Expert: JM Starkman, MD - 10/2/2009

Question
I will be undergoing a thyroidectomy soon, and I have terrible fear regarding the anesthesia process. I have a large goiter, so I am concerned intbuation will be difficult. Will I be completely asleep for the intubation process, or do they just do it while you're conscious and give Versed so you don't remember? I have had some very bad experiences with hospitals, so I am quite paranoid and fearful. If intubation is difficult, what do they do to manage it? Also, any tips on preventing nausea (which I have had with every previous surgery, even though they put a patch behind my ear and gave me meds)? Thank you.

Answer
I hope you and/or your surgeon will arrange IN ADVANCE to meet with the anesthesiologist WHO WILL DO the anesthesia for your goiter operation to have these important matters answered as they specifically pertain to you.  In almost all cases there is no reason why you cannot be asleep for the intubation--but there maybe an unusual exception/issue with you.   The prevention of nausea after anesthesia should also be no problem at this point in anesthesia history--yet so many anesthesiologists still don't actively address the matter on an individual basis (they give a dose of preventive med--whatever--and hope for the best.)

Be happy with the anesthesiologist who does your preoperative evaluation (history-taking, physical, formulation of preop, intraop, postop gameplan) or request someone else.  Ask if they are board-certified.