Expert: Ronald Levy, M.D. - 10/9/2011

Question
Dr. Levy,

The last time I had general anesthesia for an operation I was extremely nervous... for me, the anxiety came not from the surgery, but from the anesthesia... the loss of control and awareness, and the possibility that I might not wake up.

In attempt to  calm my anxieties, the anesthesiologist told me something I'd like to confirm or have clarified....

When I asked if he was prepared to reverse the anesthesia if needed, he said that there is no way to reverse it and that there really isn't a way to overdose on general anesthesia because it's mostly gas - even if more is given than is needed for the surgery, it's just a matter of providing support for the body (artificial respiration, hydration...) long enough for the body to clear everything out.

At the time, I was on the verge of an operation and wasn't thinking critically, but now - I'm not really sure whether or not he told me the truth because I know we use some sort of anesthesia medicine to put animals down.

Can you please clarify?

Thanks!

Answer
He is correct with a slight exception. When he said you can't reverse it,  that is partially true. You can't just turn a switch and the person wakes up, but obviously we do reverse it at the end of the procedure by turning off the gases and allowing the medicines to wear off. I don't know why you would want him to reverse the anesthesia? It is true that the majority of the anesthetic is inhalationally based so by adjusting the amount of gases you receive while supporting your blood pressure, the body will naturally get rid of the excess. What most people don't realize is that anesthesia is actually one of the safest types of medicine you can receive. The complication and death rates from anesthesia is lower than all other major specialties and in fact, it is the anesthesiogist that often is the more important reason that a patient survives a life-threatening surgery than the surgeon because our job is to keep the patient alive while the surgeon operates. The anesthesia that "puts an animal down" is just a humane way of doing that by giving an intentional overdose of the anesthetic agent. This is clearly unrelated to how we treat humans.

Ronald Levy, MD
Profesor of Anesthesiology
UTMB-Galveston