Do surgical patients under general anesthesia feel pain?
May 6, 2019 11:33 PM Subscribe
And also, do those very rare people who "remember everything" remember what happened if they were under anesthesia?
I was an athlete and had several surgical orthopedic procedures. I always talked the docs into using only local anesthesia, as I'd done the research and knew that those patients with only locals had shorter, easier recovery periods.
Now recent research seems to indicate that people under general anesthesia do experience pain during surgery, and don't remember it.
My husband, a curious physicist, read about this and asked me to pose this question to the hive mind: Do those rare people who "remember everything"--every day of their lives in detail (and there are such people] also remember their time under anesthesia? Does anyone have any knowledge of this?
If there are, they might be able to speak about what the body undergoes during surgery with general anesthesia---pain, stress, metabolic reactions, etc. At least that is what my husband is wondering about; as for me, I'm just glad I had only local numbing, not brain numbing.
Any and all answers are appreciated!
I was an athlete and had several surgical orthopedic procedures. I always talked the docs into using only local anesthesia, as I'd done the research and knew that those patients with only locals had shorter, easier recovery periods.
Now recent research seems to indicate that people under general anesthesia do experience pain during surgery, and don't remember it.
My husband, a curious physicist, read about this and asked me to pose this question to the hive mind: Do those rare people who "remember everything"--every day of their lives in detail (and there are such people] also remember their time under anesthesia? Does anyone have any knowledge of this?
If there are, they might be able to speak about what the body undergoes during surgery with general anesthesia---pain, stress, metabolic reactions, etc. At least that is what my husband is wondering about; as for me, I'm just glad I had only local numbing, not brain numbing.
Any and all answers are appreciated!
The anesthetics used during surgery have changed over the years. When I had my adenoids out in 1954, I think they used ether. I dreamed of a house. Years later, we moved into a house that looked like it. In operations I've had recently, they used what sounds like a date-rape drug. They insist I was conscious, but I don't remember anything.
posted by Kirth Gerson at 4:48 AM on May 7, 2019
posted by Kirth Gerson at 4:48 AM on May 7, 2019
When I had my wisdom teeth out, I woke up midway through. I was loopy, but definitely didn’t feel pain. That was under twilight sedation, with a combination of Versed and something else.
posted by chesty_a_arthur at 5:09 AM on May 7, 2019
posted by chesty_a_arthur at 5:09 AM on May 7, 2019
I’m not sure what they used (The anesthesiologist did inform me of what he was going to do, but this was minutes before my minor surgery and I definitely had other things on my mind.), but I just remember waking up after the procedure with no memory of the entire process.
posted by theappleonatree at 6:36 AM on May 7, 2019
posted by theappleonatree at 6:36 AM on May 7, 2019
Best answer: I don't have a personal experience but this amazing book talks about this exact issue. Is this what your husband read? Anesthesia: The Gift of Oblivion and the Mystery of Consciousness. By Kate Cole-Adams If not, you might enjoy it.
posted by EllaEm at 7:33 AM on May 7, 2019 [2 favorites]
posted by EllaEm at 7:33 AM on May 7, 2019 [2 favorites]
I remember what happened when heavily sedated with valium for various medical procedures, though that's not supposed to happen. There is an absolute blank for when I had propofol, an absence of any feeling of time having passed, so it seems to me that something really does get switched off for the duration there.
posted by chromium at 9:39 AM on May 7, 2019 [1 favorite]
posted by chromium at 9:39 AM on May 7, 2019 [1 favorite]
I'm not sure if there's any strong research done re: "remember everything" people (eidetic memory) and sedation.
I suspect that a lot of the "don't remember while under sedation" is that the sedation drug biochemically interferes with consolidation of memory - so whatever neural conditions that promote eidetic memory would be disrupted, and so no, they too should also don't remember their time under sedation.
posted by porpoise at 10:26 AM on May 7, 2019
I suspect that a lot of the "don't remember while under sedation" is that the sedation drug biochemically interferes with consolidation of memory - so whatever neural conditions that promote eidetic memory would be disrupted, and so no, they too should also don't remember their time under sedation.
posted by porpoise at 10:26 AM on May 7, 2019
*I am not an expert or doctor. I'm just someone who has watched/been around a lot of medical stuff.*
My understanding of all of this is that it's very complex and we don't have a single answer. Nor is it easy to study.
Firstly, there are various types of sedation. Those range from local anesthetics/numbing -where you are fully conscious but can't feel a part of your body, to sedation (twilight sleep) where you can respond to commands from your doctor but have no memory of it unless you "wake" during the procedure, and general anesthesia - where you are intubated for more serious procedures. They all use a variety of combinations of medications, as said above. It should be also noted that some of these medications have the effect of numbing your senses, while other combinations actually include additional pain medications.
During a procedure where you're not conscious, especially general anesthesia it's hard to say how our bodies interpret pain. Our nerves are likely sense it, but part of "pain" is that signal being processed by our brain then informing our conscious brain. If your brain is not able to take those nerve signals and translate them and you're not aware enough to process them, then did they happen?
For example, maybe your partner accidentally kicked you in their sleep as they turned over. But if you're a deep sleeper you probably didn't' wake up. Did that midnight kick hurt? You don't have a memory of it, so does it matter? There are reasons you can't learn a language in your sleep. Your brain isn't usually processing outside information. And that's just regular old changes in consciousness.
In my experience as well, the cocktail of meds for general anesthesia (and sometimes sedation) stay in your body for a couple of days with a numbing effect. Your body also tends to go into shock, also changing how you respond to pain. It's why often the 3rd or 4th day out from surgery can be the most painful rather than the first day.
I've had multiple sedations. One where I woke up during an allergic reaction. I felt the endoscope in my stomach but nothing felt like it hurt. Just uncomfortable pressure (and I was very itchy.) I was only aware for a few moments before they gave me more meds. I have varying levels of pre and post procedure amnesia and post procedure grogginess.
I've had multiple surgeries under general anesthesia. I don't remember any of them and often just after waking up your body feels separate from yourself and even the pain is a strange foreign sensation. You're also being pumped full of pain meds. I also have varying degrees of amnesia pre/post procedure for each one. One I remember nothing after saying bye to my spouse and another I remember everything into the OR until they injected me with drugs.
The thing to note if you're worried is most people are going under during these procedures for life-altering, often life saving treatments. If I felt pain and don't remember then I don't care as long as I feel better now. And it's not like we have other options.
posted by Crystalinne at 11:30 AM on May 7, 2019 [1 favorite]
My understanding of all of this is that it's very complex and we don't have a single answer. Nor is it easy to study.
Firstly, there are various types of sedation. Those range from local anesthetics/numbing -where you are fully conscious but can't feel a part of your body, to sedation (twilight sleep) where you can respond to commands from your doctor but have no memory of it unless you "wake" during the procedure, and general anesthesia - where you are intubated for more serious procedures. They all use a variety of combinations of medications, as said above. It should be also noted that some of these medications have the effect of numbing your senses, while other combinations actually include additional pain medications.
During a procedure where you're not conscious, especially general anesthesia it's hard to say how our bodies interpret pain. Our nerves are likely sense it, but part of "pain" is that signal being processed by our brain then informing our conscious brain. If your brain is not able to take those nerve signals and translate them and you're not aware enough to process them, then did they happen?
For example, maybe your partner accidentally kicked you in their sleep as they turned over. But if you're a deep sleeper you probably didn't' wake up. Did that midnight kick hurt? You don't have a memory of it, so does it matter? There are reasons you can't learn a language in your sleep. Your brain isn't usually processing outside information. And that's just regular old changes in consciousness.
In my experience as well, the cocktail of meds for general anesthesia (and sometimes sedation) stay in your body for a couple of days with a numbing effect. Your body also tends to go into shock, also changing how you respond to pain. It's why often the 3rd or 4th day out from surgery can be the most painful rather than the first day.
I've had multiple sedations. One where I woke up during an allergic reaction. I felt the endoscope in my stomach but nothing felt like it hurt. Just uncomfortable pressure (and I was very itchy.) I was only aware for a few moments before they gave me more meds. I have varying levels of pre and post procedure amnesia and post procedure grogginess.
I've had multiple surgeries under general anesthesia. I don't remember any of them and often just after waking up your body feels separate from yourself and even the pain is a strange foreign sensation. You're also being pumped full of pain meds. I also have varying degrees of amnesia pre/post procedure for each one. One I remember nothing after saying bye to my spouse and another I remember everything into the OR until they injected me with drugs.
The thing to note if you're worried is most people are going under during these procedures for life-altering, often life saving treatments. If I felt pain and don't remember then I don't care as long as I feel better now. And it's not like we have other options.
posted by Crystalinne at 11:30 AM on May 7, 2019 [1 favorite]
When I had my wisdom teeth out, I woke up midway through. I was loopy, but definitely didn’t feel pain. That was under twilight sedation, with a combination of Versed and something else.Just a note, part of the definition of twilight sedation is that you are *not* fully unconscious, and remain able to "respond purposely to verbal commands, either alone or accompanied with light physical stimulation". This is completely different than being under general anesthesia.
posted by Juffo-Wup at 12:08 PM on May 7, 2019 [1 favorite]
You said “any and all answers appreciated”, so I offer this brief anecdotal datapoint: I had surgery a few years ago. Absolutely no memory of the procedure, but afterwards they wheeled my unconscious body into the post-op “wake up” room. I sorta phased in and out of sleepy consciousness a few times before waking up fully. But during one of those periods of consciousness I heard someone - presumably another person in the room awakening after their procedure - yelling at the top of their lungs “OH GOD OH GOD KILL ME IT HURTS TOO MUCH OH GOD!”
(It wasn’t a dream - after becoming fully conscious I asked my wake-up doctor person “did I hear someone yelling?” and he said “yes” and then changed the subject).
posted by doctor tough love at 1:28 PM on May 7, 2019 [1 favorite]
(It wasn’t a dream - after becoming fully conscious I asked my wake-up doctor person “did I hear someone yelling?” and he said “yes” and then changed the subject).
posted by doctor tough love at 1:28 PM on May 7, 2019 [1 favorite]
That doesn't necessarily refer to the surgical experience itself, though. The way I felt after I woke up after having most of a major organ removed? I wouldn't wish that on my worst enemy.
posted by praemunire at 3:56 PM on May 7, 2019 [1 favorite]
posted by praemunire at 3:56 PM on May 7, 2019 [1 favorite]
I had a plate and 4 screws put into my collarbone a couple years ago, and I was much more than just dead to the world.
From one heartbeat to the next, I went from being on a bed in the OR, to having a nurse sitting me up so I could start getting myself ready to go home. It wasn’t just like I was asleep and out of it, it was as if the hours in between those moments were ripped out of reality.
posted by sideshow at 9:38 PM on May 7, 2019 [1 favorite]
From one heartbeat to the next, I went from being on a bed in the OR, to having a nurse sitting me up so I could start getting myself ready to go home. It wasn’t just like I was asleep and out of it, it was as if the hours in between those moments were ripped out of reality.
posted by sideshow at 9:38 PM on May 7, 2019 [1 favorite]
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posted by chiquitita at 3:03 AM on May 7, 2019 [15 favorites]