Expert: Dr Ian Jackson - please note UK based - 7/11/2004

Question
My 15 year old daughter recently had her tonsils out . She did not react well to the anasthetic and took 3 hours to recover and when she woke up she was very cold and I was told had a miniture seizure . The following day she was discharged , feeling better , however after 24 hours at home she started vomiting every 5 minutes , after nearly a day and a half of this I took her to A+E were she was treated , I was told the anasthetic caused her to have a paralyzed stomach/gut . Could you please explain to me what this was , and wether this only affects children or this would happen again if she had another general anasthetic .
thank you
Suzie Park

Answer
Suzie

Everyone reacts differently with anaesthetics but it is amazing how easy it is to pick on them as the route cause of all problems post operatively!

It sounds like your daughter started shivering quite violently following her anaesthetic. This is not unusual and is down to a variety of issues including

- anaesthetics tend to 'vasodilate you' i.e. more of your blood goes to your skin and so you tend to lose body heat

- theatres use fast ventilation to maintain sterility and this makes the above issue worse

- some of the common anaesthetics seem to cause an effect on your 'temperature control centre' in your brain (yes, this does exist) and lead to the need to shiver

I doubt very much that she had a minature seizure (the above is enough explanation) unless you were told this by the anaesthetist. If you were told by the nursing staff only then it is extremely unlikely. Anaesthetically we tend to take communicating any such problems very seriously.

So hands up to that first bit - very much all related to the anaesthetic.

Now she started to be sick after 24 hrs at home, so we are now 36-48 hrs after the anaesthetic and operation.
I suspect she may have had a touch of what is called 'ileus' which is what they have described as a 'paralysed stomach' This is where for some reason or another the gut decides to go on strike and not move the contents through as it normally does.

There are a large number of reasons for this happening after an operation e.g. linked to the pain killers that have been prescribed, after effects of the operation etc. However it is unfair to blame this on the anaesthetic. It is unusual after a fairly simple operation and is more commonly seen when someone has a big operation inside their tummy.

Off course this could all have been a reaction to the pain-killers.

Now as to the future.
It is always worth mentioning these problems to any anaesthetist in the the future. They can then try and ensure that your daughter does not get cold during the operation.

As to the 'ileus' - this is unlikely to be a problem again but I could never say it will never happen again.

I am sorry to hear of your daughters experiences and realise this will have coloured her judgement about any future operations. Naturally I hope she does not require any operations in the future!
I can only hope that this will help her understand a little of what may have taken place and reassure her that if she lets my colleagues know about the problems she experienced then I am sure they will do their best to avoid a repeat.