General Anesthesia and Sleep Apnea experience

[SleepyGuy]

I just had general anesthesia and spent two nights in the hospital for a laser lithotripsy. (That's where a laser is inserted through the urethra to break up and extract bladder stones.)

I informed them that I had severe OSA. They did not seem terribly concerned about that and did not want my APAP for the recovery room, though they urged me to bring it to be used in my room. This had me very concerned because of my memories of general anesthesia 30 years ago. At that time I woke up in the recovery room after apparently sleeping there for at least 30 minutes following an appendectomy. If they did that today, I think my chances of going into a permanent apnea would be too high for comfort.

I also recall at that time that they put me out without an oxygen mask. I don't know how long it took them to put in the breathing tube after putting me out.

In the end, I didn't need to be concerned. Apparently anesthesia has changed significantly over the years. They inserted an IV before I left the pre-op room. They brought me into the room where they were to perform the procedure. They put an oxygen mask over my mouth and nose and asked me to breathe deeply. I assume this was to get my blood well-oxygenated before putting me out. I told them I was feeling claustrophobic, so the doctor asked me to hold the oxygen mask myself. I did. He asked me to take several breaths and then said, "See you in a little while."

I woke up in the same room. My throat was sore. I assume this was from the breathing tube that had just been removed. I did feel a little dizzy and woozy, but not really like falling back asleep. I stayed there for a few hours and did a little reading. There was a nurse watching over me and one other patient during that time. The other patient appeared to be asleep. Maybe they only keep patients with OSA awake right after surgery?

They took me to my room where I read and waited for dinner.

I could not get out of bed to get my APAP. I asked the nurse to get it, but instead she called the respiratory therapist. She installed it which took all of three minutes. It hardly seemed that I needed a respiratory therapist for that!

Over the next two days respiratory therapists came by to ask if I needed any help with the machine. I told them no. They asked a few questions. One asked me if I had a CPAP or a bi-PAP. I told her it was an AutoPAP. She apparently had never heard of an AutoPAP. I then told her it was a "self-adjusting CPAP." This was a major teaching hospital! And yet one of their own respiratory therapists didn't know what an AutoPAP was!

While moving stuff around on the second day, they knocked my mask on the floor. Grrr. It is an Ultra Mirage Full Face mask. It came apart, but I put it back together and it looked OK. Later I realized that some of the plastic teeth that hold the forehead pad in position were partly stripped from the fall. It has held OK during the last two nights, but if you press on it too hard, it moves out of position. I justed ordered a new mask for over $100. It will be here in a few days. At least I will have replacement parts I guess.

There's the story. If you have OSA, make the anesthesiologist aware of it so they will be careful to wake you right after surgery. I don't know how much of what they did was because I have OSA and how much was due to modern anesthesia practice.

[ITeach]

I'm glad to hear things went well for you. I recently had general anesthetic as well, but since mine was day surgery, they did not intubate me, but instead used some sort of appliance at the back of my throat to keep my airway open. I was told by the anesthesiologist that if they had to tube me for some reason, they would not extubate until I was fully conscious. That made me nervous, but was not necessary. I was in surgery about 2 1/2 hours and all went well. I was comfortable not using my apap because I knew I was on monitors the whole time that were recording O2 sats, etc.

[ahujudybear]

i guess each procedure & hospital is different. I was in surgery for about ½ hour (same day surgery), but they had a RT come before the surgery to check out my BiPAP (She said it's amazing the products they are coming out with these days for home use - so small and quiet, and with such sensitive settings! She wished these machines were avilable for them to use in the hospital!) The hospital required that an RT do whatever needed to be done with the machine & mask. So when I woke up in the recovery room, she had put the mask on perfectly and the machine working!

Oh, btw, I had my Dr. write orders for the BiPAP to be used in recovery and afterward, and for the RT to put the mask on immediately after they removed the vent. I have no idea whether I got any O2 in between.

[SleepyGuy]

I was told by the anesthesiologist that if they had to tube me for some reason, they would not extubate until I was fully conscious. That made me nervous, but was not necessary.

I had an endoscopy last year. That's where they put a tube into your stomach to look around. I was fully concious. They had injected me with a valium-like drug and my throat was anesthetized so I had no gag reflex. In fact, I couldn't feel the tube at all and wasn't quite sure when they actually put it in and removed it. I had a rubber ring in my mouth and they put the tube through the middle of the ring.

The idea of feeling a tube in my throat would make me feel VERY nervous, but I doubt you would even be aware you had it in. You might be aware of biting down on some kind of rubber ring or mouthpiece.