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Comments on Notes of an Anesthesioboist: (This) Sux





Updated: 2017-12-14T15:13:38.901-05:00

 



I get more and more interested in this field with ...

2007-07-26T13:24:00.000-04:00

I get more and more interested in this field with every read.

Thanks for your gracious writing!



By language, I meant literally lanaguage - her Eng...

2007-07-14T16:53:00.000-04:00

By language, I meant literally lanaguage - her English seemed fairly patchy - not "watering down" medical linggo, which I realize the above could be taken to mean. Sorry for the lack of clarity!



Nice to hear from the "old gray beard!" If you're...

2007-07-14T16:50:00.000-04:00

Nice to hear from the "old gray beard!" If you're cynical, I must be as well, because I thought of the droperidol thing too when I first learned about the sux label during training. And yes, it was a Sevo induction with Iso maintenance.

Let's see, 5 times in 30 years, that's about one every 6, so hopefully I won't get my next cardiac stress test in the O.R. till 2013...oh, but wait, then my eldest is probably getting her learning permit, so that'll INCREASE my rate of coronary ischemia! Oh no!

And you're absolutely right: at some nanosecond in there my mental voice was like, "What if I do this and nothing gets better?" It was only afterward, when things were fine, that I started playing a "what would I have said to grandma" scenario in my head, trying to translate it mentally to a language grandma would have understood more easily...no fun...

I am still muttering under my breath, "thank goodness for sux..."



yep. Just like the old days, says the old gray bea...

2007-07-14T14:06:00.000-04:00

yep. Just like the old days, says the old gray beard anesthesiologist. Nothin' scarier. You had two thoughts sneak in there too, I'll reckon; one; what if it doesn't work? and somewhere in there, your thoughts flashed (just for a moment) to talking to the parents....

Fortunately, it always works (except when it doesn't) by which I mean, that in my thirty years, I've never known a nightmare case where it wasn't laryngospasm. Could happen; bronchospasm, as you mentioned, especially in the context of true anaphylaxis; not likely however in pure inhalation induction. Did you use Sevo? (of course you did - who would try to mask induce with Des) By the way, aside from parasympathetic brady with sux, and an MH trigger (I trained in Wisconsin), I've never seen the hyperkalemic arrest clinically. Granted, nobody ever used Sux in burns or fresh cord injuries. But we all used it every day for twenty years. This FDA warning is a droperidol-type of thing; sux is a great drug. I actually think the sux warning was a marketing ploy by the manufacturers of that very short acting non-depolarizer (forget its name) that was pulled from the market shortly after its introduction (bronchospasm) Am I cynical or what?

Having said all this, there is nothing scarier, as you now know. it's happened to me maybe five times in 30 years. I remember every one. You won't need a stress thallium now for five years; you're good to go.

cheers


Mitch



This is a fascinating post.

2007-07-13T14:38:00.000-04:00

This is a fascinating post.



Rebecca, I'm so glad. Hope you're recovering well...

2007-07-13T12:59:00.000-04:00

Rebecca, I'm so glad. Hope you're recovering well post-op, & blessings to you.



I had general anesthesia for the first time this p...

2007-07-13T11:30:00.000-04:00

I had general anesthesia for the first time this past monday. I thought of you and your blog while I was getting prepped. Your insight into the other side of machines allowed me to be very calm. Thank you for sharing your experiences, letting me know that the person in charge of my breathing really does care.