Is there a DR in the house (anesthesia question)

[~Magical Princess~]

I'm wondering if anyone can tell me how great the chance is of having problems "going under" these days. The lady I babysit for is electing to undergo a breast augmentation and tummy tuck (same time) and she will be "under" for approximately 5 hours. I know people are "under" every day, but I know there is a risk involved in general anesthesia. She's been under 2x (as a teen for wisdom teeth) and also in her early 20's for an emergency appendectomy (appendix removal), she's now in her mid 30's. She also smokes (pretty heavily).

Do you think you have "less" of a chance with problems if you've been under before - or is EVERY surgery unique in it's own way.

Thanks, she really is nervous and I'm having a hard time finding this specifi information on the web. Thanks!

 

[A kid at heart]

Each person reacts differently to different things. I know that I always get sick after being put under. My brother who was put under for a recent surgery was fine afterwards. I think that health and weight have a lot to do with it. Man the questions that they ask before you get anestesia!do you smoke, drink, do drugs, do you take any medications, etc. height, weight, etc.

 

[Doctor P]

I think it is very, very important to answer all questions openly and honestly. I have a medical condition that makes anesthesia very risky for me. Knowing this, the Drs. manage me much more actively and do a fantastic job when it is necessary for me to be sedated or fully under. My experience is that anesthesia has come a long way and is much safer and has fewer side effects than in earlier years. It is still hard on your body, but not like it used to be (at least for me).

 

[Kermit]

I'm no doctor, but I've heard that it is less risky the second time than the first, since they know if you are prone to having any reactions. The medicines they use may be different now, but they're all basically the same type. I don't know if that's completely accurate or not, but this will at least bump it up for you.

Regarding the length of time, she will feel worse being under for 5 hours than if it were a shorter period of time. I had surgery earlier this year that took about 20-30 minutes, and I felt fine within an hour. Longer procedures always leave me sleepy and gross feeling for the rest of the day. But that's not dangerous--just a pain.

 

[Blondie]

Working in a hospital, there were a few things I was unaware of that I found out.

Usually there are two "anesthesia" professionals in the OR, one is the (MD) anesthesiologist, and the other a CRNA (RN-that specilizes and has extra schooling in anesthesia.)

Once you are put under, and your vital signs are stable, the MD leaves his care under the CRNA and goes to attend other patients/cases, etc. Ofcourse, the MD is only a floor away should something extremely wrong happen, but I always thought the anesthesiologist stayed right there during the length of the operation.

Luckily (and I say this while knocking on wood at the same time) I have never had to "go under."

And I hope to not have to anytime soon!

*edited to add that this is how it is done at the hospital I work at, it may be different at other hospitals.*

 

[Deb in IA]

Before her scheduled procedure, she will have a pre-anesthesia evaluation. She should be sure and discuss all her concerns with the anesthesiologist at that time.

Certain problems can make you a higher anesthesia risk -- such as any underlying cardiac, respiratory, or neurologic disorder. Anesthesia can interfere with certain medications, so the anesthesiologist will need to know what she is taking -- INCLUDING any herbal supplements (some can cause bleeding disorders). Abnormalities in airway configuration can also be a factor, and this should be assessed. Finally, and personal or family history of adverse reactions to general anesthesia should be evaluated -- malignant hyperthermia is certainly the most dangerous.

 

[Pin Wizard]

Originally posted by Blondie
Once you are put under, and your vital signs are stable, the MD leaves his care under the CRNA and goes to attend other patients/cases, etc. Ofcourse, the MD is only a floor away should something extremely wrong happen, but I always thought the anesthesiologist stayed right there during the length of the operation.

In the hospital I worked at, they have had CRNAs about a year now I guess. I can't imagine the MDs being a floor away! Ours MUST be on the floor. And they generally rotate between 4 CRNAs in 4 ORs. But that's something for ALL patients to ask! Will the doctor be in the OR handling the anesthesia the entire time, or will a CRNA be there. If the answer I received was a CRNA, personally, I could request an anesthesiologist since they all know me. Otherwise I'd find a hospital that would keep an anesthesiologist in there. Personal preference...no CRNAs for me! That's something that ticks me off about the medical profession...if you don't ask, you don't find out! They're not too good on offering information. I first found that out when I was pregnant and hospitalized for increased bp.

 

[Lorix2]

I saw something about this on 20/20 last year I think. Unfortunately, a patient had a problem while under and the anesth. was no where to be found, in fact he left for lunch out of the building and she died.

Of course this is not supposed to happen but it did. Anyway, my point is that 20/20 told viewers that the best way to make sure the anest. stays in the room with the patient for the entire time, is to get that in writing from them before the surgery. Does it make them stay in there? I don't know, but I'd feel a little better knowing I requested that of them and it's documented.

I'm sure your friend will be fine with a friend like you looking out for her

 

[Disney Doll]

I would not do any sort of elective procedure requiring anesthesia. I thnk the risks are bad enough if you have to have surgery, let alone choosing to have surgery.