And some people have a very different experience while under them - they are fully aware.
The gist was that modern implementations suppress memory formation rather than induce unconsciousness. That you remain in some sense aware of what's happening but don't remember the experience. This is safer than traditional methods, but could potentially subject the patient to complex mental or emotional trauma.
Is that accurate?
Before surgery, you're given an amnestic to help reduce immediate anxiety and avoid remembering going into the OR and getting prepped - which people don't generally enjoy.
Then you get the anesthesia, which puts you to sleep. They put you on a respirator, which - alongside helping your barely/non-working lungs - delivers a gaseous anesthesic to keep you asleep.
Because some reactions to pain are reflex, they may still work. And when you wake up, they don't want you to be in pain; especially if that's on the surgery table. So next, you get the analgesic opioids. Here you may also (if you didn't already) get paralytics to stop all muscle movement.
Rest assured that they are not YOLO-ing your pain and suffering. You are given a cocktail of drugs to make sure you are comfortable before, during, and after surgery.
Luckily, opioids can be swapped for other medications that are less effective, like high dose NSAIDs. There's also local anesthetics for some stuff.
In that case, they don’t seem to work that well for me. Or maybe they do it differently here.
I always remember going into the OR and being prepped.
My anxiety for my last surgery was huge up until the moment I passed up. The best I got was the anaesthesist telling me it was normal for someone in my circumstances (I’d not had anxiety the last few times, so was very confused as to why I had so much this time, I was freaking for some reason)
You may also require either a higher baseline dose than expected, and an onset of acute anxiety can actually affect dosing too. Both totally normal!
Either way, it's best to speak with your doctor leading up to surgery if that experience was upsetting. There's lots that can be done for dosage, supplemental medication, etc. Your comfort is important!
And that is how I saw the inside of my own beating heart at 10 while I was tied down and essentially naked in front of like 10+ adults.
Oh, and the contrast dye momentarily made me feel like I was being burnt alive from the inside out.
She now insists on full sedation.
The modern implementation is to use general anesthesia as little as necessary as it has numerous side-effects. Local anesthesia with improved selectivity is used if possible.
That's called twilight anesthesia and it's used for some procedures, not others. Usually used for stuff like wisdom teeth extraction and colonoscopies. Anything "major" and you're getting general anesthesia. You can ask what type of anesthesia you will be receiving (twilight or general).
That was about 20 years ago. To this day, the last thing she remembers is lying on the table and saying "OK, let's git-er-done" and the next 5-10 minutes are missing.
In larger doses, propofol will completely eliminate consciousness. This is "general anesthesia" and what you get when you go in for a major surgical procedure. You are completely unresponsive to any stimuli.
There are levels in between these too. Consciousness is a spectrum.
As far as I know, propofol doesn't make you feel particularly good or block pain. It just kind of makes you go away. So in addition, at all levels of anesthesia, they also typically give you a narcotic like fentanyl so that you aren't suffering. They aren't just letting you scream in pain and then erasing the tape afterwards.
As someone who has had a couple of procedures where they pushed the fentanyl into the IV before the propofol, I can 100% assure that pain was the absolute last thing I was feeling. Hell, I was still high as a kite after the propofol wore off when I got home. I was sitting at the kitchen table with a bunch of metal recently unscrewed from my leg bones thinking about literally nothing in the world beyond, "holy fuck this eggnog is the best beverage I've ever had in my life I wish I could drink it forever".
The only thing I got for my endoscopy a couple of years ago was some numbing spray for my nose and a decongestant.
All in all, I really appreciate the loss of memory formation, since the most annoying part of these procedures for me is the boredom. Just splice all that out, thanks.
With whatever he did additionally, as he did it he goes:
“Let’s try this again, start counting back from 10”
I might have made it to 9 the second time around.
Does this mean they messed up the dosage or something? I’ve had the same guy since and it’s never happened again.
The fact that he gave you something else that time, and that you've never had that experience again would make me believe he thought it was a fault in the product he initially gave you.
That's not what they usually use... but people have different reactions to novacaine, and different innervation; for dental work, there's a couple typical options for where nerves are and which nerves cover which teeth, some of which need more shots in more places.
For the GP, most likely the anesthetist put a note in the chart that they need more or different drugs to go under.
My lips and gums go numb but my teeth generally do not. I am sure it takes the edge off, but I can still feel it and it is still incredibly uncomfortable.
On the other hand, while having a tooth pulled and opting to be put under, the nurse and I were having a great laugh after because I was so awake. Apparently there are multiple drugs and whatever the first one was hit me so hard they only have me a half dose of another. It was enough though. They said count, I hit nine, and I woke up somewhere else. Exactly what I wanted considering local doesn't work.
Not just in surgery for example but in extreme other situations (nukes, titan sub, piano to the head, etc)... You're just there then you aren't and you don't even know. Shook me (lightly) for a while
I'm guessing being properly flattened by a truck is similar, though of course that's adjacent to being severely injured and dying later.
One may think, any existence is better than nothing.
Interestingly some medications like tadalafil restore my dreams... My smart watch also tells me the phases like remand deep have normal lengths. So I'm not sure why it is so rare for me to dream, but I suspect low glucose or oxygen may have something to do with it.
You might be having those but “not having dreams” is not an indication of that. And i put the “not having dreams” in quotes because for most people they have dreams but then go on to forget them.
If you are having other symptomps by all means get it checked out. But if your only symptom is not remembering dreams i wouldn’t worry about that.
Same. I was put under twice and both times it was like someone flipping a switch from conscious to unconscious. When I woke up it was like nothing happened save for a slight groggy feeling. It was not like sleep where you feel rested, as if you lost time.
edit: to add when going under the first time I was laying down on the operating table as the anesthesiologist made small talk with a nurse I suddenly felt super high while the room started to spin - POOF out.
I talked to the nurse about this as I was prepping for the procedure, and he said that a recent patient talked throughout the procedure, but when he got back to his room afterwards, he asked "so when will the procedure start?"
So, I think the drugs you get might let experience everything. But the "nothing in between" might actually be memory loss, not loss of consciousness.
all this stuff is spooky and philosophically tricky.
Nothing stops us from using both, where strategically appropriate.
In the latter case I actually remember more of the procedure - although I was completely detached and thought it lasted about a minute (it was a 10-15 min procedure). In that case I can recall having the tube removed and passing out what seems like instantly.
Sometimes people fall asleep that way too, especially when very tired. The expression ‘out like a light’ seems apt.
Ouch. Excessively appropriate choice of words there.
They really got under your skin.
I thought I would gently fall asleep, but it was actually extremely fast. It went from "tell me about your life" which the anesthetist uses to check your state to "oh so came here for uni..." to "huh the surgery is over" in a single cut.
Nothing in between, nothing like that thing you feel when before you fall asleep at night or wake up in the morning. I felt tired when I woke up, but I didn't think I had dreamed or felt anything at all in between.