgeon really ought to respect a patient's request to skip local anesthesia, or at least coordinate with the anesthesiologist to combine local numbing with a lighter dose of general anesthesia. Especially when we're talking about a procedure that drags on forever and was already excruciatingly painful the last time around.
The patient has every right, while fully conscious and aware, to refuse any medical intervention—particularly one that could be performed in a much more "comfortable" and manageable way!
If a patient refuses local or regional anesthesia, that should be considered an absolute contraindication.
Furthermore, if the device they had implanted previously is functioning perfectly fine, doesn't that mean the risks associated with anesthesia are actually lower this time than they were before?
But then again, that's just how you surgeons operate, isn't it?
Of course, the patient can always go looking for a different specialist, though perhaps they should have done that much sooner. The catch is, what happens if this specific surgeon is the only one in the country who performs these types of implantations? In that case, they're essentially stuck with him.

Everything went smoothly this time, and they were actually merciful enough to use "general anesthesia."
thanks again