Expert: Ronald Levy, M.D. - 8/23/2009

Question
QUESTION: I just extracted my wisdom teeth under General Anesthesia on Tuesday.

I was just starting to come out of the anesthesia in a semi-conscious state when I realised that I had difficulty breathing (i.e. very very shallow breathing). I could not even shout for help, as I felt that my air passageways were constricted and almost shut completely. The nurse also noted that I had a red rash on my chest.

I managed somehow, to pull out of that.

When I called the hospital the following day, they told me that everything was fine and ok during the recovery stages before they wheeled me to my ward and they ruled out the possibility of me being allergic to the anesthesia used.

What could this be caused by?

I need to know as I will be undergoing jaw operation soon and this episode has left me reeling.

ANSWER: I don't know if you had this procedure in the destist's office or in a hospital. If you were intubated, the symptoms you describe are very common.  Usually the tube is removed before you wake up. If you wake up with the tube still in, it is like breathing through a straw and gives you the feeling you describe. I am sure you are not allergic to anesthesia. Just make sure to tell the next anesthesiologist the problem you had with this procedure so he can take steps to avoid it next time.


Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston

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

QUESTION: This was done in a hospital and the tube had already been removed when this occurred.  

Answer
Then likely you had some resideual muscle relaxant on board. During many surgical procedures, we paralyze the patient so that the muscles are relaxed to make it easier for the surgeon to work. At the end of the case, we reverse these meds but occasionally either the reversal dose was too small or the reversal dose wore off before the relaxant did and the patient feels very weak to breathe. Often reassurance is enough to bide the time until the patient is stronger but occasionally the patient needs to be reintubated. This is not likely to happen next time.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston