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Question: Is it the muscle relaxant that causes the most risk respiratory during an operation procedure?

Discussion in 'Cardiovascular and Respiratory' started by Rosie, Nov 12, 2019.

  1. Rosie

    Rosie Senior Member (Voting Rights)

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    I don't know if anyone here can answer this or have any idea what happened to me when going under anaesthetic last week.

    I should first say that I have COPD from many years of smoking. I've had a very difficult time giving it away.

    I also should have mentioned what happened to me to the anaesthetist after I had come out of the operation but I was not feeling great with the after effects of being put to sleep.

    When the anaesthetist gave me the muscle relaxant in the operating room I suddenly found it very difficult to breathe. There was about 5-10 seconds of time between being given the muscle relaxant and then the anaesthetic, but during the small amount of time I was shocked at how hard it was to breathe.

    So, is this what is the riskiest part of being anaesthetized - the muscle relaxant? And what causes a cardiac arrest during an operation?

    Anyone else experience the breathing difficulty with the muscle relaxant? I have had two general anaesthetics but I was a lot younger, in my 20's then and didn't notice any breathing problems back then.
     
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  2. Patient4Life

    Patient4Life Senior Member (Voting Rights)

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    Muscle Relaxants During Anesthesia May Increase Risk of Postoperative Pulmonary Complications AJMC

    Muscle relaxants increase risk of respiratory complications Medical Xpress

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    Featured snippet from the web

    Sixty-four percent of anesthesia-attributable cardiac arrests were caused by airway complications that occurred primarily with induction, emergence, or in the postanesthesia care unit, and mortality was 29%. Anesthesia-contributory cardiac arrest occurred during all phases of the anesthesia, and mortality was 70%.

    Anesthesia-related Cardiac Arrest Anesthesiology

    Hope that helps.
     
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  3. Rosie

    Rosie Senior Member (Voting Rights)

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    @Patient4Life Thank you very much for finding this reading for me. x
     
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  4. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    I had problems when I came out of an anaesthetic about 25 years ago. In my case it was the anti-nausea drug I was injected with that caused the problem. The effect wasn't breathlessness in my case - I'm just mentioning it because it is another type of drug you might expect to get while under anaesthetic, so possibly worth researching. But there are lots of different types of drug used in anaesthetics :

    Source : https://en.wikipedia.org/wiki/Anesthesia
     
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  5. Ryan31337

    Ryan31337 Senior Member (Voting Rights)

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    I'm possibly talking complete rubbish but I thought it was a sedative that you were given before the hypnotic that puts you to sleep. Muscle relaxer comes later to stop you fighting the forced ventilation?
     
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  6. Rosie

    Rosie Senior Member (Voting Rights)

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    @Ryan31337 I'll try to find out exactly what I was given, and will post eventually. Next clinic appointment I will ask the nurse if I can take a look at my op notes. If she is a bit funny about it I will order my notes at a later date. Thanks for your thoughts.
     
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  7. Ryan31337

    Ryan31337 Senior Member (Voting Rights)

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    No problem. I think normally a benzodiazepine like Midazolam would be used. Respiratory depression is a well known side effect.
     
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  8. Rosie

    Rosie Senior Member (Voting Rights)

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    I heard back from the hospital today and the test results are showing I have a high grade for something that could be happening in the uterine. Which means I will need to go under anaesthetic again and have a cone biopsy.
    Sigh. At least it is pre-cancer (I think) so I need to get this seen to.
     
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  9. Trish

    Trish Moderator Staff Member

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    Sorry to hear that, @Rosie. Very best wishes to you for successful surgery and speedy recovery.. :hug:
     
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  10. Rosie

    Rosie Senior Member (Voting Rights)

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    Thanks @Trish
     
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  11. Milo

    Milo Senior Member (Voting Rights)

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    Hi @Rosie sorry about your diagnosis which will require more attending to.

    i have had several surgeries since sick and have never noticed any muscle paralysis while conscious. Most anesthetics (which require ventilation) cause you to stop breathing, but in 99% of the cases you never know, you go unconscious (Or ‘to sleep’ )first.

    i do not know for sure whether your COPD interferes or the anesthetist is giving you something to cause you to not go unconscious right away, but regardless it would be useful to get operative and anesthetist notes, and to make sure you mention this to the surgeon and the anesthetist next time you get surgery. Often times, (at least in my area) complicated patients get an anesthesia consult as part of the pre-op visit, and that would also be useful so the anesthetist can get to the bottom of this before your surgery date.

    Best wishes.
     
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  12. Rosie

    Rosie Senior Member (Voting Rights)

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    @Milo Thanks very much. I didn't know that under general anaesthetic they have to ventilate. I'm very curious to find out what they actually gave me in those few seconds before the anaesthetic.

    I have a clinic appointment coming on the 18th of this month if I heard the nurse correctly, just waiting for a letter in the mail to confirm the appointment. Thanks for reminding me about the things I need to do at this next appointment. I'll start making some notes so I don't forget anything.
     
    Last edited: Dec 6, 2019
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  13. Mij

    Mij Senior Member (Voting Rights)

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  14. Rosie

    Rosie Senior Member (Voting Rights)

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    Thank you @Mij x
     
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  15. Milo

    Milo Senior Member (Voting Rights)

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    Rosie, when they put you to sleep, the anesthetic is in the syringes that they push into your Iv line. There may be more than one agent and sometimes other meds that prevent side effects as well. It would be a good question to ask for sure and for them to know your reaction to whatever was given.

    Edit to add: of course there are different types of anesthetics, such as general anesthetic where you ‘go to sleep’ totally and where you need to be ventilated. There are also sedation drugs, where you breathe on your own, but you usually cannot remember anything of the procedure (often used for colonoscopy or dental procedures under sedation) . I assumed you had a general anesthetic but i could be wrong.
     
    Last edited: Dec 6, 2019
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  16. Rosie

    Rosie Senior Member (Voting Rights)

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    Thanks Milo. I'll read your post a few more times so I don't miss anything. I'll post the names of what they gave me when I find out.
     
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  17. Daisybell

    Daisybell Moderator Staff Member

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    Sorry to hear this @Rosie - will be thinking of you....
     
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  18. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    Sorry to hear your bad news, @Rosie . I hope that everything goes well for you. :hug:
     
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  19. Rosie

    Rosie Senior Member (Voting Rights)

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    Update.

    I had a pre-admit appointment today to see the anaesthetist and I now know the name of what I thought was muscle relaxant that they gave me in the operating theatre before the anaesthetic was given. Apparently it wasn't a muscle relaxant at all ?

    The name of it was called Alfentanil. I could hardly breathe in the few seconds after this was given before the anaesthetic. They are going to use something different next time.
     
  20. Milo

    Milo Senior Member (Voting Rights)

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    Fentanyl is a narcotic commonly used.
     
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