UKC

Anaesthetics

New Topic
This topic has been archived, and won't accept reply postings.
 mypyrex 04 May 2014
Just a general interest question to any medical people out there. I recently had an excision biopsy under a local anaesthetic along with a sedative. Having been apprehensive beforehand I was quite amazed at the lack of sensation; at one point I saw the surgeon's hand and a length of thread as he did the stitches(something I've always been fearful of) and I was totally unaware of any feeling. Post-op all I took was two paracetamol.

Am I right in assuming that the anaesthetic used for such a procedure would be quite a bit stronger than that used by a dentist for an extraction or filling?

Just interested
 Paul Atkinson 04 May 2014
In reply to mypyrex:

No it's all basically the same stuff. It's very effective if used well. I had the tables turned on me a couple of months ago when I broke my ankle in France and needed a load of metalwork putting in. The anaesthetist gave me the choice of GA or spinal plus sedation and I opted for the latter - was a very interesting experience and I got to practice my French all the way through the procedure. As you may have noticed the LA takes away pain sensation but not all feeling - I could feel them gently shaving my leg seconds before they made a 10cm incision in it without me noticing. In my own work I implant pacemakers and defibrillators under LA with and without sedation (I leave that choice to the patient) and the vast majority of people tolerate it really well. If the dentist is really painful change dentist!

I'm sorry to read of your illness - best wishes for recovery

Paul
In reply to Paul Atkinson:

Pretty much the definition of surreal: talking calmly to the surgeon about the upcoming Autumn internationals whilst he pokes about in your happy sacks with a tiny branding iron. The smell of barbecuing meat doesn't help the situation any.

We routinely do caesarean sections on cows in sheds, with just a line of local anaesthetic for intra-op analgesia; trust me, if it hurt them, we'd be a damp stain on the floor pretty quick. If dentists were vets, they'd have far fewer teeth left.

Stick with it, mypyrex, old man. It's going to be OK, I'M sure.

Martin

OP mypyrex 04 May 2014
In reply to Paul Atkinson:

Thanks for that interesting snippet, very fascinating. Incidentally the anaethetist told me to hold her hand and I wondered if that was a way for her to get any indication if I felt any pain. Maybe had I done so it would have been a reflex action to clench my fist - I don't know.

Many thanks for your best wishes.
OP mypyrex 04 May 2014
In reply to maisie:


> Stick with it, mypyrex, old man. It's going to be OK, I'M sure.

> Martin

Thanks and thanks to all of those on UKC who have sent me good wishes.

 Paul Atkinson 04 May 2014
In reply to maisie:

Thanks Martin. The smell of the diathermy is a weird experience, especially to the unaccustomed. I use it routinely for all implants so it's something I always discuss when consenting and quite a lot of people who have been totally unphased by the prospect of any pain, danger, etc they have been expecting opt for the sedation purely because they don't like the idea of smelling the BBQ. I've put a couple of pacemakers in dogs, working with their vet, in the past and they had GA

Paul
 Rob Exile Ward 04 May 2014
In reply to maisie:

When I was having the snip I casually mentioned to the doctor that it seemed a lot of fuss over a ingrowing toenail.

His look, just for a moment, was priceless, though I suppose I was lucky that he didn't do some (unplanned) damage.
 Paul Atkinson 04 May 2014
In reply to Rob Exile Ward:

if you're going to play Russian Roulette better use a six shooter than a shotgun
 Thrudge 04 May 2014
In reply to Rob Exile Ward:

LOL! Somebody give this man a medal
 Carolyn 04 May 2014
In reply to mypyrex:

> Incidentally the anaethetist told me to hold her hand and I wondered if that was a way for her to get any indication if I felt any pain.

I imagine that was the main reason, yes

And yes, it'll be basically the same local anaesthetic the dentist uses. The trick is get it it where you need it (the nerve - it basically stops them transmitting any signals) and keeping it there (sometimes you can use adrenaline, or similar, to constrict blood vessels, so it doesn't wash away in the blood stream too fast). I suspect mouths are quite tricky to get it where you want it with all the bones and stuff, whereas if it's a soft bit of the body it might be easier.
OP mypyrex 04 May 2014
In reply to Carolyn:

> I imagine that was the main reason, yes

And there was me thinking...
 AndyC 04 May 2014
In reply to Paul Atkinson:

General anaesthetic is pretty amazing these days too - when I had the metalwork removed from my elbow a few weeks ago, was on the table at 10:00, eating breakfast at 11:15 and taxi home at 12:00. Spent the afternoon helping to lay a new floor.
 Paul Atkinson 04 May 2014
In reply to AndyC:

It's a bit unpredictable though Andy - whilst many people tolerate it really well like you did a lot find it makes them feel very rough indeed
 The Potato 04 May 2014
In reply to mypyrex:

its hard to guess which anaesthetic was used although in terms of anaesthetising properties they are all about the same 'strength' one of the main differences is how long they last afterwards
Something like Bupivacaine can last all day whereas Lignocaine or Articaine last only for a short while which is sometimes beneficial. Also they come in different concentrations so again it doesnt always matter which is used e.g. 2% 4% strength.
For soft tissues Lignocaine tends to be quite effective and has low toxicity, hard tissues are more difficult to anaesthetise i.e. dental treatments then lignocaine (2%) or articaine (4%) are usually effective
mgco3 04 May 2014
In reply to mypyrex:

Weirdest experience of my life was under an epidural. I was having 2 plates removed from my leg.

They gave me the epidural in the pre op room and wheeled me in. I was having a conversation with the aneasthetist (to my right) whilst also being aware of the theatre technicians doing stuff (to my left).

I glanced at one of the techies and thought that he had walked into the theatre carrying a leg!! It was my own leg being held vertical whilst they slipped an inflatable tourniquet over my ankle. It took me several seconds to realise that it was my own leg!!
OP mypyrex 04 May 2014
In reply to mgco3:

Nice one
 AndyC 04 May 2014
In reply to mgco3:

Weirdest thing for me was going to sleep on an operating table and waking up in a bed. First time I asked them how they managed to move me to the bed, they told me I did it myself! Apparently they wake you up, get you to move off the table, then put you out again. What you do doesn't get moved from short to long term memory (or something like that) so you don't remember any of it. Quite disturbing!
 The Potato 04 May 2014
In reply to AndyC:

there are many drugs that prevent memories from being stored alcohol, midazolam, propofol. it does raise quite an interesting question once youve experienced it - iif i dont remember it, was it me? in that case is the me that i think of myself nothing more than memory?
 Rob Exile Ward 04 May 2014
In reply to ow arm:

I've wondered that about pain - if you didn't anticipate it, and you can't remember it, did it happen?
 The Potato 04 May 2014
In reply to Rob Exile Ward:

pain and pleasure and all other sensations last only as long as the electro chemical signal, once thats gone then without a memory of it its gone. unless theres some kind of noticable physical injury or damage then pain itself is simply a message
 RockAngel 05 May 2014
In reply to Carolyn:

I can't have any type of anesthetic if it has adrenalin in it. I start sliding off chairs in the dentist waiting room & I go several shades of green and woozy! I'd had some with adrenalin for my appendix op & needed to be tipped upside down almost for 24 hours after so I could have a blood pressure again
 Dr.S at work 05 May 2014
In reply to ow arm:

> pain and pleasure and all other sensations last only as long as the electro chemical signal, once thats gone then without a memory of it its gone. unless theres some kind of noticable physical injury or damage then pain itself is simply a message

not really true - the CNS is 'plastic' and changes in response to stimuli - so it would be possible to expose you to some intensely painful stimuli during a GA, but stop the pain trigger before waking you up - you would not form a memory of the event but the bit of your CNS that responds to pain would have altered how it processess future stimuli.
 Paul Atkinson 05 May 2014
In reply to ow arm:

another old timer - I totally refuse, even if threatened with torture, to say lidocaine. Or epinephrine.

Got to have some standards
 ranger*goy 05 May 2014
In reply to Paul Atkinson:

> It's a bit unpredictable though Andy - whilst many people tolerate it really well like you did a lot find it makes them feel very rough indeed

I've had 2 and threw up afterwards and felt really rough and groggy for the rest of the day.
 AndyC 05 May 2014
In reply to ranger*goy:

> ...felt really rough and groggy for the rest of the day.

My natural state - no wonder I didn't notice anything!

Maybe I was lucky, or maybe it's different in Scandinavia, but I thought it was some of the best sleep I'd had for years. And then the nerve block they put on my arm started to wear off...


New Topic
This topic has been archived, and won't accept reply postings.
Loading Notifications...