Anesthesia, Resuscitation, and ICU: Q&A

Why exactly do anesthesiologists care so much about the number and type of previous anesthesias? Are they picking the next anesthetic based on those stats, or is this just data to track potential complications the patient might have faced before?

So yeah, that’s basically the lowdown on what we're looking at regarding potential implications and the specific type of anesthesia being used. You have to remember, anesthesiologists are like those silent, invisible shadows following you through the whole process.

I need some help here. I just left the dentist, and they injected local anesthesia directly into my gums. Right after that, I started feeling incredibly dizzy, and my legs felt weak and painful—it was a miserable experience.
Is this normal?
In two weeks, I have to go back for a minor procedure on my tongue because of a fistula. They’re going to apply 2-3 drops of anesthesia to the area, and frankly, I'm terrified of those side effects returning. Are these symptoms dangerous?

Chris Miller said:Why do anesthesiologists care so much about the specific number and type of previous anesthesias? Are they picking the next anesthetic based on that, or is it just info regarding potential complications the patient might have dealt with before?

It’s all about knowing how you reacted to past anesthetics and how everything went down! They want to make sure you don't run into those same complications again. On the flip side, it’s also a green light—if those drugs worked perfectly for you last time, there's a good chance they'll work just as well this time around...

Amanda Howard84 said:I need some help here. I was at the dentist recently and they gave me local anesthesia in my gums. Right after that, I started feeling dizzy—and then this weird pain and weakness in my legs kicked in—it was incredibly uncomfortable.

Is that even normal?

In about two weeks, I have to go back for a minor procedure on my tongue (dealing with a fistula) where they'll probably just drop 2 or 3 drops of anesthetic on it again, and honestly, I’m terrified of those side effects coming back. Are they dangerous?

I suppose you should just ask your dentist exactly which type of anesthetic they used—then take that info to whoever is handling the fistula procedure and describe what happened to you. There are quite a few different kinds out there... maybe you just need a different formula applied.

How strict are our anesthesiologists usually? I’ve got a procedure coming up soon—sinus surgery, if that matters—and I’m assuming the anesthesiologist is the one who gives the final "thumbs up" or "thumbs down." Can they basically shut the whole thing down based on my labs?
-My hemoglobin is slightly high; the range is 138-175 and I'm at 177.
-My fibrinogen is a little low; the range is 1.8-3.5 but I'm at 1.7. This part really has me worried because it's basically a marker for how well the body heals wounds. Does the anesthesiologist have some kind of legal mandate that says fibrinogen has to be within the standard range?
-Potassium is a bit elevated; the range is 3.9-5.1 and I'm sitting at 5.9 (I may have polished off about two pounds of dried figs the night before 😁).
-Creatinine is a tad high; the range is 64-104 and I'm at 114.
-My liver enzymes, ALT and AST, are nearly double the reference limit, though GGT looks fine.

Just answering this for my own sake—maybe someone else out there needs to hear it too. My anesthesiologist didn't care one bit about my other numbers, but he got really hung up on the potassium levels. He told me I had to go back in and get blood drawn again just to be sure.

Has anyone here ever gone through spinal anesthesia, or maybe there's an anesthesiologist on the forum I could pick a brain? I have a few quick questions!

Olivia Wright49 said:Is there anyone here who's experienced with spinal anesthesia—or maybe an anesthesiologist lurking on the forum—so I can pick your brain about a few things?

Just ask.

So, I’ve got this laparoscopic surgery coming up to clear out a benign tumor/cyst near my liver and kidney. Honestly, since I struggle with anxiety and panic attacks, I'm starting to spiral a bit. My mind is racing with questions about the anesthesia part. I deal with thyroid issues, lipid metabolism problems, and PCOS, so I'm on a bunch of meds—including stuff for my anxiety. I’m really worried about potential contraindications because my metabolism has been super sensitive to certain drug groups in the past. Is it actually possible to get allergy testing done for anesthesia before the surgery? Also, my blood pressure tends to run low—is that going to be a major issue? On average, how long do these abdominal laparoscopic procedures actually take? Am I going to be intubated for breathing once the anesthesia kicks in? And will I have to deal with a catheter after the surgery? My biggest fear, though, is the idea of waking up before the muscle relaxants wear off. Like, what if I regain consciousness and feel pain but can't signal anyone? I know it’s incredibly rare, but that tiny chance is still eating at me. I’ve never had surgery before, unless you count getting my tonsils out when I was just a kid.

quiettinker9 said:Since I’m facing laparoscopic surgery to remove a benign tumor/cyst near my liver and kidney—and given that I struggle with anxiety and panic attacks—I’m starting to get really scared. I have a ton of questions about the anesthesia itself. I also deal with thyroid issues, lipid metabolism problems, and PCOS, so I’m on several medications, including anti-anxiety meds. I’m worried about potential contraindications because in the past, my metabolism has been hypersensitive to certain drug groups.

Before surgery, you shouldn't eat anything. Depending on the facility, some morning meds can be taken with a tiny sip of water. You might be able to take your calming meds the night before or even in the morning at the ward; personally, I prefer having my pills at room temperature before hitting premedication, where they usually give you the sedative stuff anyway. A panicked patient often requires higher doses of anesthetic, and because of the hormones released during a stress response—some of which stay active longer—that state can actually linger even after you're knocked out. That's why it's vital to take your regular anxiety meds and stay fully informed about the procedure and its risks from both the surgical and anesthesia sides. Don't let irrational fears make things harder—they don't help anyone.

To minimize complications, it’s crucial to have your thyroid levels within the normal range. I’d recommend having thyroid hormone results that aren't more than a year old. If your levels aren't regulated, work with an endocrinologist to get them steady before heading into surgery.

Drug interactions and contraindications aren't your burden to carry—that's the doctor's job, so there's no reason to stress. Just write down everything you take, including dosages and timing, on a piece of paper for your pre-op exam. Make sure to include any supplements (Ginkgo, herbal stuff, etc.). Your medical team will then advise you on what to take during the perioperative period. The key is being honest and listing everything.

quiettinker9 said:Is there a possibility to do allergy testing for anesthesia before the surgery?

Regarding actual allergy tests, they do exist for all our IV anesthetics, relaxants, and analgesics. However, there has to be a specific clinical indication to run those tests—usually a history of a prior allergic reaction. Among the anesthetics we use, there are certain ones that trigger fewer reactions, which we prefer for patients prone to atopy, and premedication with corticosteroids or antihistamines is also an option. I should mention that doing all this without a very good reason is total overkill.

What kind of allergic reactions have you had in the past, and to what (food, meds, environment, anything)?

quiettinker9 said:Also, I have low blood pressure—how much of a problem is that?

Low, high, or no pressure at all—it’s not a problem for us. 🙂

Before, during, and after the procedure, your blood pressure will be constantly monitored, along with your pulse, via EKG, pulse oximetry, urine output, and capnography while you're on mechanical ventilation. Depending on the facility and ruggedpuma12, we might also perform neuromuscular blockade monitoring, sedation/consciousness levels, or various invasive monitoring—though those would be overkill for this specific procedure.

We have the protocols and medications ready for any deviation from the baseline, and we can correct everything—including blood pressure—very quickly.

quiettinker9 said:How long do laparoscopic abdominal surgeries usually take?

It depends on you—your anatomy, the surgeon, the equipment used, and the anesthesiologist. As far as you're concerned, time is irrelevant; fifteen minutes will feel like fifteen hours, or vice versa.

quiettinker9 said:Will I be intubated for breathing after the anesthesia?

The procedure requires intubation.

quiettinker9 said:Will I have a catheter after the surgery?

Catheters are mostly placed after you've been put under to avoid discomfort. Whether or not you actually need one is decided by the surgeon and the anesthesiologist based on their own clinical indications. You can ask if they can remove it before you wake up, provided there aren't any contraindications and if one was even placed to begin with.

quiettinker9 said:

Look, honestly? With all the modern monitoring and the drugs they use today—both now and even back in the day—someone would practically have to do it on purpose for that to happen. Don't let it get to you.

quiettinker9 said:I've never actually had surgery—just had my tonsils out when I was a kid, but that's about it.

If your previous anesthesias went smoothly, that’s a massive green flag. It’s a great sign that things won't go sideways this time either.

Just a top-tier, standard bit of commentary

I can't believe I'm actually typing this out! Seriously, you guys won't believe the day I've had. It’s been a total whirlwind! Everything is just moving so fast, and honestly? I am loving every single second of it. Life is wild! says:
Look, if you want to keep complications at an absolute minimum, you’ve gotta make sure your thyroid levels are sitting right within the normal range. Seriously. I highly recommend getting a fresh blood test—nothing older than a year. If your hormones are all over the place, get them under control with a specialist first. Get that sorted out with an endocrinologist before you even think about stepping foot into the OR!

This might get a little tricky because I’ve been dealing with hypothyroidism and taking medication for 15 years now. My labs have actually been acting up over the last few months—it's kind of weird because my levels have stayed super steady for years, but suddenly they jumped just past the limit. I had a follow-up blood test for my TSH a couple of weeks ago and things dropped back down a tiny bit on their own. My endocrinologist went ahead and bumped my dosage up a little too. Honestly, I wouldn't be surprised if all that intense stress I was under this past year played a huge role in how my thyroid is behaving!

ruggedpuma12 said:Look, drug interactions and contraindications? That’s not your problem to solve. That is strictly between you and your doctor, so seriously, stop stressing! You have zero reason to be afraid. Here’s the game plan: Before your pre-op appointment, just grab a piece of paper and write down every single thing you're taking. List the exact dosages and the specific times you take them. And don't get sneaky—include everything, even the "extra" stuff like Ginkgo, supplements, or anything else you're using. Just lay it all out there. Your medical team will handle the rest and give you the green light on what to take during the surgical period. The most important thing is to be 100% honest and list everything. No secrets!

I’ve got nothing to hide, so I’m just gonna lay it all out there. I don't touch alcohol, I don't smoke, and I don't do drugs—period. But honestly, between these genetic issues I was born with and some mental health stuff I'm dealing with, I'm taking five different medications every single day. It really feels like that cocktail might be causing some trouble. My liver enzymes are all over the place; one month they’re sky-high, then the next they’re totally normal, and it just keeps looping like that.
Man, this whole thing moved way faster than I expected! I went to see my doctor for the first time, and he straight up told me I need surgery. I wasn't even prepared—I didn't have all my test results on me, and I totally blanked on mentioning some important details during the appointment. He just handed me a checklist of everything I need to get done before the procedure—X-rays, EKG, the whole nine yards—and told me to follow up with the anesthesiologist. Now I’m stuck wondering if I should schedule another visit at his clinic just to drop off my MRI results and those reports from the endocrinologist. It's a bit of a mess! The very first specialist I saw privately actually told me not to sweat it and just monitor everything every six months with an UZV. Back in 2018, the mass was about 30 mm. By 2019, it hit 55 mm, and in 2020, it was up to 80 mm. The report says the mass is fluid-filled. Seriously, things are moving fast!

ruggedpuma12 said:So, what kind of allergic reactions have you guys dealt with so far? I'm talking everything—food, meds, environmental stuff, whatever! Lay it on me!

So, quick heads-up: I’m allergic to penicillin. Like, for real. As far as basic stuff goes—dust, pollen, whatever—I’ve been fine forever. No issues there at all! But when it comes to psychiatric meds? Man, my doctor had a total nightmare trying to find anything that worked for me. Every single time we tried certain ones, the side effects were just brutal. On the flip side, I haven't had any trouble with my other prescriptions. My cholesterol statins, Metformin for PCOS, and Levothyroxine for my thyroid have all been smooth sailing. No side effects whatsoever!

I haven't seen any posts from ruggedpuma12 yet! Still waiting for that input. says:
Low blood pressure? High blood pressure? Not having enough pressure at all? Honestly, we don't care. It’s absolutely no big deal to us! 🙂

I get what you're saying. My blood pressure is usually on the lower side anyway, but lately—I've been checking it with my digital monitor at home—it’s been dropping down to 82/45 even when I'm just chilling out.

I can't believe we're actually doing this! It's finally happening! I am seriously freaking out right now—in the best way possible! Everything is moving so fast, and honestly? It’s kind of wild. I’ve been sitting here just staring at my screen, waiting for the next update, and I am totally pumped to see where this all goes. Let's get this show on the road! says:
It all comes down to you, your own body, the surgeon, what kind of procedure they’re running, and honestly, whoever is handling the anesthesia. Time is totally irrelevant once you're under. You'll feel like maybe five minutes passed, when in reality, it could have been fifteen minutes or fifteen hours!

I’m mostly just trying to wrap my head around how long these kinds of surgeries actually take. Here’s the deal: based on what they’re guessing, this "clean" or benign tumor isn't just sitting on one single organ. It’s basically hogging space between my liver, colon, and kidney. It's getting weird, too—one radiologist read the scans and only saw it near the liver and colon, but then another one comes along and says, "Nope, it's touching the kidney too." Also, I've got this double renal collecting system on my right side, which is super strange because none of my recent MRIs have picked up on it. Honestly, it might be a smart move to go get a kidney scintigraphy done. The last time I had one of those was like 25 years ago!

ruggedpuma12 said:If your past anesthesias went off without a hitch, that's a massive win! It’s a huge indicator that everything is going to go smoothly next time around too. Seriously, it's a great sign.

Honestly, I have zero clue. I’ve never actually been through any major surgery before. I definitely don't count getting my tonsils out as a "real" operation!

I have a question regarding dietary supplements and medications generally known to affect blood clotting. Why is there this standard recommendation to stop taking them two weeks before surgery? What’s the deal with that specific two-week window? Is it simply about giving the body enough time to flush those substances out so blood clotting returns to its baseline state? And why specifically two weeks—why isn't it longer or shorter? For instance, if I'm on a supplement that increases bleeding risk, I sometimes hesitate to take it when I know a procedure is coming up, even if the timing isn't exact, because that supplement is actually treating a different issue. I'm stuck wondering whether to play it safe or just trust that mentioning it to the anesthesiologist covers my bases. I'd really like to understand the logic behind that two-week rule I keep seeing everywhere...

Chris Miller said:I have a question regarding dietary supplements and generally any medications that are known to affect blood clotting. Why is it almost always recommended to stop taking them two weeks before surgery? What’s the deal with that specific two-week window? Is it because the body needs that much time to flush those substances out so the blood can return to its normal state—normal clotting, I mean—and why is this particular "clearing" period suggested instead of something longer or shorter? For example, if I'm on a supplement that affects bleeding, sometimes I'm afraid to take it when I know an operation is coming up, but I don't know exactly when, and that supplement helps with some other condition unrelated to the surgery. So, basically, I don't know whether I should avoid it entirely or just trust that mentioning it to the anesthesiologist will be enough. That's why I'm really curious about this two-week rule I keep reading about...

Why exactly two weeks? You really need to ask the specific medical authority who makes those calls. From my perspective—since I've had to deal with stuff like this before involving antiplatelets and anticoagulants—all I can think is that 14 days covers the longest duration of action for many of these drugs (like ticagrelor, which impacts platelets for about seven days).

But look, this temporary suspension of things like Heparin or Warfarin really only applies to elective procedures anyway. Anything even remotely urgent is handled under triple therapy if the situation demands it. Even some non-emergency surgeries can go ahead even if the INR is at 2.5; there are a massive amount of variables involved.

What exactly are you taking (and for what reason), and what kind of procedure are we talking about here?

I'm sipping on some herbal tea blends. Take a coffee table, for example. I read online that certain herbs can affect bleeding, suggesting people stop consuming them before surgery. If this were a prescription medication, I’d just call my doctor, but when it comes to tea, you're basically flying blind. It's hard to gauge exactly how much these botanicals impact blood clotting. I did see advice suggesting you cut them out two weeks prior to a procedure, just to be safe.
I suspect a specialist would have a definitive answer. It isn't just about that specific two-week window; I want to understand the general rule for stopping these "risky" supplements before surgery and the logic behind it.

I honestly had no clue until now that lovage and tea made from it actually contain coumarin (which acts as an antagonist to Vitamin K—something that is absolutely btin for producing several clotting factors). It’s basically (almost) the exact same thing as good old-fashioned Oral AntiKoagulansi coumarin and warfarin.
Now, why two weeks? The only way that makes sense is if someone was actually monitoring the INR levels of people chugging that tea and discovered they were walking around with dangerously high INR readings, right on the edge of spontaneous bleeding. But I'll leave the hunt for randomized controlled studies to anyone else who cares; if the INR is within the therapeutic range of 2.0–3.0, then five days is more than enough time for the effects of that substance to wear off. For all the impatient folks out there or those dealing with (too) high INR, there is plenty of Vitamin K available for both oral and IV administration.

Hi there,

My sister’s four-year-old son is dealing with an undescended testicle—or whatever the medical term is for when one hasn't dropped into place yet. He’s going to need surgery, but it requires general anesthesia. Honestly, his mother is absolutely terrified of the whole idea of anesthesia; she’s incredibly hesitant about putting him through any kind of operation at all, arguing that maybe they can just wait it out since these things are sometimes "migratory" and might just settle on their own later. Basically, because she's so scared of the anesthesia, she wants to hold off on the procedure entirely and just wait.

How risky is this kind of surgery when you factor in the anesthesia? And is there any realistic possibility of performing this under local anesthesia instead?

While fatalities resulting from general anesthesia are incredibly rare, some studies suggest a rate of roughly 2 in 10,000 procedures, which means that every single time such an outcome occurs, it sparks this intense, unavoidable debate over what exactly triggered the event.

To me, 2 in 10,000 feels like a staggering number. :O

My dad is getting ready for hip replacement surgery. The catch is he had a myocardial infarction about 11 years ago. He’s been on all his meds since then and hasn't had any major heart issues—aside from the actual damage left over from the heart attack itself.
So, I'm wondering which type of anesthesia is best given his history.
General or regional (like a spinal)?
Basically, which one carries fewer risks...
Thanks in advance for any insight.