I have a majorly embarrassing fear of surgery. It is so irrational that I will put off procedures that I need. I’m afraid that when I’m under anesthesia that I could wake up, or I could have awareness/feel pain and not be able to communicate it to the surgical team. I’ve heard that they give you drugs so you don’t remember at all- my anxiety-ridden brain wonders if we are all suffering during the procedure and we just forget upon waking. I understand that quite a few folks will require surgery during their lifetime. I have had IV sedation during procedures, and despite having no problems, I am utterly terrified. Please tell me about how ridiculous I am being.
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You aren’t being ridiculous at all, its actually a common fear my patients have. There are different types of anesthesia along with different “depths” of anesthesia. When a patient is completely asleep, we call that “general anesthesia”. And we give different medications to put someone under general anesthesia. It can be just through their IV, or a combination of medication through their IV and gases that they breathe. For example, lets say you needed to have your appendix taken out. Once in the OR, and connected to all my safety monitors, I would give you propofol in your IV to put you to sleep. Once you are asleep, I put a breathing tube into your windpipe and attach that breathing tube to a machine that gives you gases while breathing. Earlier gases were called ether- you’ve seen the villain with the soaked rag come up behind someone and hold it over their mouth until they pass out? It’s the same concept. So you are put to sleep with medicine through your IV, and kept asleep with gas medicine you breath. At the end of surgery, I turn off the gas medicine that is keeping you asleep, you breathe it off and wake up.
There are times when patients are awake and aware and unable to communicate. And that is a scary thought. But its so very rare. And remember the heart monitors and blood pressure monitors that every single patient has in the OR- they are continuously looking at your vital signs. So those monitors would alert me if there was an issue with your depth of anesthesia. Also my anesthesia machine (what gives you the sleepy gas) has monitors and alarms and it too would let me know if there was an issue. And finally, most of the time when someone has awareness under anesthesia, it is in trauma cases or crashing obstetrical cases. These are where the patient (or unborn baby) are so critically ill that even giving them a little anesthesia medicine or anesthesia gas could make them so unstable that they could die. Those are the most common scenario for anesthesia awareness.
I hope this helps your anxiety a little. When you are receiving anesthesia, you are my only patient and my sole focus. I literally just sit there and watch you sleep. Every breath you take etc.
Take care. You’ll be ok!
Your friendly neighbourhood Nurse Anesthesiologist
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