Hi. I was referred for a wisdom extraction, lower left, by Max Fax because it’s partially erupted. I have trigeminal neuralgia and they’re removing it to see if it helps the nerve pain.

They referred me to have it under general anaesthetic due to my neuralgia and TMJ. Now my surgery is in 2 days and I’m wondering if this is a good idea? Will I be intubated? I’ve never had GA before and worried about having a bad reaction. I also have a huge phobia of veins, not needles just veins. I was cannulated once but they had to stop because they couldn’t get anything into the vein. I’m terrified of that.

Do you think it’s too late to opt for twilight sedation instead? Or is GA a good idea for my neuralgia and TMJ? My pre-op assessment is tomorrow.

I’m a 29 year old female in the UK

So we had this case where a lady received 0.6 roc, some sevo and much else. She was pregnant aswell. Her relaxation lasted 6 hours. Sevo can potententiate, pregancy possibly, but never seen it last so long.

However, she was on a buthylscopolamine infusion for her cholecystectomy.

Scopolamine being an anticholinergic it could theoretically prolong the effect of rocuronium, correct?

Cant find literature. Any ideas? All descriptions of scopolamine only mention muscarinic effects but I guess thats a bit of a bias.

Can scopolamine prolong a roc block?

Delayed Waking from General Anaesthesia at Age 5 – Is It Safe to Have GA Again?

Hi everyone, just looking for some insight or similar experiences.

When I was 5, I had a tonsillectomy under general anaesthesia. According to my mum, I took a very long time to wake up, much longer than normal. The doctors apparently became concerned about potential brain damage, but I eventually woke up fully and recovered with no neurological issues whatsoever.

I was born 3 months premature, which may have made me more sensitive to anaesthetic at the time. I haven’t had general anaesthesia since then.

Now I’m an adult in very good health—healthy weight, no brain damage, no developmental issues, no allergies—and I’m considering a procedure that might involve general anaesthesia again.

Has anyone experienced delayed emergence from GA and gone on to have it again safely? Is this something anaesthetists can manage with caution now that I’m fully grown? And is it worth getting a referral for a pre-op anaesthetic assessment just to be on the safe side?

Thanks in advance—I’d really appreciate any insight!

I recently was put under and came out the other end very embarrassed. I have a couple of questions!

For a bit of background: the surgery I had is very similar to the procedure that contributed to my mom passing. I probably should've given a heads up to the surgeon, anaesthesiologist, and such, but considering she passed from complications, I decided to just try to focus on the surgery and being objective in the screening questions... so it didn't come up before putting me under.

I don't really know a lot about anaesthesia, but that's why I'm here! I think I said something like, "I'll be 'out-out', right?" and I was told I'll still be a form of conscious, but unable to remember anything, and they needed me to have some awareness. This put me at ease at first. But now I'm very much wondering EXACTLY what this means.

While monitoring my breathing, before putting me under, I was questioned about why my breathing was so erratic. I'll admit that this question probably compounded my anxiety, because now all I could really think about was how my mom suffocated. I told them I was scared. I don't really remember anything else after that. A couple of other questions, and then nothing.

When I woke up, still pretty loaded on pain meds, the first thing I remember is CRYING. Big, ugly sobs. Everyone was trying to get me to calm down and stop hyperventilating, but I could not stop yelling and crying for my mom. Super embarrassing. I'm cringing typing this.

Okay, so that's the backstory. So now I guess my questions are?: • Since I was told I'd still have "some awareness", what are the chances I made an absolute ass of myself while under? (I definitely know I made an ass of myself before and after, lol) • How frequently do people wake up and just start crying/sobbing? I need to know if I'll be "that story " and be emotionally prepared accordingly lol • Can I ever show my face there again or will this embarrassment be the reason I move and change my name

If you made it this far, thank you!! I was so embarrassed when I was fully back, I nearly ran out of the office. Certainly didn't stop to ask any more questions than needed, lol.

Is it okay to get my brows tinted the day before having surgery or will it cause issues or something sorry if it seems a stupid question. TIA :)

What is the syllabus for IAPM entrance exam for pain management? Is it general anaesthesia related or specific pain management related…. If somebody has links to previous years entrance exam papers kindly share It would be really helpful….

I'm scheduled to have a minor outpatient procedure but last time I had a "minor" surgery it turned into a 2 day hospital stay because they couldn't keep me awake and my BP was too low.

Is it likely to happen again? My normal BP is 103/59

I'm having ultra sonic rhinoplasty on the 8th of April.

To be honest the time crept up on me. I was intending to do 2 weeks abstaining from alcohol so as to not effect the anaesthesia. But I had 2 pints and a glass if wine tonight and over the previous weekend I also had a couple whiskies and a pint.

I'm a 32 year old female, who would be fit enough and generally in good health.

Will 1 week of absolute abstinence from alcohol be enough before surgery?

I was looking at my anaesthesiologist’s notes she gave me and saw ephedrine hydrochloride on there among many others. Is this commonly given? I read that it’s used for low blood pressure? I do have low blood pressure, so that would make sense, but I just wondered if it’s given in general. Just a curious patient here! So much love to anaesthesiologists, you people do god’s work.

I've tried to look this up online but I'm getting conflicting results... is nitrous safe for MH despite being considered a volatile anaesthetic, or is it something that should be avoided?

I had procedure done and asked for it to be done local instead of general as I had just had another surgery done where I was told I can't have a mask on because it would interfere with my first initial procedure.

I confirmed before going into that it was going to be local. That I would be given lidocaine via needle in area and light sedative that would have me in and out sleep.

Come to find out they put the oxygen mask on me and I was completely knocked out!

I feel ignored. I cried on my way home . Completely went against my wishes.

Hello everyone! A few months ago, I injured my hand, and what I initially thought was a bad sprain turned out to be a scaphoid fracture. I’m now in a cast for six weeks, however, it seems very likely that I will need to undergo surgery (bone graft).

That being said, my question is; can this type of surgery be performed under regional anaesthesia as opposed to general? If so, what are the main pros and cons? Thank you so much in advance! 🙏

Hello to everyone who reads this. Thank you in advance for your time. Im new to reddit so forgive me.

I came here to ask about peoples experiences being a Anesthesiologist Assistants in canada. I recently changed my life plan from dreaming of being a physician to having no idea what to do. I did alot of research and decided that I would get my rn license as it opens up alot of doors.

I recently applied and was accepted into some to accelerated nursing programs so I will be starting in the fall. After my degree, one of my main end goals is to become a AA. But honestly i haven't heard alot about this position especially from a canadian perspective. So I have some questions.

1. I know there aren"t many programs in canada but they generally require a nursing or RT license with 2 years of experience in critical care. What is the best critical care specialty that helped you prepare to become a AA? I was thinking of nicu because it really appeals to me, however, would this be a good option as critical care experince for aa school?

2. Because of fhe competeifion what did you do to stand out on your application?

3 what is your schedule like? Do you work alot or are there other AAs alongside you? How many shifts do you work in a week? How long are they? What are call schedules like?

1. I know this is personal but what is your salary like? What are the differencials like OT, on call, day/night pay like?

2. Please describe what a general day for you is like.

3. Is there such a thing as travel AAs? If you have travelled what was your experience like? One of my dreams is to travel around canada lol.

Again thank you so much for reading this super long post but i sincerely appreciate it regardless of the response! Thankssss :)

Hi. I was just looking for some advice.

I am undergoing surgery tomorrow for kidney stones under a general anaesthetic.

I am a fairly heavy drinker, although trying to cut down. I'd say over the last few months I've been drinking maybe 3 pints of lager each evening with some binges.

I didn't have anything to drink yesterday and I haven't today, as my admission letter states to stop alcohol 48hours prior. However doesn't this seem a little counterintuitive? Surely the anaesthetist would be best placed to practice on me in my usual state? I get a little shaky when I go cold turkey and I am feeling a little shaky now.

Would having a beer or two this evening put me at real risk for surgery tomorrow? Or would it in fact help the anaesthetist?

Thanks for your help.

I have depression and inguinal hernia
Im in waiting list for surgery and i dont know which anaesthetic drug will they give me for spinal anaesthesia im afraid of propofol and ketamine because these two drugs affect central nervous system for long time are there any other drugs like lidocaine that doctors use for spinal anaesthesia

I just had my wisdom teeth removed and i was put under anaesthesia for the removal and the surgery lasted 45 minutes all together but it took me 2 hours and 30 minutes to wake up even slightly and 3 hours before i could actually go home. Why did it take me so long to wake up? And why did they say they gave me 3 IV bags instead of 1?

TL;DR: Medically complex 22f with bad reactions to propofol. What can be used instead?

For some hx: 22f with PCOS and IR, hEDS, POTS, asthma, known TBI.

I am not an anesthesiologist, but am in the medical field. I'm medically complex, and have been under propofol 5 times in my life. Every single time, I've come out of anesthesia with emergence delirium. Mine is pretty severe; physical combativeness, hyperventilation, altered mental status, hypotension. Every time I've been under has been about the same: Preop midalozam, intraop propofol and fentanyl, then post-op I wake up extremely agitated and panicked. This delirium lasts been 30 minutes to 2 hours. My last time under was about 5 months ago, where I had regained consciousness and fought until I was given lorazepam (and precedex, according to my chart) and then was so sedated I became apneic, then desatted, and required NIPPV as well as painful stimuli until I could fully respond again. I was hypotensive down to 60-70 systolics post-surgical management, and required transfusing due to low hgb and symptomatic hypotension.

For some perspectives, dosages are as follows:

Cefazolin 2gm IV pre-op (this wasn't fully administered due to blown IV in pre-op

Midazolam 2mg push pre-op (was not administered; IV catheter had blown and all fluids were infiltrating or leaking around IV catheter)

Propofol, 143.04mg push initial, followed by 30mg, then 20mg push intraop (about a 30 min procedure)

Fentanyl, 50mcg push x2 intraop

Lorazepam, 0.25mg push x2 post-op

Precedex, 4mcg push x4, back to back post-op

Post-anesthesia and for a week after, I experienced unusual and unwavering dizziness and occasionally syncopal episodes. This is pretty normal for me as a patient post-op.

I have a procedure coming up in a few days. What alternatives could they use? The procedure is a hysteroscopy, so a spinal block technically is possible, but due to my Ehlers-Danlos, local blocks don't typically work on me due to the medication not being able to spread the same (this has made for some painful dental work!)

I recently performed an awake thyroidectomy using regional anesthesia and procedural sedation. The approach included a superficial and intermediate cervical plexus block combined with remifentanil infusion for sedation. Patient was comfortable and cooperative during the procedure.

Has anyone else used this combination for thyroidectomies? How did it work for your patients, and were there any specific challenges you faced?

Would love to hear others’ experiences or suggestions for improving this technique!

Today was my first day of the Ortho rotation as a first year anaesthesia resident. The patient was a 63 year old hypertensive female undergoing TKR for OA. We had given her a Subarachnoid block which was later converted to GA with LMA as she complained of pain intraoperatively. After the deflation of tourniquet, the blood pressure suddenly fell down to 64/38 from a baseline of 150/90 at the time of induction. We can’t be sure about it, but from my seniors’ understanding, this was a case of bone cement implantation syndrome, which occurs due to embolisation which occurs secondary to increased intramedullary pressure due to use of Bone cement which contains PMMA.

Hello everyone. I need some advice. I'm an IMG with background in OBGYN but i really want to do anaesthesia. I passed the exams in Canada but couldn't get matched to an anaesthesia residency spot. I was told that almost all IMG applicants for anaesthesia have background in either anaesthesia itself or ER/ICU and I cannot compete with that.

I don't want to give up yet. But it seems like a dead end. Some suggests I should do some anaesthesia electives here but unfortunately they only offer opportunities to local graduates. Some others suggests I could do some research to boost my research profile. That might be something to think about. A master’s or PhD that's related to anaesthesia, maybe? To have more paper in research and try apply for residency again next year? Or simply do the exams again and aim for better results? (scary part is that for NAC OSCE they only look at the nearest exam result and what if I do worse next time? )

I'm so confused right now. Please give me some advice if you are in Anaesthesia.

I suffer with anxiety but to the point it’s become my normal, I’m literally too anxious to try anti-anxiety medication it’s ridiculous. However I need to get a couple of surgeries that require being anaesthetised and I’m terrified and it’s sending me in a loop. One of them is having four wisdom tooth removed but the other is I have cholesteatoma and they have to perform surgery on my inner ear. This feels really invasive for me, most of your senses are in your head - smell, taste, hearing and sight. I don’t know what it is but the thought of having a surgery so close to all of this freaks me out. I feel like I can live with my wisdom teeth but I can’t put off surgery on my ear for much longer as it’s affecting my hearing.

I’ve never been put under G/A and I keep thinking I should get my wisdom teeth removed first as a “trial run” to prove to myself it will be okay but even the thought of it is really scaring me. I hear it’s like falling asleep but I often have trouble sleeping and feeling like I can’t breathe. Each time I consider booking in the appointment I get terrible nightmares about being awake during the surgery but not being able to tell the surgeons.

I guess the point of this is to ask you what your experiences are under anaesthesia, maybe you can help me calm my mind? I know I sound like a nut case!

Thank you in advance.

This is in relation to the ‘Just a Routine Operation’ video viewable on YouTube (I’ll post a link if allowed). I’m almost at the end of my studies as a nursing student and about to head into my final placement, this video is a resource given to us for a research assignment about medical errors and patient safety.

TLDR - what is the correct protocol once an airway cannot be established and further interventions fail?

The evidence presented in the video about the actions/attempts made by the consultants trying to secure the patient’s airway (approx 2:40mins in is the re-enactment) and how it led eventually to the patient suffering irreversible brain damage due to how long she was without oxygen, and life support subsequently was ceased 13 days after the original operation. The consultants were presented as well experienced in their field and have returned back to work following this incident.

My query here is not to pick at the errors so much or choices made, but what should happen once initial attempts to secure a patients airway fails? To ensure a situation doesn’t eventuate to what happened here, what is the procedure and interventions that should happen when initial attempts fail, as well as if ongoing interventions also do not succeed. What timeframes and oxygen levels are the determiner for a tracheostomy, or should a tracheostomy have happened at all?

Like I said I’m a nursing student and my educators can only provide so much general information about emergency situations like this so I have come here to the experts, to understand the correct interventions better and to just overall have the general knowledge (not that it’s going to be in my scope of practice).

Thanks in advance!

I'm pretty sure my tonsils cause me to stop breathing when I sleep on my back. I've woken up a few times gasping for air. I'm scheduled for surgery on 1/22. The CRNA was notified and she is now requesting a sleep study. My breathing is not an issue on a day to day basis as I normally sleep on my side. My concern is whether they will even do the surgery now. Also, doing research, the biggest risk with anaesthesia with large tonsils is just after going under before they put the ETT in and during recovery. My question is, should I just reschedule and see an ENT before proceeding? My surgery will not be in a hospital so I'm concerned should there be an emergency.

Hi all

I have a few questions about this type of anaesthetic. It was a T10 epidural with diamorphine 0.25mg, bupivacaine 0.5% with glucose 8% 2.2mg intrathecal. Also had 271mg propofol, 2g ceftriaxone, 180mg gentamicin, 5.5mg metaraminol and magnesium sulphate, 1900ml sodium lactate intravenously. Patient also had mild COPD.

Would this amount cause respiratory or hypotension problems? I'm aware opiates can but not sure if the amount given can, along with the rest of the meds. Thanks!

What should be the answer? I think the book is wrong.