Anesthesia, Resuscitation, and ICU: Q&A

Anthony, thanks a ton for getting back to me 🙂

I just stumbled onto this thread today and wanted to pick the brains of either urbanscout50 or Anthony Dubledore.

I ended up having emergency surgery—small intestine stuff—and during the anesthesia, I remember hearing conversations in the OR. I was clearly in some kind of semi-conscious state, though I didn't feel any pain at the time. But the real issue happened when I was "waking up"—I couldn't breathe on my own. I definitely remember that, and honestly, the feeling was terrifying.
I'm not going to name the hospital where I was, but they discharged me incredibly quickly—and of course, they didn't mention a single thing about what happened in my discharge papers. One thing they did suggest as a possible reason was a genetic predisposition to being "hypersensitive to anesthesia" (if that's even the right way to put it).
Anyway, I want to know: is there actually a way to test if I'm allergic to a specific ingredient in what they gave me? Or was this just a mistake by the anesthesiologist?

analogmason13 said:I just stumbled upon this thread today and I've got a question for urbanscout50 or Anthony Dubledore.

So, I ended up having emergency surgery for an ileus. It was one of those wild situations where I actually remember parts of the conversation happening in the OR—I must have been in that weird semi-conscious limbo, though thankfully, I didn't feel any pain at all. But man, the real nightmare started when I was coming around. There was this terrifying moment during the recovery phase where I felt like I couldn't breathe on my own. I definitely remember that sensation, and honestly, it was absolutely terrifying.
I’m not going to name the hospital I was at, but they basically kicked me out in record time—and of course, they didn't mention a single thing about what actually happened in my discharge papers. One thing they did suggest while I was still there, though, as a potential reason for everything, was some kind of genetic predisposition toward being "hypersensitive to anesthesia." (Not sure if that's even the right way to put it, but you get the gist.)
So, I was wondering—is there actually a way to find out if I’m allergic to a specific ingredient in what they gave me? Or was this just some kind of mistake on the anesthesiologist's part?

Hey there! How's it going?
Man, I am so sorry you had such a rough time with that. Seriously, I really hope it doesn't happen to you again.
When it comes to that semi-conscious state you experience while you're in the operating room—and those conversations you think you heard—you really have to look at it through two different lenses:
So, here’s the deal: what you heard probably happened during that initial induction phase right before the surgery kicked in. Since you were coming in as an emergency case, there's a good chance you didn't get—or didn't get enough of—that specific sedative meant to relax you and wipe the slate clean. Because of that, those snippets of conversation in the OR before you went under, combined with the hazy chatter while you were groggily waking up from anesthesia, just blurred together. Your brain basically stitched those two moments into one long, continuous memory, making it feel like you were actually awake during the whole procedure. Honestly, it’s totally understandable how much these pre-op jitters can mess with your head. When you're dealing with all that fear, anxiety, or even a little shred of hope, you're mentally raw. You're hyper-sensitive, so those sounds and voices cut much deeper into your consciousness than they normally would if you were feeling chill. That’s how we end up with this version of events. I wouldn't necessarily blame it on some weird genetic thing or being "overly sensitive" to meds, and I don't think it's a mistake by the anesthesiologist either. In emergency situations, things move so fast—and the patient's condition is often so critical—that they sometimes skip the anxiolytic (you know, the stuff that takes the edge off and helps you forget) to get straight to the induction. It's just how it goes sometimes when things are moving at high speed.

So, there's this second possibility: you were actually semi-conscious during the procedure. If that’s the case, you could probably recount some of the conversations happening in the OR while you were under. Honestly, that’s a much scarier version of events. For you, it might have felt relatively harmless since you didn't actually feel any pain, but I get why it would leave you feeling pretty anxious about any future anesthesia. I wouldn't go so far as to say you have some genetic predisposition to being "hypersensitive" to anesthetics, though. It’s more likely just a miscalculation on the anesthesiologist's part regarding the right dosage for you. Look, I’ll say it again—in an ER setting, things move fast. Sometimes, because of a patient's overall condition, the doctors might underdose the anesthetic just to make sure they don't destabilize the patient even further. That’s how you end up in that weird half-awake state. Since our operating rooms aren't always decked out with high-tech gear to monitor the exact depth of anesthesia, we really have to rely on the anesthesiologist's experience and gut instinct. You can see how easily a misjudgment can happen, especially when things get hectic in the room. At the end of the day, we're just human beings, not machines immune to stress and emotion.
Another possibility is that you were just metabolizing the anesthesia way faster than the anesthesiologist was expecting. Basically, you might have drifted out of deep sleep and into that weird, semi-conscious "twilight zone" much quicker than planned. Since they had you on muscle relaxants, you wouldn't have been able to move or even twitch to signal that you were waking up, so the doctor didn't realize you were drifting toward consciousness. Plus, since you weren't feeling any pain, your vitals—like blood pressure and heart rate—stayed steady and calm, so there were no red flags on the monitor to tip them off that something was wrong. As for why your metabolism would kick into overdrive like that, it could be anything from certain medications you’ve taken lately (like specific sedatives or antibiotics) to alcohol. Those things get processed in the liver and can actually prime it to break down other substances, including anesthesia, at a much higher rate. Or, honestly, it could just be how you're built—some people just have livers that process drugs faster due to genetics. In those cases, the doctor really needs to tweak the dosage or the timing to match the patient's unique chemistry, but when you're dealing with an emergency case, that kind of fine-tuning isn't always possible. That’s just another way your experience could have gone down.

So, that terrifying feeling when you wake up and suddenly realize you can't move, can't breathe properly, and can't follow any commands? It actually happens more often than you’d think. Usually, it’s what happens when the sedative—the stuff used to put you under—starts wearing off, but the muscle relaxant is still hanging around in your system. You're essentially stuck in a body that won't obey you because those muscles are still totally paralyzed. Once we administer the reversal agent for the relaxant, the block finally breaks and your strength starts coming back. But man, that transition is rough. Even after the paralysis lifts, you're left with this intense, overwhelming sense of discomfort while you wait for your motor skills to fully reboot. Most patients breeze through it without a second thought, and honestly, most don't even remember it happening because the anesthesia keeps things pretty hazy. But for the rare few who do catch that moment? It's definitely not something you forget easily.

Why didn't they mention those incidents in your discharge papers? Honestly, it’s probably because they don't see them as anything that would impact future anesthesia. Basically, the ball is in your court now. Next time you head in for a pre-op screening or any kind of procedure, just be upfront with the anesthesiologist about what happened and the anxiety it caused you. They'll do their best to make sure you don't have to go through that again. Usually, the stuff they actually bother putting in writing are things like a nightmare intubation or a clear allergic reaction to a drug—neither of which happened to you.
Look, a real allergic reaction to a filler isn't going to look like the symptoms you're describing. Trust me on this—if things were actually going south, people would be shouting it from the rooftops and telling you straight up. We’re talking about life-or-death situations here, not just some minor irritation.

So, long story short: I don't think you actually need more testing. Honestly, it’s probably just a matter of being upfront with the anesthesiologist about that awkward situation next time around. Given how urgent the procedure was, there's a real chance the anesthesiologist just misjudged things—not even calling it a "mistake," really, but more like a miscalculation based on your overall health and what medications you were already on. It’s one of those things that happens to everyone eventually; you just happened to have the bad luck of being the one on the table when it went down this time.
I really hope you never have to deal with anesthesiologists ever again. But if life throws that at you down the road, I truly hope it’s smooth sailing—no weirdness, no discomfort, just drifting off into a deep sleep and having some genuinely beautiful dreams.

analogmason13 said:...during anesthesia, I remember hearing conversations happening in the OR (I was in a semi-conscious state, but I didn't feel any pain at all)...

I had a very similar experience. In my case, I could clearly recall the dialogue between the surgeons. A few days after the procedure, I mentioned this to my anesthesiologist; he was initially skeptical, but once I started reciting specific sentences they had said, he stopped trying to argue his point. The experience itself wasn't shocking in terms of physical sensation—I felt no pain—but I was overcome by this inexplicable, heavy sense of sadness. My breathing became rapid, which the surgeon noticed, noting that the patient was starting to wake up, and then everything went quiet again. Then, just before the end, right before being wheeled out of the OR, I experienced another moment of consciousness accompanied by tears. Just this immense, overwhelming sorrow...
And I know several people who have also recalled conversations from the operating room. It really isn't as rare as one might think.

urbanscout50, thanks for getting back to me.
The situation makes much more sense now—it sounds like my body was just processing the anesthesia way faster than the anesthesiologist anticipated. Basically, I slipped from deep sleep into a semi-conscious state far too quickly, and because they had me paralyzed with muscle relaxants, I couldn't move an inch to signal that I wasn't actually out. That’s why the doctor didn't realize I was drifting back toward consciousness.
I knew exactly who I was and where I was, but obviously, I couldn't say a word or even twitch—plus, there was that terrifying struggle of not being able to take a breath on my own.
Anyway, it was a deeply unsettling experience—one that I bet leaves most people who go through it (in whatever form it takes) absolutely terrified of it happening again.
Thanks again for the info, and honestly, I really hope I never have to deal with an anesthesiologist ever again. 😉

Look, sorry if I’m being a total pain in the neck here, but I’ve got one more question rattling around in my brain. I was reading somewhere that one of the potential complications from anesthesia is actually being conscious during the procedure—like, you aren't fully under. Could someone please break this down for me a bit better? And honestly, what are the actual odds of that happening to someone?

There’s already been plenty written about this on this thread. You should probably take a look back at the previous pages. 🙂

Alright, I’ve gone through every single page here, and it seems like everyone is obsessing over anesthesiologist screw-ups—you know, those instances where they mess up and give you shallow anesthesia. But then again, I did read somewhere that for certain types of procedures, being conscious is actually listed as a side effect. Honestly, whatever. I’ll just grill my anesthesiologist when the time comes—which is in about ten days, by the way. 🙂

It doesn't necessarily mean the anesthesiologist messed up. Sometimes, you just have one body out of a hundred that processes anesthesia way faster than everyone else, so the dose that works perfectly for someone else just doesn't hit the mark for you. The real headache is figuring out how to tailor all that to a specific patient.🤷🤷🤷

neontrucker39 said:I’d love for anyone who has personally experienced—or even just heard about—situations where patients feel pain while being fully conscious during surgery despite being under anesthesia, to chime in. I went through this myself, and for a long time after, I kept waking up in the middle of the night terrified that it would all happen again...

Sorry, I'm a bit slow to catch up here. This happened to me when I was 15—at the start of my first surgery and again toward the end of my second. Both times were brief. I felt the pain, but there was also this weird numbness on the surface of my skin, almost like it had turned to rubber.

That initial realization was terrifying because I knew the procedure had only just begun. After a few minutes, I think the anesthesiologist realized I was awake and sedated me again. Waking up from that part was rough—breathing with the tube was difficult, so they took it out, though even without it, I struggled. They gave me an oxygen mask, and it took a few hours to finally feel human again.
During my second surgery, I woke up right near the end while they were finishing the stitches. They did a pretty good job trying to coax me back to sleep😁 before I actually spoke up, but honestly, I felt incomparably better than I did the first time.
My third surgery, which was 12 years later, went perfectly smoothly—though, naturally, I made sure to mention my history with waking up beforehand.

🙂

velvettiger15 said:I’m trying to find out if someone can tell me whether it's possible to undergo surgery—meaning general anesthesia—with myasthenia gravis. From what I've read, they use Lorsilan for muscle relaxation, which can trigger or worsen MG symptoms. Thanks!

My child is 1 year and 11 months old, and about two weeks ago, she was hospitalized at a local children's hospital for a fractured forearm. They had to perform a reduction under general anesthesia and applied a cast up to her shoulder. Since it was an emergency, I wasn't told exactly what kind of anesthesia was used, but based on the IV line she had in her arm, I assume it was intravenous. The procedure and recovery went smoothly, and she was discharged after four days. However, at her first follow-up appointment, they found that the bones had shifted, so she had to be readmitted for another reduction. Again, I didn't receive information regarding the type of anesthesia used this time, though she didn't have an IV line in her arm during this second stay. After the procedure and a 15-minute nap, my daughter woke up and cried from pain for the next five hours. I asked for some pain medication, but the nurses just said she had already received pain relief along with the anesthesia. After five hours of crying, she was given a suppository and fell asleep within 15 minutes. She was sent home the same day, and as we were leaving, the nurses seemed surprised that there was no IV line left in her arm.

Please, I am looking for any help or advice...

What kinds of anesthesia might have been used? Did she actually receive any pain medication during that second procedure, or was that perhaps an oversight by the nursing staff?
Also, I recently read that children who undergo general anesthesia more than once might face learning difficulties later on. Does anyone know anything about this...

fadeddrifter262 said:My child is 1 year and 11 months old and was hospitalized at the local children's hospital two weeks ago due to a fractured forearm. They performed a reduction under general anesthesia and applied a cast up to the shoulder. I don't know exactly what kind of anesthesia was used since it was an emergency, but based on the IV line she had in her hand, I assume it was intravenous. The procedure and recovery went well, and she was discharged after four days. At the first follow-up, they found that the bones had shifted, so she was hospitalized again for another reduction. Again, I wasn't informed about the specific type of anesthesia, but this time she didn't have an IV in her hand. After the procedure and a 15-minute sleep, the child woke up and cried in pain for the next five hours. I asked for some pain relief, but the nurses told me she had already received pain medication along with the anesthesia. After five hours, she was given a suppository and fell asleep within fifteen minutes. She was discharged the same day, and as we were leaving, the nurses seemed surprised that she didn't have an IV line.

I am asking for your help and advice!

What kinds of anesthesia could have been used? Did she actually receive any pain medication during the second procedure, or was that just an oversight by the nursing staff?
And finally, I read somewhere that children who undergo general anesthesia more than once might face learning difficulties later on. Does anyone have any information regarding this?

In the case of a second procedure, it was likely inhalation anesthesia. This is incredibly convenient for kids, but the catch is that they don't always get post-operative analgesia during the anesthesia itself. The staff taking over the little one at the ward really should have been warned about that. It seems the nurses made a mistake by not checking what kind of anesthesia was administered, wrongly assuming the child had already been given pain relief. Personally, I wouldn't worry about any potential impact on cognitive function.

Thanks for the reply! I had a feeling that was what happened.
Luckily, the baby is still so young, so I'm hoping they'll be able to move past everything scary that happened at the hospital...

So, I went through my first bout of anesthesia too. Based on what the anesthesiologist told me, they hit me with the Propofol to get things started, and man, I was out like a light—totally dead to the world. But here’s the kicker: when they were trying to wake me up, I couldn't hear anything, couldn't see anything... all I could feel was this intense, violent sensation of being hit in the back and, like, blood being sucked out of my throat. I remember panicking, desperately trying to catch my breath, but nothing was happening. It felt like I was straight-up suffocating. Once they finally rolled me onto my side, I managed to gasp for air, but it was such a struggle, and trying to swallow that thick mucus in my throat? Impossible. They ended up moving me to the ICU for a bit just to make sure I was actually breathing and conscious. It wasn't until I threw up that I could finally see clearly again, and after about ten minutes, I was fine. Honestly, I'm dying to know—was that some kind of glitch, or is that just a normal part of the experience?

fadeddrifter262 said:Thanks for the reply! I kind of assumed that was what happened.
Luckily, the baby is still so young, so I’m hoping they’ll eventually forget all the unpleasantness they went through at the hospital...

In my view, what happened here is nothing short of medical negligence. A total breakdown in communication that results in a lack of pain management—leaving a patient to suffer unnecessarily—is pure incompetence and deserves consequences.

When we fail to take action after incidents like this (whether it's a lawsuit, a formal complaint, or a protest), we aren't just telling lazy staff that it's okay to prioritize their smoke breaks over doing their jobs properly; we're also increasing the odds that someone else will have to endure the exact same painful experience.

Maybe the staff isn't 100% to blame, and part of the fault lies with an institution that overburdens its employees (though under the Hippocratic Oath, doctors shouldn't accept subpar conditions that harm patients), but until people start suing both the individuals and the institutions for failing to do their jobs, both the patients and the overworked medical staff will continue to suffer. It all stays swept under the rug.

I’m sorry if this question is a bit off-topic, but I honestly wasn't sure where else to turn to find some actual information on this. If there's anyone here with medical expertise who could weigh in or offer an opinion, I’d really appreciate it. So, my daughter’s physiatrist recommended she get an X-ray of her entire spine along with some ankle imaging following the Barschonij method, but when I called over to the Holy Spirit hospital to schedule it, they actually pushed back on me... they asked why I was okay with exposing such a young person to that much radiation, and basically told me to think twice about whether this is truly necessary!?! I mean, I’m completely in the dark regarding how harmful X-ray radiation actually is, and I'm torn on whether I should just go ahead and book the appointment or not. 🤷

And how old is the girl? Is she dealing with any bone issues, fractures, or maybe some swelling and pain?

Alexander Lewis said:In my view, what happened here was nothing short of irresponsible medical care. A total breakdown in communication that results in a lack of pain management—leaving a patient to suffer needlessly—is pure negligence and deserves consequences.

If we don't take action after incidents like this (whether through lawsuits, formal complaints, or protests), we aren't just telling lazy staff that they can prioritize their cigarette breaks over quality work; we're also increasing the likelihood that someone else will have to endure the same agonizing experience.

Maybe the staff isn't entirely to blame, and some of the fault lies with an institution that overburdens its employees (though under the Hippocratic Oath, doctors shouldn't accept substandard conditions that harm patients). However, until people start holding both the staff and the institutions accountable for poor performance, patients and overworked medical professionals alike will continue to suffer, as all these grievances are simply swept under the rug.

I agree that the general state of communication in our hospitals needs a major overhaul, along with a better understanding of the anesthesia process itself. Many surgeons, and by extension their nursing staff, don't fully grasp it, not to mention other physicians. There are plenty of reasons for this, but I won't dwell on them to avoid making insinuations. That said, had the doctor and nurse bothered to check the anesthesia report from the surgery, they would have seen that the child received absolutely no analgesia. At my hospital, being aware of these situations, we tend to take the path of least resistance and administer an analgesic ourselves right as the child leaves the operating room.

Hello everyone, greetings from a new member here!

I'm currently working on my final thesis at a major medical center in Chicago, and I've included a section on testing for malignant hyperthermia, but now I've hit a bit of a wall.

Specifically, I can't find any information on whether the CHCT (Caffeine Halothane Contracture Test) is actually performed here in the US, and if it is, where one might go to get it done.

Thanks in advance for the help!