How do anesthesiologists keep you under during surgery?


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.

In: 17

You have absolutely nothing to be embarrassed about, its extremely common, they usually give you drugs to calm you down before they bring you down to the operating room. Best advice is to tell your surgeon at the first appointment and they’ll talk you through it, probably have some resources for you.

You wont feel or remember anything.

Even if you were to wake up, first they would put you right back under. No one wants to do surgery on someone awake who is not supposed top be.

Second, you don’t feel anything. Both my children were born c-section while I was awake. I got to watch the first one with mirrors set up. No pain, no feeling.

I hope this helps, but I’m afraid it might not. This is an irrational fear which can sometimes be conquered with logic and information, but might also need a doctor’s input and/or therapy of some sort. Good luck, I hope things work out for you.

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

Anesthesiologists tend to be one of the highest paid people in the room for a very good reason – their entire specialization is fully dedicated to getting anesthesia right.

It’s complicated stuff, and they spend years perfecting their skill. Every person has a different mix of height, weight, overall health, and medications that they are on that makes dosing anesthesia different for everyone. Despite this, anesthesia failure remains fairly uncommon – about 1 in 1000 on a bad day.

Even then, anesthesia is made of multiple drugs – usually sedative, a painkiller, and a paralytic. Generally, anesthesia failure is in the sedative, meaning you might become vaguely aware but you won’t actually feel any pain or be able to move. And anesthesiologists are trained to look for awareness, so if you do become aware you’re generally put back under fairly quickly.

Worse complications generally only happen when the patient doesn’t disclose something – e.g. if a cocaine user doesn’t disclose that they used in the days leading up to surgery.

As a whole, if you disclose every medication/drug you’ve taken recently and all medical conditions you have to the anesthesiologist, and follow the instructions in your pre-op booklet, you don’t really have anything to fear. Having been through surgery with the same fear, I look back at the lack of mobility and post-op pain with much more disdain than the anesthesia.

Not a medical professional, but I’ve been responsible for older folks for enough surgeries. Basically there are 2 forms of anaesthesia:

1. **Local or spinal anaesthesia** – basically they pump some drugs into the spot being operated if it’s a very specific spot, or around your spine above the area (this is especially used for lower abdomen or lower limb surgeries). You can stay awake, but you lose all sensation in the area, or below that part of your spine. Sensation returns slowly, so it’s not likely it’ll “run-out” and leave you feeling everything that’s going on there mid-operation. Usually sensation comes back a few hours to a day after the operation.

2. **General anaesthesia** – this is where they put you under. It’s more risky and needs to be carefully monitored, but the risk doctors talk about isn’t you feeling pain or waking up, rather it’s the other way round, that you might go too far under. It’s like a dreamless sleep. You’ll be nowhere close to waking up, so there’s no chance of you feeling any part of what’s going on.

To be the best of my knowledge hospitals in most parts of the world require separate consent for general anaesthesia, so you can just ask them regarding the details at that time.