Expert: Ronald Levy, M.D. - 6/29/2009

Question
QUESTION: I was told that I could not have intravenous anesthesia because I am allergic to soy and egg products in propofal. I have COPD and am afraid to have general anesthesia with a breathing tube and gas. I have reactive airways and am afraid I will have shortness of breath or get a lung infection from the gas and breathing tube.  Is there any alternative?  Cathie

ANSWER: First of all, you can have general anesthesia, just not with Propofol. We have many other anesthetics that work as well or better than Propofol. While you are certainly at more risk for lung problems because of your COPD, we do general anesthetics on COPD patients (including very severe COPD) all the time without any complications. Since you don't state what kind of surgery you are having, it is hard for me to tell you alternatives, but when you see the anesthesiologist pre-op, ask him/her about alternatives. They'll be happy to explain the risks and benefits of each.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston

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

QUESTION: Thank you very much Dr. Levy for your answer so far.  I went for an 1 1/2 hour enteroscopy yesterday but decided not to have it because all the anesthesia options seemed dangerous for me. What other anesthetics would I be able to take?  Cathie

ANSWER: When you say enteroscopy, do you mean endoscopy or laparoscopic surgery? If the former, you could do anything from nothing to sedation to general. For the later, you pretty much have to have general anesthesia unless, occasionally, you can get away with regional anesthesia.

Ronald Levy, MD
Professor of Anesthesiology
UTMb-Galveston

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

QUESTION: I was told that I need an enteroscopy where the doctor goes deeper than an endoscopy. The procedure would take about 1 hour and 1/2. Can you please tell me what the other alternatives would be to Propofol? Are they soy and dairy free?  Cathie

Answer
I don't understand what that means! One thing is a procedure where they put a scope up through your rectum to look at your colon from the inside, the other is to make an incision and look at your colon from the outside. In either case, there is no problem with Propofol...in fact, it is one of the safest alternatives.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston