Anesthesia, Resuscitation, and ICU: Q&A

Did Huseđinović get you hooked on this topic? 😁...Look, I’ve been messing around with anesthesia for about 20 years now, and honestly, I’ve never heard of a single patient over here being sent for a CHCT. Maybe I just haven't had the luck to run into one yet.
Besides that, we don't even really use halothane in our hospitals anymore, so I'm not even sure if that test carries much weight for the isoflurane or sevoflurane we usually go with. It’s kind of the same deal with leptosuccin (succinylcholine)—since that's the stuff most people link to MH, it's pretty much phased out of regular use too...
I don't know, man, I can't help but feel like you could've picked a slightly more interesting anesthesia topic to dive into...

Hey🙂
Quick question about laparoscopic gyno surgery.
I know they use general anesthesia, but do they actually intubate you during the process?

Attention all on-call doctors 🙂

I’m looking into getting rhinoplasty purely for cosmetic reasons. But before I start touring different outpatient clinics, I wanted to get your take on my diagnosis and the anesthesia situation. I was diagnosed with pregnancy-induced thrombophilia back in 2009-10 based on these labs: aCL IgG and IgM at 13, and PAI-1 heterozygote. Throughout my entire pregnancy, I was on Fraxiparine 0.3, even though my coagulation profile and platelet counts stayed perfectly normal the whole time. Does any of this actually link back to thrombophilia? My GP mentioned that if I weren't pregnant, he’d probably just read those results as totally normal. Given my history, am I taking any unnecessary risks with anesthesia?

Susan Ramos96 said:Hey everyone on the forum, greetings from a new member!

I'm working on my final thesis at a health sciences university here in the States, and I've been looking into testing for malignant hyperthermia, but now I've hit a bit of a wall.

Basically, I can't find any info on whether they actually perform the CHCT (Caffeine-Halothane Contracture Test) here in the US, or if they do—where would that even happen?

Thanks for the help!

Nope.

wanderingcrane said:Hey there,🙂
I have a quick question about laparoscopic gynecological surgery.
I know general anesthesia is used, but does the patient actually get intubated during the procedure?

Basically, yeah. That’s the safest way to go. You could technically get by with a laryngeal mask or even just a regular mask, but honestly, that's basically playing Russian roulette with anesthesia. We just pray to God everything goes smoothly.

Elizabeth Hernandez4 said:sent to all the on-call doctors 🙂

I'm thinking about getting nose surgery just for the looks, but before I start hitting up different outpatient clinics, I wanted to get some thoughts here regarding my diagnosis and anesthesia. Back when I was pregnant (2009-10), I was diagnosed with pregnancy-related thrombophilia based on these labs: aCL IgG and IgM 13, and PAI-1 heterozygote. I was on Fraxiparine 0.3 through the whole pregnancy, though my blood counts and platelets stayed totally normal the entire time. Does any of that actually link back to the thrombophilia? (My doctor mentioned that if I weren't pregnant, he'd probably just read those results as perfectly normal.) Also, would I be taking any extra risks with anesthesia given my history?

Honestly, just sit down and talk it out with your hematologist or transfusion specialist along with your surgeon. As far as the anesthesia goes, that's usually the least of your worries in this situation.

[QUOTE=casualcobra;30003209]So, I survived my first anesthesia experience too! From what the anesthesiologist told me, they gave me Propofol to start things off, and man, I was out like a light. But when I started coming around, it was scary—I couldn't hear or see anything, just felt this intense sensation of being hit hard in the back and feeling like they were sucking blood up through my throat. I remember desperately trying to take a breath, but nothing was happening; I honestly thought I was going to suffocate. Once they finally rolled me onto my side, I could breathe again, though it was such a struggle, and I tried so hard to swallow that mucus in my throat, but it just wouldn't go down. They moved me to the ICU for a bit just to make sure my breathing stabilized and I was fully conscious. It wasn't until I threw up that things finally cleared up—about ten minutes later, I was okay. So, I'm wondering, was there a specific issue there, or is this just a normal thing? [/QUOTE
]

I actually had some pretty similar "symptoms" when I was waking up from anesthesia, so in my opinion, what you went through sounds totally normal. You had that tube in your throat—just like I did—and it made breathing and swallowing feel impossible. I was dying for a sip of water, but of course, they couldn't let me have any. My memory is a bit fuzzy at first; I just remember being transferred from one bed to another, then everything gets blurry, then it comes back... it’s all part of the process. It’s normal, really, because the anesthesia just takes its time letting go of you.[/QUOTE]

Hey everyone... I have a quick question (for 😁 now).... reading through some older posts, I noticed people mentioning paracetamol being used during anesthesia (or maybe just right after it wraps up).... why is that?

urbangull25 said:Hey everyone... I've got a quick question (well, 😁 )... looking back through some of the older posts here, I noticed people mentioning that acetaminophen gets used during anesthesia (or maybe it's just for the recovery period?). Why is that?

To help with the pain!

I’m not totally sure if this is the right thread for my questions, but I couldn't find anything else even remotely close to this topic...
Basically, I’m wondering why some hospitals here in the US provide anesthesia for certain procedures and exams, while others—like the KBC over in Rijeka—won't even talk about it.
Is it because they’re short on anesthesiologists? Is it just because anesthesia is too expensive? Or maybe they think they know what's best for the patient? Or is it something else entirely?
If money is the issue, is there actually an option for me to just pay for the anesthesia and the anesthesiologist myself? (Honestly, it would still be cheaper than doing everything at a private clinic).
And if the argument is whether it's "good" for me or not, don't I have the right as an adult to choose a specific level of risk in exchange for avoiding pain? (And obviously, I’d sign a waiver or something to that effect).
I am just so incredibly frustrated, and I honestly have no idea how to handle this situation.😢
Back in December, I had a colonoscopy, and I practically had to beg them to give me sedation, and even then, it was pretty painful. They had their "legitimate" reason—basically saying that if they can't get feedback on whether it hurts, they might accidentally perforate my bowel. Fine, I get that.
But now I’m prepping for a different procedure where those kinds of risks aren't even on the table, and yet they *still* won't budge on providing anesthesia. Meanwhile, plenty of other hospitals in the US will offer general or local anesthesia if the patient asks for it.
Alright, let me demystify what's actually happening here. I'm currently going through the IVF process, and I have an egg retrieval coming up—follicle aspiration or whatever you call it. This is my first time, and I am so terrified that I'm starting to question the whole damn process. I've been a nervous wreck for weeks, and I'm scared I won't sleep at all in the days leading up to it. I mean, should women going through something this delicate and intense really be subjected to extra stress and pain? We're living in the 2000s; anesthesia isn't some avant-garde luxury, thank God... yet somehow it changes everything.
I know I'm rambling a bit, but if anyone can help me find a real solution to this, I would be so grateful. I was thinking maybe I could hire a private anesthesiologist to meet me at the hospital during my appointment, but I have no clue if that's even feasible or even where to start looking for info.
Also, could someone explain "local anesthesia" for internal organ procedures?
In my opinion, for both a colonoscopy and an egg retrieval, you'd need general anesthesia or maybe an epidural. I don't get why I constantly see—even on the websites of respectable clinics like CITO in Split—offering local anesthesia for egg retrievals. Can anyone explain how that kind of local anesthesia actually works and where it's applied on the body?
Is there any kind of mild anesthetic available at a pharmacy that won't cause a massive drama regarding previous tests and stuff? And ultimately, if I can't secure anesthesia, what would you recommend as a "cocktail" to help me relax and dull the pain? I was thinking about taking 10 mg of normabel and one Voltaren rapid about half an hour to an hour before, but I don't know if that's safe. Would something like Praxitan be better than normabel, or maybe Apaurin? (I know that's used for sedation).
Help.

coppernomad7 said:I’m not entirely sure if this is the right spot for my questions, but I couldn't find anything else that really fit the bill...
I’ve been wondering lately why some hospitals here in the States will just go ahead and give you anesthesia for certain procedures or exams, while other places—like the big medical center over in Seattle—won't even budge or talk about it. It feels pretty inconsistent if you ask me.
Is it because they’re short on anesthesiologists? Is it just that anesthesia costs an arm and a leg these days? Or maybe they actually think they're doing the patient a favor by skipping it? I don't know, could be something else entirely.
If money is the main issue here, is there any way I could just cover the cost of the anesthesia and the anesthesiologist myself? It still feels like it would be cheaper than trying to go fully private for everything.
Look, if the whole debate boils down to whether something is "good" or "bad" for me personally, shouldn't I, as a consenting adult, have the right to choose a specific risk over dealing with constant pain? I mean, I'm more than happy to sign a waiver and put that in writing for them.
I'm honestly so frustrated right now, and I have absolutely no clue how to fix this mess.😢
I had my colonoscopy back in December, and man, I practically had to beg them to let me have sedation. It ended up being pretty painful. They had a valid reason for pushing back on it, though—basically, if I don't give them honest feedback about the pain, they might end up perforating my bowel. So, yeah... definitely not exactly a walk in the park.
So, I'm gearing up for a different procedure now. It’s nothing nearly as intense as the last one, so the risks are way lower, but they're still being stubborn about the anesthesia. They won't budge on it. It's kind of frustrating because, in a lot of hospitals here in the States, if you specifically ask for general or even just local anesthesia, they usually just go along with it. But apparently, that's not how things work in this neck of the woods.
Alright, let’s demystify this whole thing. I’m currently in the middle of an IVF cycle, and I've got the egg retrieval—or follicle aspiration, if you want to get technical—coming up. This is my first time going through it, and honestly? I am absolutely terrified. It's gotten to the point where I'm questioning the entire process. I've been a total wreck for weeks now, and I’m genuinely scared that in the final few days leading up to it, I won't even be able to sleep because of the anxiety. I mean, seriously, do women going through something this delicate and physically demanding really need to deal with extra layers of stress and pain on top of everything else? We’re living in the 2000s, for crying out loud. Anesthesia isn't some experimental, avant-garde concept, thank God... yet somehow, things can still change so much.
I might have gone a little overboard here, but if anyone has ideas on how to actually handle this situation, I’d really appreciate the help. I was thinking about maybe hiring a private anesthesiologist to come meet me at the hospital on the day of my biopsy, but honestly, I have no clue if that’s even doable or where I’d even start looking to find out.
I was also hoping someone could clear something up for me—what does "local anesthesia" actually look like when you're talking about procedures involving internal organs?
If you ask me, for something like a colonoscopy or an egg retrieval, you really should only be looking at general anesthesia or maybe an epidural. I honestly don't get why I keep seeing places—even on the websites of reputable clinics like CITO over in Split—offering local anesthesia for egg retrievals. Can someone walk me through how that kind of local anesthesia actually works? Like, where exactly on the body is it applied?
Is there any kind of mild anesthetic available at pharmacies that won't trigger a massive interrogation about my medical history or previous tests? Honestly, if I can't track down actual anesthesia, what would you guys recommend as a "cocktail" to help me relax and take the edge off the pain? My plan was to take 10 mg of normabel and a Voltaren rapid about half an hour to an hour beforehand, but I'm not sure if that’s a smart move. Would something like Praxitan be better than the normabel, or maybe even Apaurin? I know they use that stuff for sedation, so I'm just wondering what the best bet is.
Hey, I'm here. What's going on? Just let me know what you need help with and we'll figure it out together.

Seriously, just insist on getting anesthesia. If you're dealing with the hospital in Seattle, it really makes you wonder who’s actually trying to dodge the job—is it the anesthesiologists or the OB-GYNs?
It honestly feels like OB-GYNs just refuse to do it for reasons I can't quite wrap my head around. Seriously though, don't let them off the hook—insist on getting anesthesia. If they try to brush you off, demand a specific reason why they're choosing not to provide it. For a procedure like this, I really can't see any legitimate excuse to skip out on anesthesia.
If you were looking for a private anesthesiologist, who would you actually bring in? Honestly, I wouldn't even consider it!
Getting anesthetics from a pharmacy? Not a chance!
For egg retrieval, they usually go with local anesthesia. I haven't personally been through those specific procedures, but typically they inject a local anesthetic right into the vaginal vault—basically where the needle passes through the vaginal wall—so that big needle poke doesn't hurt nearly as much. Gynecologists can handle this themselves without needing a full anesthesiologist on standby, so it’s definitely doable.
As for you taking any meds on your own before the procedure, I really wouldn't recommend that. Especially things like normabel or other anti-anxiety meds. You have to be upfront with your doctors about everything you take, otherwise, they might actually kick you off the program because you took something they didn't authorize.
Seriously though, don't be afraid to insist on anesthesia. It's your right as a patient. If there's a way to do something just as effectively but with less invasion, less pain, and fewer side effects, that's the route we should be taking. A patient has every right to refuse a procedure if a less painful alternative exists and the doctor chooses the rougher way instead. So, if they don't give you a solid, logical reason why they won't use anesthesia, keep pushing for it.
It's 2011; people shouldn't have to be in pain! They can take their "house policies" and shove them.
Best of luck! Please, just let us know how it goes and what they end up saying. Fingers crossed for you!

Thanks so much for such a thoughtful reply. Usually, when you ask about anesthesia, people just give you the standard brush-off: "Why do you care? You can handle it," or "It’s only ten minutes," or "It’s just a couple of needle pricks, just think about why you're doing this in the first place (the baby), etc."
I’m guessing the right move would be to ask the actual person performing the puncture? The catch is, getting to that person is nearly impossible. My meds are handed over by a nurse, and then I'm basically left to fend for myself (like most women here) unless she absolutely has to step in. On top of that, the person in charge is incredibly tactless and, frankly, difficult—and that’s not just my take, it’s their reputation built up over years—so you end up being terrified to even ask for anything or advocate for yourself. From what I’ve gathered, women at the Mayo Clinic undergoing this same procedure just sort of accept that it’s going to hurt; they see it as part of the price they have to pay to try for a pregnancy. Because they're scared and left in the dark, they end up huddled together giving each other advice on which painkillers or muscle relaxants to take beforehand just to make it bearable. We're really just on our own. That said, I don't think it's a great idea to start popping heavy medication on my own, especially during peak egg maturation right before implantation, but I might be forced into that if I can't get things handled professionally. I’ve got about 15 days left until the puncture since I’m on the long protocol, so I’ll definitely ask the nurse about the anesthesia when I go in for my next round of meds, though I'm not holding my breath. I'll keep you guys posted, for sure!

Oh, and just one more thing... a friend of mine told me they didn't even give her anesthesia during her D&C procedure.😢 Dodus, she wasn't talking about what happens in Rijeka, but in some other city in America. Now that I've spent some time digging through forum posts on this topic, I'm honestly just shocked. It turns out that even for a D&C, anesthesia is treated like some exotic luxury, and it's actually incredibly rare for it to be used in our hospitals here. Apparently, women just have to go through it completely wide awake!!!!
It honestly makes me want to cry just thinking about it. I truly believe that no woman—no living being in a civilized society—should ever be subjected to that kind of pain. It’s not enough that a woman loses her baby and is left with this massive physical and emotional void; she also has to endure having her insides scraped while she's fully conscious. Like, she has to suffer through every single second of what happened to her. It's pure horror.

Hey coppernomad7, maybe this helps. Regarding endoscopic exams—at the hospital here in my city, they aren’t exactly big fans of doing them comfortably.👎But, from what I’ve seen personally, if you have the cash, those procedures can be done under Propofol sedation. For instance, at Liganj Hospital or at some of the private clinics in the city, you just pay up to $667. They have the gastroenterologist, the anesthesiologist, and the nurses all on-site, so there’s no need for an anesthesiologist to travel to a different hospital. I'm not trying to shill for any specific place, but you really do have options, because honestly, some of the ways things are handled can feel pretty inhumane. As for D&Cs and other gynecological stuff, I heard about this drug called Fortral that certain hospitals use for D&Cs... I'm not sure what the requirements are to get it for an egg retrieval, though. I know it's injected into a vein and works by blocking pain signals in the brain; it can even knock you out for a few minutes. If that isn't basically total anesthesia, I don't know what is. I mean, what does it actually cost them to provide a drug like that, unless the patient has some specific medical issue? Does anyone happen to know?

Thanks, electricpanther82🙂
I’m definitely going to Google Fortral right away. Honestly, I actually needed a specific name for something that might help me out, just so I know what to bring up with the doctor.
Unfortunately, that local Liganj clinic—which is basically right in my backyard—isn't even a hospital anymore; they turned it into a nursing home.😢
Everyone I know has had a painless, high-quality colonoscopy there, but of course, I decided to go in for mine right when they were shutting the whole place down.😬
But hey, whatever, that's in the past now....
As for the puncture, I'm pretty much at the mercy of Social Security and the whims of the local hospital in the area, because I don't think I can even get that done privately now that I'm already stuck in their system....
I'll ask about that Fortral, or at least about the sedation they gave me during my colonoscopy at that same hospital. I just don't know exactly what they used, even though I asked... I mean, I literally asked, "What are you giving me?" and the nurse just gave me this blank stare like I was being difficult for not having enough trust. So I repeat the question, and she just says, "Apaurin." I ask if there's anything else, and she just goes silent—nothing. And I know for a fact they didn't just give me one thing... it was a whole cocktail!!!!!! Plus, the doctor didn't even look at me or say hello when I arrived or when I left. Not a single word was exchanged... honestly, WTF.😕

Fortral is an opioid analgesic. I'm thinking that might be the one...
For those who actually know their stuff, is it stronger than Voltaren?
I'm going to try to fight for sedation because, honestly, trying to get general anesthesia for this feels like a lost cause, and local numbing probably won't do much for me anyway. If they refuse to give me even basic sedation, I might just try to get some Fortral through my private OB-GYN. I mean, can a private gynecologist even write a prescription for Fortral?
Basically, I was thinking about combining 100 mg of Fortral with about 0.25 mg of Helex roughly an hour before the egg retrieval. Would that be okay?

coppernomad7 said:Fortral is an opioid analgesic. I think that might be the one...
For those who know their stuff, is it stronger than Voltaren?
I’m going to try to fight for sedation because I feel like trying to get it for my mom beforehand is basically a losing battle, and local anesthesia probably won't do much anyway. If they won't even give me sedation, then I'll try to get some Fortral through my private OB-GYN. Can a private gynecologist actually write a prescription for Fortral?
Basically, I was thinking of combining 100 mg of Fortral and about 0.25 mg of Helex roughly an hour before the puncture. Would that be okay?

I don't think so. Fortral is a heavy-duty opioid, and because of that, there's a real risk of respiratory insufficiency—or, in plain English, you could stop breathing, which carries some pretty scary consequences. Especially if you mix it with a sedative. Plus, Fortral can have another annoying side effect where some people end up wheezing, which is super uncomfortable (though luckily it passes). That’s why it’s always recommended that these kinds of meds be handled by doctors who actually have experience with them. (To me, Michael Jackson is the ultimate example of how a great medicine can become fatal if it ends up in the wrong hands).
So, just forget about the Fortral.

If you absolutely have to play your own anesthesiologist—which, man, what a bummer!—maybe try this instead. Take something to take the edge off, whatever you normally use or are used to taking at your usual doses (that Helex could work). Then take 1 or 2 Zaldiar (which is a tramadol and acetaminophen combo) about 45 minutes to an hour before the procedure. After it's over, if it still hurts, move on to something else like Voltaren, Tylenol, Advil, or Ibuprofen—or if those don't cut it, take another Zaldiar.
Just please keep in mind that this isn't actual anesthesia; it's only going to take the sting out a little bit. And most importantly, if you're DIY-ing your pain management, make sure you have someone to drive you to the hospital and pick you up. Under no circumstances should YOU be the one driving. Personally, I’d suggest just taking those meds once you're actually at the hospital (show up a little early and wait for the procedure). Just to be safe.

Hmm, wait, don't you need a prescription for Zaldiar? I've been hearing lately that they’re even asking for prescriptions for Voltaren now too?
I was actually planning on grabbing my usual combo while I was out running errands before heading into the hospital, since you always end up waiting for hours there anyway... one girl told me she took a mix of normabel and regular caffeine, but she spent three whole hours sitting in the waiting room, and by the time her name was finally called, the meds had already worn off.
My ride is all set, and I honestly don't think I'll need anything once I'm out later. Apparently, women feel totally fine after they get that done—some even head straight out for a walk. I'm not really worried about any lingering discomfort or dull aches afterward, but the thought of sudden, sharp pain—and potentially having to deal with ten of them in a row right in my most sensitive area—just absolutely terrifies me. 😢
urbanscout50, thanks so much for understanding 🙂

I'm heading in for knee reconstruction surgery soon, and honestly, I am spiraling into a full-blown panic. I can't stop obsessing over the anesthesia part—it’s like this constant fear of that "X factor," just waiting for everything to go sideways. I have an allergy to Voltaren, and I'm sitting here wondering if that has any connection to the meds they actually use during the procedure. I know people might think I'm being dramatic, but I really need some perspective. Does anyone know the actual statistical risk of something tragic happening under anesthesia, or like, the odds of things going wrong to the point where I lose my leg? I know this sounds silly to some, but I'm genuinely struggling to cope with the anxiety right now.

vividtrucker92 said:I'm heading in for knee reconstruction soon, and honestly, I am freaking out—it’s full-on panic mode. I can't stop obsessing over the anesthesia part, just terrified of that "unknown factor" where everything goes sideways. I have an allergy to Voltaren, though I'm not sure if that even matters for the meds they use. Does anyone know what the actual risk is? Like, what are the odds of something tragic happening during anesthesia, or worse, something going wrong and leaving me unable to walk? I know people probably think I'm being dramatic, but I really don't know how to handle this anxiety.

Listen, you can rest easy knowing that any sane person would be feeling exactly what you're feeling right now. You aren't some outlier here; this is totally normal.🙂

The Voltaren thing shouldn't affect the anesthesia itself, but you should definitely mention that—along with every other little worry running through your head—to the anesthesiologist during your pre-op appointment. That consultation is actually the perfect time to lay all your cards on the table and ask about everything else you're worried about.
Specifically, for a knee surgery like yours, they'll almost certainly go with some kind of regional anesthesia, which is way easier on your body than going under completely.