Expert: Ronald Levy, M.D. - 3/28/2009

Question
Dear Dr. Levy,

I had multiple complications after having my gall bladder out; specifically a lot of bile and infection that needed to be removed/controlled.  I did fine under anesthesia for the gall bladder removal and one ERCP to put in a stent.  

I needed another stent put in and I was given sedation, then the paralytic.  After the paralytic was given they could not get the breathing tube down my throat to administer anesthesia and I stopped breathing (they sent out a code blue) for 3 minutes and was syanotic.  I did start breathing again on my own but not effectively. After this I spent 5 days in ICU for a total of 3 weeks in the hospital.

I understand I need to have this stent out soon (this happened in late February).  I truly am frightened that this will happen again and do not want to be put to sleep.

My question is, no one told me why this happened, and is there a good chance that this will happen to me again?

Thanks so much for your time.

Answer
It sounds like you have a difficult airway and they used succinylcholine (SUX) as the paralytic. SUX only lasts a few minutes so that is why you started to breathe again on your own. They may have told you but because of the meds you got, you may not remember. The next time you go in, you should mention this to your next anesthesiologist. They should look over the previous chart to make sure this is what happened and then they will then use other techniques to make sure that doesn't happen again. One possibility is to do an awake fiberoptic intubation. This guarantees that you continue breathing until the tube is in place.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston