Expert: Ronald Levy, M.D. - 12/3/2009

Question
QUESTION: I underwent surgery to remove my ovaries last Tuesday. I have previously had 2 abdominal surgeries (a hysterectomy and an open appendectomy). On each of the previous occasions I have requested no versed be used, as I have personal reasons for not wanting amnesia induced. This has not been a problem in any way, they just wheel me in to the OR awake and alert, I get on the operating table, they give me oxygen and then the IV medication to put me under. Twice before it has been no problem. I'm a tough cookie.

This time, however, there was a big problem. The Anesthesiologist said he was giving me the medicine to put me under in my IV, however the feeling I had was of being paralyzed. Gradually I couldn't move, but worse, I couldn't breathe! I tried to take a breath and my lungs were paralyzed. I was able to get out of my mouth, "I can't breathe! I can't breathe!" before my mouth became paralyzed as well. The nurse said sweetly, "Oh your'e doing fine," but I didn't think not being able to breathe was fine at all. This only lasted about 10 to 15 seconds and then I was unconscious, but I haven't been able to even speak of it in a week, and have had flashbacks and a terrible time recovering from this incident. I truly thought that I was being killed and finally gave up and was ready to die.

My question is, What Happened??

ANSWER: This is one of the reasons we give Versed! When they put you to sleep, they use an anesthetic and a muscle relaxant (paralytic). The anesthetic usually takes effect before the muscle relaxant so you don't realize anything happened but occasionally (for safety reasons) we use a very fast acting muscle relaxant and (rarely) it starts to work before you are completely asleep. The amnestic effects of Versed would have taken care of this and you wouldn't remember this happened but since you didn't get Versed, you remembered. Many people don't like the amnestic effects (I have had Versed and personally I prefer not knowing what happened) but, as you can see, this is the downside of not getting it. This is not an allergy and it won't likely happen agian should you need surgery but I would ask you to reconsider your insistance not to get Versed. For me, the beneficial effects far outweight the downsides.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your speedy reply. After my research this is what I figured out must have happened. I do understand your point on the versed, so I thought I would explain mine: I am of the belief that just because i don't remember it, doesn't mean it didn't happen. I believe that the mind is always recording, if even on a subconscious level, and those things recorded whiile a person is unconscious can adversely affect him later in life. So those moments of terror at not being able to breathe did happen, and were recorded, and my ability to go back and recall them in full means the difference between suffering from psychosomatic ills or not. This is covered in depth in the book Dianetics, The Modern Science of Mental Health. I have actually recalled, using Dianetic counseling, my entire prior surgeries which were done under full anesthesia.  By being able to recall them, I am able to release any subconscious hold they may have (words said around an unconscious person, "He'll never walk again," etc., act as hypnotic suggestions until released using this technique). I am giving a quick explanation of something covered in a big book, but wanted to explain why I don't want something making it HARDER for me to recall what occurred -- something such as an amnesia causing drug called versed. But I truly appreciate your quick answer, and I have gotten relief out of understanding what happened.

Answer
Thank you for explaining. People have many different reasons for not wanting Versed (loss of control, etc) so your's is no better or worse and I would certainly not try to change your belief system. If you are willing to risk living out these potentially scary moments (as opposed to just believing they are imprinted in your subconscious) that is fine. The people I am more concerned about are those who don't want Versed, have a bad experience, and then are afraid of all surgery (to their own health detriment) because of this newly acquired fear. I'm glad I was able to give you some relief.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston