When anesthesia does not work

«Doctor, I found out everything they said during the operation». "How? But … have you felt pain? »« No, but I've heard everything they talked about ». This is what happened to us a few years ago when leaving the operating room. When she asked the patient again during the postoperative period, she recognized that she was a habitual smoker of marijuana. During the numerous interrogations by the anesthesia and surgical team prior to the surgical intervention, the patient had hidden this information. He told us he felt ashamed to tell about his addictions and had not taken into account the possible consequences.

Cannabis addiction

The scientific journal Journal of the American Osteopathic Association has recently published an article in which it is assured that patients addicted to cannabis may need a higher dose of anesthetics than a person who is not. Some of them, like propofol, may need almost twice as much.

According to it has been possible to analyze in diverse publications, One or two of each 1,000 people subjected to general anesthesia suffer the one that has been denominated as intraoperative awareness. This phenomenon consists, as its name suggests, in notice things that happen during an operation with general anesthesia, like sounds or conversations. Sometimes patients feel intense pain too. This may occur during part or all of the surgical procedure.

The phenomen is not new. Even in 2007, a movie called Despierto has this issue as an argument. There are numerous testimonies of people who have felt how they are manipulated or cut their tissues. They have been able to smell burning or listening to everything that happened in the operating room. Sometimes accompanied even with a sensation of pain and intense panic.

The interaction

This phenomenon can occur after habitual consumption of drugs such as cocaine, opioids, tranquilizers, marijuana or other medications used to sleep, for example. What happens is a phenomenon known as 'cross tolerance'. This situation occurs because these substances bind to cellular receptors that become less sensitive over time, requiring a higher dose to achieve the same effect. Medications that are used during general anesthesia bind to these same receptors and therefore will require a higher dose as well.

To the people who take An excess of alcoholic beverages will have a similar phenomenon. In this case they will need more medication to maintain general anesthesia since their 'alcohol-trained' liver will eliminate these anesthetic drugs much more quickly and therefore they will need more of them.

Today, during an operation multiple constants are monitored such as heart rate, respiratory rate, blood oxygenation, heart rate and even brain waves. There are methods that measure the depth of general anesthesia. Therefore, it is more difficult for us to wake up in the middle of an operation, but it is not impossible.

In the consultations prior to surgery, especially in anesthesia, you will be asked, sometimes insistently, if you consume any type of drug, tranquilizer, or analgesic. They will also interrogate you regarding the use of tobacco and alcohol. If you want to minimize the risk of awakening in the middle of a surgical intervention or of exhausting the anesthetic reserves of the hospital, be as honest as possible. The majority of patients are.

Keep in mind that the writer Miguel Delibes stated, in an interview with the newspaper 'ABC'. That to an operation (with general anesthesia) «An intelligent sick man came in and he came out a healthy man», who could never write again, despite leaving without cancer. Be as honest as possible with your doctors, they are there to help you and minimize the risk of any complications.

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