Anesthesia

[BRICKS]

Going under on Tuesday for my shoulder. I can't recall what it was but you said to ask for some special med.

You're going to make sure and ask for an interscalene block. Your provider will use ultrasound to inject about 30 ml or so of local anesthetic around the nerve that go to that shoulder. This will give you a decreased need for pain med in the first 24 hours and also allow anesthesia to use a lot less narcotics during surgery. You should wake up comfortable and feeling pretty good. You want this bro. Shoulders hurt like a mthrfkr afterward. My shoulder patients are usually out of recovery and out the door in about 20 min post op and they're comfortable for 24-36 hours. Results with different providers may vary. I have a rep as being really good with blocks.

 

[dk8594]

...::.

Already answered

 

[j2048b]

After 23 years in practice I'm still amazed at all the nonsense people believe or have been told/read on the internet. Post any questions you have about anesthesia and I will be happy to address them.

why do i have such a hard time waking up? last time took 4 nurses and the doc to wake me and had to shake me, yell at me and almost called it, then i woke up....veryone was panting and bent over and nurses were freakin out....

 

[BRICKS]

why do i have such a hard time waking up? last time took 4 nurses and the doc to wake me and had to shake me, yell at me and almost called it, then i woke up....veryone was panting and bent over and nurses were freakin out....

People all respond differently, but you may have had an anesthesia provider that was heavy handed with the drugs.

 

[Flyingdragon]

Bricks, this post is making me sleepy, was that the intent?

 

[BRICKS]

Bricks, this post is making me sleepy, was that the intent?

Whatever works brother. It's boring as hell, until it isn't. And when it isn't that means you're not having a good day and very bad things are probably happening.

 

[TODAY]

Which flurane do you use most often?

 

[Jin]

Which flurane do you use most often?

Showoff.....

 

[TODAY]

Showoff.....

Lol, I'm genuinely interested. I have ZERO practical experience in operating rooms.

 

[Flyingdragon]

Did u not get my humor? Anesthesia = sleepiness....

Whatever works brother. It's boring as hell, until it isn't. And when it isn't that means you're not having a good day and very bad things are probably happening.

 

[BRICKS]

Which flurane do you use most often?

I use desflurane for pretty much everything, except for asthmatics and pediatrics. Desflurane is quickest on and off. Sevoflurne is less pungent for pediatric mask inductions and less irritating for asthmatics. In fact, it's used in definitive treatment of status asthmaticus (intractable asthma attack).

More info than you wanted perhaps

 

[BRICKS]

Did u not get my humor? Anesthesia = sleepiness....

Yeah bro, I got your humor.

 

[TODAY]

I use desflurane for pretty much everything, except for asthmatics and pediatrics. Desflurane is quickest on and off. Sevoflurne is less pungent for pediatric mask inductions and less irritating for asthmatics. In fact, it's used in definitive treatment of status asthmaticus (intractable asthma attack).

More info than you wanted perhaps

No, that's great info. Desflurane appears to be less likely to contribute to beta amyloid plaques, as well. Are there any circumstances that would lead you to choose isoflurane over the others?

Also, is it always necessary to use propofol alongside the flurane?

 

[notsoswoleCPA]

I know my wife was given Propofol for her ECT treatments. She said it felt like fire was running through her veins just before going under, every single time.

The only time I was completely under was for the removal of my wisdom teeth. My last oral surgery was for dental implants, and I was awake for that, albeit I did take two Valium before the procedure.

 

[j2048b]

People all respond differently, but you may have had an anesthesia provider that was heavy handed with the drugs.

Possibly, every surgery ive had ive warned them i dont wake up so.kick my ass and do what u got to do fo make sure i wake up or ur gonna be payin some monies hahaha plus being allergic to certain things, they have to watch what they do, or one of those items may just end me if they arent aware or attention to detail...

 

[BRICKS]

No, that's great info. Desflurane appears to be less likely to contribute to beta amyloid plaques, as well. Are there any circumstances that would lead you to choose isoflurane over the others?

Also, is it always necessary to use propofol alongside the flurane?

Isoflurane has pretty much gone by the wayside. Used to use it a lot for longer cases and inpatient surgery as it's slow to come off. Desflurane and sevo used to be more expensive, but when parents expire the price drops.

Propofol has replaced sodium thiopental (pentathol) as the induction agent (what we use to put you to sleep). Propofil is used exclusively now pretty much save for certain settings like trauma, where different agent (s) better serve that purpose.

 

[BRICKS]

I know my wife was given Propofol for her ECT treatments. She said it felt like fire was running through her veins just before going under, every single time.

The only time I was completely under was for the removal of my wisdom teeth. My last oral surgery was for dental implants, and I was awake for that, albeit I did take two Valium before the procedure.

Propofol has a tendency to sting a little as it first goes in. I mix it with a little but of lidocaine to mitigate that.

 

[BRICKS]

Possibly, every surgery ive had ive warned them i dont wake up so.kick my ass and do what u got to do fo make sure i wake up or ur gonna be payin some monies hahaha plus being allergic to certain things, they have to watch what they do, or one of those items may just end me if they arent aware or attention to detail...

Definitely have to keep my head out of my ass at work. Anesthesia is very safe, but that's because your provider has his (her) head in the game. Of the millions of anesthetics given annually their are about 30 deaths from anesthesia per year. Compare that to the average of 100 deaths per day in cars. Nobody gets nervous when they jumped in that car to come have that anesthetic that they're all nervous for. Again, that's cause we make it safe.

 

[snake]

I know my wife was given Propofol for her ECT treatments. She said it felt like fire was running through her veins just before going under, every single time.

Propofol has a tendency to sting a little as it first goes in. I mix it with a little but of lidocaine to mitigate that.

Yeah I had it the last time I went under and the burn wasn't bad but I remember a crushing feeling in my shoulder before I went ZZZZZ