How many of your patients wake up paralyzed and have to go through hours of agonising surgery fully conscious but unable to move?
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Quote: Kevin Murphy @ October 20 2009, 12:13 AM BSTHow many of your patients wake up paralyzed and have to go through hours of agonising surgery fully conscious but unable to move?
None of mine. And I've anaesthetised thousands. In modern-day anaesthesia it should be pretty much unheard of, except in cases where there is equipment/monitoring failure or gross incompetence of the anaesthetist.
The only way the type of "overt" awareness you describe above can really happen without the anaesthetist noticing is where infusions of paralysing agents are being used. There's very few areas of surgery where these are really needed and they are not as commonly used on this side of the Atlantic as in the US.
Every few years a few anecdotal horror stories are dredged up (usually for a TV documentary), but considering the millions of general anaesthetics that take place every week in the world these cases are ultimately as rare as hen's teeth. In most of these cases where awareness has been considered to have actually happened, it's usually down to a criminally poor anaesthetist.
Put it this way, if my patient was aware of what was going on, I shouldn't need them to be able to move or be able to tell me they're in agonising pain, in order to realise they are not properly anaesthetised. 
I know you have to say that for legal reasons, but I recently saw the statistic "Every year, one in 700 people wake up during surgery" in a documentary where it happened to Darth Vader, so I'm not sure I can fully believe you.
Quote: Kevin Murphy @ October 20 2009, 12:23 AM BSTI know you have to say that for legal reasons, but I recently saw the statistic "Every year, one in 700 people wake up during surgery" in a documentary where it happened to Darth Vader, so I'm not sure I can fully believe you.
I'm telling you the truth, I've no reason to say it for legal reasons. The figure you quote I would have to know the source of to comment properly. There is a difference between someone showing signs of "waking up" during surgery and them actually having any memory or awareness of the event. Involuntary movement under anaesthesia does not equate with patient awareness of surgery. The rates of "overt awareness" are something in the order of less than 1 in 100,000 general anaesthetics (varying from study to study - the numbers are so small compared with the rate of anaesthetics that the rates can vary due to small clusters of cases).
Consider the fact that an average, medium-size district general hospital in this country will routinely perform around 300-400 general anaesthetics per week. I think if I was lying about this you'd be hearing a lot more stories in the press to contradict me.
Doesn't matter if you believe me, particularly, but the culture of covering-up in the NHS is fortunately very rare thesedays. It's only the really bad doctors that try to hide their mistakes. In anaesthesia this is actually quite difficult to do.
Well said Tim.
Just found out that my nemesis in college, the evil Amanda, is now an anesthesiologist and was bragging about how she was sooo much more successful than the rest of our group. Too bad she weighs about 300 lbs and looks like Alfred Hitchcock in a Cher wig. 
Just thought you'd all like to know. I read it on Facebook, so I am kind of on topic.
Quote: AndreaLynne @ October 20 2009, 12:46 AM BSTJust found out that my nemesis in college, the evil Amanda, is now an anesthesiologist and was bragging about how she was sooo much more successful than the rest of our group. Too bad she weighs about 300 lbs and looks like Alfred Hitchcock in a Cher wig.
Well, anaesthesia can involve a lot of sitting around, doing crosswords and eating cakes if you're not careful... 
Quote: Tim Walker @ October 20 2009, 1:04 AM BSTWell, anaesthesia can involve a lot of sitting around, doing crosswords and eating cakes if you're not careful...
Or whole sides of beef... 
Tim, she's enormous!!!!
I'm going to look like a twig next to her at our reunion...I love it!
Are female anesthesiologists usually mean from your experience? She started out as a pediatrics student (as did I, truth be told 
)...
Quote: AndreaLynne @ October 20 2009, 1:07 AM BSTAre female anesthesiologists usually mean from your experience? She started out as a pediatrics student (as did I, truth be told
It would be very wrong of me to say that quite a few of them are nutters. Very wrong indeed . (To add balance, I've known some weird male ones as well.)
It's a mad, mad world!
I'm glad she's taking care of sleeping people. It's awake ones that she tends to have issues with.
Quote: Tim Walker @ October 20 2009, 12:32 AM BSTI'm telling you the truth, I've no reason to say it for legal reasons. The figure you quote I would have to know the source of to comment properly.
The movie starring Darth Vader?
Sure.
Quote: Kevin Murphy @ October 20 2009, 2:22 AM BSTThe movie starring Darth Vader?
Sure.
Ah, so it's not a documentary then? It's fiction.
Sorry, I guessed you'd probably already watched it, if only for giggles. Misjudged gag
Quote: Kevin Murphy @ October 20 2009, 2:27 AM BSTSorry, I guessed you'd probably already watched it, if only for giggles. Misjudged gag
No, I wasn't "aware" of it (geddit!). Might have to get hold of it for a watch-see. There was that channel Five(?) documentary on a couple of years ago, something like 'When Anaesthetics Go Wrong!'. What a fun couple of weeks it was after that reassuring the patients. 
EDIT: I also now get the Darth Vader reference. I thought you were saying that David Prowse had gone for an op and had a bad experience. Wondered why I hadn't read about it.
I saw a news report the other day about the highest-paying jobs in the U.S. and anesthesiologists were Numero Uno.
Really? They're certainly not over here. That is, of the specialists who do private work, the highest earners are still usually the orthopaedic and plastics/cosmetic surgeons. Dermatologists do pretty well too.