Anesthesia, Resuscitation, and ICU: Q&A

quietharbor2 said:There’s actually another major headache with general anesthesia, especially during emergency surgeries rather than scheduled ones. If a patient hasn't had time to empty their stomach, there's a real risk of stomach contents being aspirated into the lungs, which leads to pneumonia. Lately, they've been using supraglottic devices to handle this. Instead of sliding a tube straight down into the trachea, the end of the device is shaped like a mask that sits over the opening of the larynx, partially resting against the esophagus. It lets air through while acting as a shield against aspiration. [/B]

Laryngeal masks are definitely becoming a go-to in anesthesia. They let you ventilate the patient and protect those lungs from aspiration—which, by the way, can absolutely kill someone—all without having to shove anything deep into the trachea, which isn't exactly great for avoiding infections.
But I'm a little lost on what you mean regarding aspiration risks during general anesthesia. See, when a patient has an endotracheal tube placed during general anesthesia, the doctors always inflate the "cuff"—that little balloon at the top of the tube. Once that cuff is inflated, it expands to create a tight seal against the tracheal walls, making sure nothing can slip past the tube and up into the airway, including stomach acid. When it's done right, the airway is totally secure from aspiration.
To give you a visual, here's what a classic endotracheal tube looks like...


Or maybe you were thinking of something else entirely...😉

quietharbor2 said:There is an additional complication with general anesthesia, particularly during emergency procedures rather than scheduled elective ones. In those high-pressure situations, if the patient hasn't had time to fast and their stomach isn't empty, there’s a real risk of aspirating gastric contents into the lungs, which leads to pneumonia. Lately, medical teams have been utilizing supraglottic airway devices to mitigate this. Instead of a standard tube going straight down the trachea, the device features a specialized cuff or mask that sits over the glottis and partially occupies the esophagus, effectively sealing off the airway entrance. It manages to facilitate airflow while providing a physical barrier against aspiration.

Fair enough, but when you're dealing with true emergencies, general anesthesia is pretty much the only viable option left on the table, isn't it?

Take it from Scott Allen10—he’s hands down my favorite boss. The guy knows his stuff, he’s sharp, looks good, and honestly? He’s basically the definition of perfection.

... plus, he never makes a fuss when someone needs to take a sick day! 👍

So, I’ve got this dental surgery coming up this Tuesday, and they’re actually planning to put me under general anesthesia for it. Not gonna lie, I’m feeling a little jittery about the whole thing—I’ve never actually been knocked out like that before. I don't really have any major health issues or anything...

Has anyone else here ever gone under general anesthesia? Is it something I should actually be stressing over?

I was in general anesthesia twice when I was a kid and everything went totally fine... though I guess there's definitely a risk for people with heart conditions.

I actually just posted a question on another thread about this exact thing... I need my wisdom teeth pulled and the surgeon wants to take all four at once. I'm not really feeling great about that idea.
In my opinion, you shouldn't be afraid, but you also shouldn't go under general anesthesia for something trivial.

They’re gonna charge me for five damn teeth plus some bullshit cleaning fee too!

Why go all at once? Honestly, you’re much better off having them pulled one by one under local anesthesia. If your logic is, "It’s going to hurt later regardless," well, you're right—it will. But do you really want to deal with five different bouts of minor pain, or would you rather face one intense period and just get it over with? It’s about choosing how you handle the recovery.

I’ve been through this ordeal twice now—once when I was eight and again at sixteen. The first time, I remember watching my sister spinning around above my head in circles, and the second time, they told me to count backward from ten to zero, though if I recall correctly, I barely even made it to six before everything slipped away. The part that really sticks with me, though, wasn't the loss of consciousness itself, but rather the sheer, overwhelming noise the nurses were making while I was drifting back to reality. It was easily the worst part; my head was ringing so loudly it felt like I’d spent the entire night drinking gallons of cheap wine. Oh, and I should mention that during the second procedure, the anesthesia had this absolutely revolting smell of garlic 😲 so perhaps I had already blacked out by then.
don't worry too much, maybe you'll just have some interesting dreams!😘

Don't just pull them one by one; go to the general section and grab everything at once.
It isn't like anesthesia or anything scary—at least it wasn't for me...

And why on earth do you have to pull five at once?!!!
In my book, pulling a tooth is always the absolute last resort...
I wouldn't agree that doing them all in one go is better either. It’s not even about the anesthesia; it’s about how much of a wreck you'll be afterward because you had five teeth ripped out. The swelling... the pain... then the antibiotics

I’ve had to go under general anesthesia twice now, and honestly, I haven't had a single bad experience with it. It was fine..
As for antibiotics, look—if you have to go in five times, you're going to end up on antibiotics five times. If you do it once, you're done. Plus, if you're seeing an experienced surgeon, the whole thing is pretty low-trauma. The pain isn't even that unbearable, especially since you'll still be a little looped from the anesthesia when the worst of it hits..

What do you mean by "clean"? Are we sure it isn't a granuloma?

I was watching the movie Awake the other day, and it really got me thinking about that whole phenomenon—you know, where a patient is totally conscious during general anesthesia, but their body is completely paralyzed. They can't move a muscle, can't even blink... nothing.😲Theoretically, a patient might actually feel pain, though apparently they mostly just sit there hearing the doctors chatting away in the OR throughout the entire surgery. And the scary part is, the doctors have no idea the patient is actually awake. I mean, if the anesthesiologist doesn't catch it, then who on earth will? 😕I haven't really come across this specific thing before, so I was wondering if there’s already a thread about it on here, or maybe some specific term I should use to Google it? Also—God forbid anyone here actually goes through this—but has anyone ever had an experience like that...?

It was my mom, unfortunately. She went through a C-section with me about 34 years ago, and the doctors actually didn't believe her at first. It wasn't until she recounted the conversations they had in the OR—stuff like how one doctor was talking to a nurse—that they finally took her seriously. She felt the pain, though, whenever she was conscious enough to process it; given how intense those pains are, the doctors told her she was a bit of a medical anomaly. Looking at the tech you're hooked up to now, it seems a little strange to me that her heart rate would have stayed within the normal range.

That whole thing with the heart rate and blood pressure being totally normal... it’s just weird. In the movie, the guy is mid-heart transplant, under deep anesthesia, right? But they show his vitals staying steady while he's basically wide awake—not even fully out from the start of the procedure. I know how those heavy surgeries usually go; you've got the stuff for pain, the stuff to knock you out and wipe your memory, and then the muscle relaxants that paralyze everything so the surgeon can actually do their job without things jumping around. So why does it happen where the body gets paralyzed and numb, but the consciousness and the ability to feel pain stay stuck on "on"? Like, how is it even possible that they can't blink or move a single finger? I think I remember seeing something about this a long time ago on The Tonight Show; they had guests who had gone through exactly this. Some poor souls were in six-hour heart surgeries and ended up with massive trauma afterward—nightmares, phobias of hospitals, all that stuff.😢 And the people who tried to sue the hospital? They ended up losing the lawsuits because they could literally recount every single conversation in the OR, every little detail of what was happening to them, just... vividly.👎 Does anyone actually know why this happens? Is it some weird biological quirk, or just a massive screw-up by the anesthesiologist?

I went through something pretty similar during my C-section. They paralyze your whole lower half—legs, stomach, everything—and it’s honestly terrifying. I think my anesthesiologist might have botched the dosage because my legs felt awful; they were tingling and cramping, but I couldn't move them at all. It wasn't like I was numb, either. I could hear the doctors talking and everything, but you just feel so helpless.

I had a similar experience during a throat surgery. The difference was that I didn't feel any pain at all, though I could hear the surgeon's conversation quite clearly.

electricpanther82 said:I recently watched the movie Awake, which depicts this terrifying phenomenon—where a patient remains fully conscious while under general anesthesia.

Ugh... I saw that one too. Honestly, it was absolutely chilling—a complete nightmare. 😱😱😱😲
I always assumed that kind of thing was just Hollywood exaggeration, but now I realize it actually happens in the real world. 😲😲😱😱

I’ve heard similar stories about those cases where patients don't actually feel any physical pain, they just hear voices and people talking, though I guess I'm not quite sure what all determines that part🤷

A bit off-topic, but if you think that’s a major issue, consider this case I read about the other day: "a man spent 20 years in a coma, completely awake and aware of his surroundings"
Basically, the guy fell into a coma and just lay there with his eyes closed—paralyzed, yet fully conscious and hearing everything happening around him.
To me, that sounds way worse. I mean, what would you even do with yourself, lying in the same spot for 20 years? Honestly, I’d rather just be put out of my misery immediately.
I deal with sleep paralysis quite often, maybe twice a month, and I know firsthand how terrifying that sensation is. You just want it to let go of you.