Allergy to Anaesthesia. Whats the best option for G.A the next time I have to go under?

[advancebooking]

Over a year ago I had a Colonoscopy and the general anesthetic (GA) drug they gave me was Fentanyl and Dormicum. When I woke up I immediately was vomiting and it persisted for at least an hour. The hospital gave me an allergy card and told me not to have that one again

 

I just had minor surgery under GA again and I obviously gave the dr the above info. He also knew that I have heart issues (dialated cardiomyopathy). 

 

So I was lying there and they started injecting in my hand via the needle there. Immediately my hand had a hot feeling which is normal. But then suddenly I had a massive hot weird feeling on my chest / heart area. I alerted them to this but then went under for the hour. Woke up and no immediate vomiting. But 2 hours later I ate something and then was vomiting a few hours after that. 

 

The next day I asked what GA did they use. They told me it was first Propofol and then Morphine. I read on google that Propofol is risky to use on patients with cardiac issues. 

 

The next time I have to go under GA what brand should they be using do you think? If options are limited I would rather go back to Fentanyl / Dormicum and be vomiting than have the shock feeling to my heart like that. 

thanks

[FritsSikkink]

Ask a doctor

[connda]

33 minutes ago, FritsSikkink said:

Ask a doctor

Actually?  Ask a doctor who specializes in Anesthesiology.  That's probably about 0% of the people on this forum.
Your surgeons and anesthesiologists are obviously not listening to your complaints.  Nobody here should do anything but point you back to a fully qualified and licensed anesthesiologist.  Ask @Sheryl for referrals.

[advancebooking]

1 hour ago, connda said:

Actually?  Ask a doctor who specializes in Anesthesiology. 

Ever tried to make an appointment with such a specialist at a major private hospital in Bkk? I have and no success. It seems they dont do outpatient appointments. 

[bkk6060]

I find it unbelievable that a person would come on here and ask such a question.  

Please, ask a qualified physician..

[Doctor Tom]

A well aimed base ball bat will do the trick. 

 

Seriously, ask a medical professional mate,  It will depend on fat too many variables for you to get any sensible advice on here. 

[Lacessit]

The anaesthetist should be visiting you before the operation, that is the time to alert them to your concerns. They can then adjust medications and administer an anti-emetic. Or you could take Pramin a couple of hours before the operation.

What I do find objectionable is being on a surgical list, when I am required to fast and have no fluids for 9-10 hours, before I actually get wheeled into theatre. IMO it is stupid and dangerous to have patients who are dehydrated before operating. I usually sneak a few sips of water on the pretext of a toilet break, that practice has never harmed me. Having had one anaesthetist who gave me a cup of tea about 2 hours prior to a cystoscopy, I am inclined to doubt whether the constraint on fluids is necessary.

I love anaesthesia, wake up with a warm glow, and hungry enough to think hospital food is delicious.

[moogradod]

1 hour ago, advancebooking said:

No. I will ask in this public forum. Im sure there's many people who have allergies to G.A and can share their experiences. I hope this doesn't ruin your day. 

Of course you should ask the hospital which will perform the GA. In this respect I can as well not help you since I am not qualified to do that as everybody here points out as well. I would do that well before they treat you (mabe they have to order some special medicaments) and then mention it again directly to the anesthesist that will do the GA.

 

But your post was indeed not for nothing ! You have helped ME. I have used Propofol many many times to perform a colonoscopy. The last time many years ago with Propofol - after that in Thailand only with Dormicum (no Fentanyl) but out of the cost issue and not for a medical reason ! But after that I was diagnosed with a severe cardiomyophaty (not caused by the Propofol I suppose) and now I hear from you for the first time that it might be critical to use Propofol with this precondition.

 

As I have always loved the Propofol sedation (for a colonskopy it is not really deep so I was told) I will be very careful in the future once I would again do a colonoskopy and demand Propofol which would be due soon again. Thank you for the hint. Who knows, maybe this has even saved my life.

[Sheryl]

Obviously, give this full history to any future anethetists and surgeons.

 

Vomiting after anesthesia is not an "allergy".  It is a common side effect  and can usually be controlled by giving an anti-emetic drug. 

 

It would likely be the morphine in the second procedure that made you vomit (and the fentanyl in the first) , propofol usually does not (in fact has anti-nausea properties). 

 

Some people are extremely prone to nausea and vomiting from opiods. I am one...even a tiny dose of codeine in cough syrup has me vomiting severely.  I avoid opiates as much as possible and when I require anesthesia (or post op pain meds) I tell both surgeon and anethetist in advance and request that they give anti-emetic drugs prophylactically. One dose in OR before I wake up then at regular intervals thereafter.  Does the trick. 

 

If you do not normally get nauseous from opoids (e.g. if you take them in other situations without nausea) then the culprit may be Naloxone which is routinely given in the OR/procedure room or recovery room to reverse the effect of opiods when these have been used for  short term IV  sedation. Naloxone  too often causes nausea. Either way answer is the same: 

 

- avoid opiods/synthetic opoids as muchs as possible.  For IV sedation, easily done if doctor is informed of the need.

 

-when opoids are unavoidable (for example post op pain after surgery), administer anti-emetic drug routinely with each opoid dose. Do now wiait for nausea to occur first. 

 

The hot feeling you got in your chest the second time was from the morphine and a common reaction.  

[advancebooking]

2 hours ago, bkk6060 said:

I find it unbelievable that a person would come on here and ask such a question.  

Please, ask a qualified physician..

Unbelievable but theres a sensible reply above. This is a public forum where people can discuss things. Don't think too much. 

[Puccini]

You had a side-effect (vomiting) after oral administration of Dormicum and fenatinyl and as a result were listed as being allergic to both medicines. How silly.

 

If you want to find out if Dormicum makes you vomit, take a tablet at bedtime and see how it affects you.

 

Separately, on another day, take 1,000 mg (1 g) paracetamol, not fenatinyl or another opioid, and see how this affects you.

 

If you have no particularly unpleasant side-effects with both medicines, ask for these two to be given prior to your next colonoscopy. For one of my many ESWL (extra-corporeal sound wave lithotripsy) procedures for the fragmentation of kidney stones, an anaethiologist gave me this combination and I slept through the whole procedure and woke up without any ill effects.

[advancebooking]

6 hours ago, Puccini said:

You had a side-effect (vomiting) after oral administration of Dormicum and fenatinyl and as a result were listed as being allergic to both medicines. How silly.

Are you a medical doctor or just a patient? I will probably trust the doctor who gave me the allergy card suggesting I should avoid Dormicum and Fenatinyl. He has trained in Thailand and the States and currently works at the top private hospital in Bangkok. 

[worgeordie]

In a lot of films ,especially Westerns ,it seems to be a bottle of whiskey

 

regards Worgeordie

[Puccini]

46 minutes ago, advancebooking said:

Are you a medical doctor or just a patient? I will probably trust the doctor who gave me the allergy card suggesting I should avoid Dormicum and Fenatinyl. He has trained in Thailand and the States and currently works at the top private hospital in Bangkok. 

Thank you for your clarification. I understand now. You started this topic with the belief that medical doctors specialised in anasthesia would read it and give you the desired information.

 

I wish you all the best.

 

[thaibeachlovers]

17 hours ago, advancebooking said:

No. I will ask in this public forum. Im sure there's many people who have allergies to G.A and can share their experiences. I hope this doesn't ruin your day. 

NO. I worked in theatre for 10 years and the number of patients that I assisted with that had an allergy to anesthesia were ZERO.

 

Ask someone that actually knows about that thing- an anesthetist consultant would be good if you could, but failing that an anesthetist that has been doing it more than a few months.

 

What Joe Blogs on here had may not be applicable to you.

[thaibeachlovers]

I don't understand why the OP is having a GA for a colonoscopy anyway. I had one done under sedation without any problems. I could have had it done without sedation had I opted for that, but I thought it might have been a bit much.

[connda]

17 hours ago, Lacessit said:

The anaesthetist should be visiting you before the operation, that is the time to alert them to your concerns. They can then adjust medications and administer an anti-emetic. Or you could take Pramin a couple of hours before the operation.

What I do find objectionable is being on a surgical list, when I am required to fast and have no fluids for 9-10 hours, before I actually get wheeled into theatre. IMO it is stupid and dangerous to have patients who are dehydrated before operating. I usually sneak a few sips of water on the pretext of a toilet break, that practice has never harmed me. Having had one anaesthetist who gave me a cup of tea about 2 hours prior to a cystoscopy, I am inclined to doubt whether the constraint on fluids is necessary.

I love anaesthesia, wake up with a warm glow, and hungry enough to think hospital food is delicious.

Some people get sicker that a dog with GA.  My ex-wife was one.  She'd puke every time afterwards.

Me?  I'm like you.  "...wake up with a warm glow...," unless I'm in pain then I ask for morphine.

[advancebooking]

31 minutes ago, thaibeachlovers said:

I worked in theatre for 10 years and the number of patients that I assisted with that had an allergy to anesthesia were ZERO.

So it seems that you are a retired nurse. Allergies to GA are common. Read the new post from member Connda above. Another example. 

 

A lady friend from back home recently had surgery for breast cancer. She was also vomiting from the GA. 

 

Its very common. You should at least know that. 

[thaibeachlovers]

2 minutes ago, advancebooking said:

So it seems that you are a retired nurse. Allergies to GA are common. Read the new post from member Connda above. Another example. 

 

A lady friend from back home recently had surgery for breast cancer. She was also vomiting from the GA. 

 

Its very common. You should at least know that. 

The thing Connda referred to was vomiting. As Sheryl pointed out that isn't an allergy- it's a side effect.

[Tazmo]

From my experience as a Head Nurse for an Endoscopy Unit ( doing colonoscopy) and an Operating Theatre.  I would just share my experiences on the topics.

Propfol is dangerous only if not used under supervision and with the correct equipment available, so in an Operating Theatre is is considered safe and I worked where it was the drug of choice, particularly for short procedures eg day cases/ day surgery because it effect was immediate and recovery fast without a hangover, but not remembering anything, some even asked if the procedure was completed. ( I believe this was used and referred to as “ the rape drug”, and also I believe it was the drug prescribed for Michael Jackson for his insomnia, he could go off to sleep quickly and wake up to do his work. That’s what I have read. But his Doctor was prosecuted because it was prescribed without the necessary equipment available!).

 

 In the Unit for colonoscopy we  never referred to anaesthetic but said it was done ‘ under sedation’ and only used pethidine 2mgs and 2 mgs of I think midazolam?

 

Most anesthesiologists give an emetic pre operatively, as it cannot be trusted that the patient would have fasted and there is a danger of fluids etc getting into the lungs. In fact it was a standard pre op medication back in the UK. I know because I had to order drugs to restock our cabinet!

 

vomiting post surgery is not unheard of, but a rarity.  In years gone by, preparation of a post operative bed for someone returning from surgery, always had a vomit bowl. Up to 10-12 years ago this was not the case. Logically if the stomach is empty then there is nothing to vomit. But some patients do feel nauseous.  But I have never heard of an allergy that causes vomiting, but having said that I would not doubt it. I know of warm and hot feelings during the administration of a drug. Also some had become aggressive and violent with the sedative having a paradoxical effect. The ones that I saw vomited had either eaten before the procedure or ate too early after.

 

With Cardiac problems an experienced anesthesiologist would administer a spinal anesthesia. But not all anesthesiologists are trained for this.  It’s very effective and does not compromise your heart or brain functioning.

 

There should be a pre assessment before any surgery ( except emergency) and you should get the opportunity to see and discuss your condition, concerns, preferences etc with a anesthesiologist.

Personally I would not accept surgery if I didn’t have this opportunity.

Often it’s the anesthesia that kills people not the surgery.
 Where I worked in the Middle East they performed gastric banding for obesity. A patient died because of the anaesthetic and they stopped the procedure altogether!

 

 

[Doctor Tom]

23 hours ago, Lacessit said:

The anaesthetist should be visiting you before the operation, that is the time to alert them to your concerns.

That is way too late.  Conversations should have happened way before the pre op room. As soon as any surgery enters the conversations. 

[Rimmer]

A couple of abrasive inflammatory posts have been removed also a reply

[Sheryl]

7 hours ago, thaibeachlovers said:

I don't understand why the OP is having a GA for a colonoscopy anyway. I had one done under sedation without any problems. I could have had it done without sedation had I opted for that, but I thought it might have been a bit much.

He did not have GA. He had IV sedation for both procedures. Use of the term General Anesthesia is misnomer here. But a common one. 

[Sheryl]

9 hours ago, advancebooking said:

I will probably trust the doctor who gave me the allergy card suggesting I should avoid Dormicum and Fenatinyl. He has trained in Thailand and the States and currently works at the top private hospital in Bangkok. 

 

He quite probably used an allergly card as the easiest way for you to ensure you did not receive the same drug combination in future -- they don't have cards for "non allergic adverse reactions".

 

Either that (most likely) or you had more reaction than just the vomiting, perhaps before you awoke.

 

Vomiting itself is not an allergic reaction  just a fairly common side effect. Actual allergic  reactions to these drugs are extremely rare. 

 

 

 

 

[Lacessit]

13 hours ago, Doctor Tom said:

That is way too late.  Conversations should have happened way before the pre op room. As soon as any surgery enters the conversations. 

I don't know how it works where you come from, but I have never heard of anyone in Australia having had a consultation with an anesthesiologist. The surgeon, yes. The first I have ever seen of an anaesthetist is when they are preparing me for surgery.

[thaibeachlovers]

11 hours ago, Sheryl said:

He did not have GA. He had IV sedation for both procedures. Use of the term General Anesthesia is misnomer here. But a common one. 

Thank you for that clarification.