Expert: Dr Ian Jackson - please note UK based - 2/4/2009

Question
Recently I had and upper and lower blepharoplasty.  They put me under in "twilight sleep".  Next thing I know I wake up fully awake and in horrible pain.  I thought they were slicing my eyeball open.  I told them it was so painful and the doctor told the nurse to give me more Versed.  They kept giving me more and more but nothing helped.  It was a nightmare.  I've never been in so much pain.  The question as to why so much pain, I guess needs to answered elsewhere, but I was hoping you might give me some insight into what went wrong with the anesthesia.  I have several surgeries scheduled in the next few months and a couple might be twilight again.  I have had twilight before with no problem.

One other question.  When they first put me on the table for the operation, they kept telling me to take deep breaths because my oxygen was low.  I'm concerned about having surgery if my oxygen will drop so low.  Thanks for your help! Judy

Answer
Hi Judy
The main anaesthetic for your operation should have been the local anaesthetic injected by your surgeon. Your pain was due to the fact that there was some issue with this - perhaps it wore off as the op progressed or perhaps it was never really right. Midazolam is a sedative to make you sleepy - it has no analgesic properties so I am not surprised it didn't help much. If they got your local right then I'm sure you would have fallen asleep.

I wouldn't worry unduly about the oxygen bit it can dip a bit during sedation and it is reasonable to ask the patient to take some deep breaths.

So as long as they get your local anaesthesia right then you shouldn't have any further problems.
Kind regards
Dr Ian Jackson