Expert: Ronald Levy, M.D. - 12/23/2006

Question
I've had anesthesia seven times, and have become quite sick after most of the surgeries. I've been hospitalized twice after one day procedures because of this. Even after carpal tunnel surgeries on both hands -- I actually woke up several times during one of the carpal tunnel surgeries. But, nobody pays any attention to this history when I try to tell them. I have had one person stand with his back to me during the "interview"! When I told the person interviewing me before gall bladder surgery, she said "oh, you gall bladder people all get sick." Should I get my family Dr more involved? I also always need more local anesthetic whenever I had it. During a recent breast biopsy the Dr had to stop and give me more. And cortisone injections in my shoulder are a nightmare -- the orthopedic surgeon who gave me one of these injections said " I don't think you are actually having any pain, you're just afraid of the injection." How can I get through to these people?

Answer
Regarding waking up during carpal tunnel surgery, was this under general anesthesia? These procedures are most often done under local with sedation, so waking up is a relative term. Post op nausea and vomitting (PONV) is a real entity and something we try to treat (but not always successfully). There are drugs we can give to reduce the incidence and other drugs we try not to give because they cause PONV. I'm sorry you had a person who interviewed you with their back to you. This is the exception, not the rule. Basically you need to explain your history to them and make sure they understand that this is not your imagination. While it is true that some surgeries are more prone to PONV (ear surgery, gyn surgery and gallbladder), there are still things we can do to help. As for your need for more local, the problem here is more likely that the surgeon doesn't know how to give local well, so he needs to give more.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston