Expert: Dr Ian Jackson - please note UK based - 9/8/2008

Question
hi there. i am 27 yrs old and i have had 2 operations. one in 2000 to remove my appendix. i had a severe reaction to the general anesthetic , my whole body swelled to twice its size and i could not stop being sick even after being administered every anti sickness drug i remained in hospital for 2 weeks due to high temp and blood pressure.  i then had my gall bladder removed in 2005 and i had to tell the anesthetist about the problems in 2000 as it had not been recorded in my notes. he decided to use a different mix of anaesthetic and this time they could not wake me back up. i went for the operation at 11.am and it took until 7pm to get me back on the ward. again they have not recorded this in my notes. i am due to give birth to my fifth child in nov and i have a history of pph. so i am terrified that i may need another operation and that nobody will no of my reactions. plz could you explain why this is happening to me. i am fit and not overweight for my height of 5ft 2 and weigh 9st 12lb. thankyou for any help given xxxxxxxxx

Answer
Hi Rachel
It sounds like the anaesthetist had far fewer problems the last time - I wouldn't worry aboout being in recovery unit for a long time as long as you were fine once you got back to the ward. Many patients remain in the post op care unit for quite a time for various reasons e.g. getting cold during the operation.
I find it reassuring that you didn't have to stay in hospital for 2 weeks again and don't mention any further probs with nausea and vomiting.
Now as to your history of PPH. If you do need an operation then just ensure that your anaesthetist is aware of your history. Also we often do ops around pregancy and delivery under what is called a spinal anaesthetic during which you remain awake. You merely receive a small dose of local anaesthetic via an injection in your back. This is a very useful technique for patients who have a hhistory of anaesthetic problems.
As to what is happening to you then this is difficult to say without knowing the agents that have been used during your anaesthetics. You are obviously sensitive to certain agents. However the story of being in hospital for two weeks following your appendicectomy is a bit strange. It is quite possible that your symptoms were secondary to the surgery and your appendix if it was very inflammed. It would be more likely that your temperature and vomiting were secondary to problems associated with this rather than the anaesthetic. Were you formally referred back to the anaesthetists while this was happening for a review?
People (read surgeons) love to blame the anaesthetic for problems.
So overall I wouldn't worry too much. However ensure that any anaesthetist looking after you is aware of your previous problems. I wish you an uneventful delivery.
Kind regards
Dr Ian Jackson