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An interview with Lucas Brozek, anesthesiologist

Patients worry about anesthesia.

In my office I noticed that many of my patients worry about anesthesia. Because the success of an operation does not only depend on me, but on the entire team that take care of our patients at Bergman Clinics, I thought it important for this blog to discuss anesthesia with my associate anesthesiologist Lucas Brozek te praten over de narcose.

1. What percentage of patients is afraid of anesthesia?

About 50% of the patients is anxious of anesthesia.

2. Is that anxiety justified?

That anxiety is completely uncalled for, because nowadays anesthesia is very safe. There's not a place where a patient is monitored better than during anesthesia in an operating room. You see, all important vital signs like blood pressure, pulse rate, amount of oxygen iin the blood, pulsations in the fingers, and lung ventilation are being recorded continuously, and corrected as soon as there's even the smallest deviation. It's my opinion that sleeping at home after having a good few drinks is a lot more dangerous than anesthesia.

3. What can people do to be less afraid?

If a person is very nervous, they can always take a sleeping pill on the night before their operation. Extremely anxious people will receive a tranquilizer tablet when they arrive at our clinic.

4. More and more has become known about the calming and healing effects of music. Do you at Bergman Clinics ever make use of that? If not, would people be allowed to bring their own music on their iPod or phone?

At the moment we do not use music as yet, but everybody can bring their own music on their iPod or phone, and this can be anything: from singing whales to hardrock or from Bach to gurgling mountain streams. Do bring your own headphones, though!

5. How often does it go wrong?

Not very often, and if that happens, it's almost always because a patient is very old and / or seriously ill. In the past, and then I'm talking about the previous century, about the sixties, things sometimes went wrong because the equipment and the monitoring techniques were still quite primitive. That has been improved enormously in the last 50 years, to a safety of nearly 100%. It is comparable with flying. Fifty years ago quite a few accidents happened with flying, but nowadays these are very rare.

6. Could anesthesia cause permanent damage?

If anything would go wrong, yes, that could happen. That did happen a few times in the previous century, but nowadays that chance is next to nothing.

7. What happens actually when you doze off under anesthesia?

You will fall in a very deep sleep, medication will relax your muscles and your respiration will be taken over by a ventilation machine. That deep sleep will be maintained during the entire operation by continuous administration of sleeping medication.

8. Will you get crazy dreams from anesthesia?

Typically no dreams are being observed because your sleep is so deep. Sometimes we hear patients talk about dreams, but I think that happens while they are gradually waking up.

9. Will people ever wake up during anesthesia?

Unfortunately, that does happen very rarely, because of a particular anesthetic technique, or because people forget to switch on the continuous sleep medication. At Bergman Clinics we use an anesthetic technique where waking up during the operation is as good as impossible. This technique means that you are kept asleep by a precise dosage of gaseous sleeping medication which is continuously added to the inhalation air.

10. Is a local anesthetic also an option?

For some procedures that is certainly possible, for example in hand or foot surgery. Selective anesthesia of the lower body is also an option, using an epidural. During your spinal or neck surgery at Bergman Clinics you will receive a so-called general anesthesia. This means you will be in a deep sleep, completely still and won't notice anything.

11. Is nitrous oxide as much fun as they say?

Nitrous oxide, if inhaled, is fun for just a few moments, when it will give you a happy feeling. But inhaling nitrous oxide for too long, is dangerous because your blood will not get enough oxygen. That is why in operating rooms it is always given in combination with oxygen.

12. Will you be nauseous after anesthesia?

You could be nauseous, but this mostly happens after abdominal procedures. And nausea following surgery is often caused by morphine, given against wound pain after surgery.

13. Why is it nice to be an anesthesiologist, and do you only work at Bergman Clinics?

It is great to be an anesthesiologist, because our profession is quite dynamic and has many aspects, technical as well as social. We support our patients through the entire period of the operation, estimating the risks in advance, ensuring a good palliative treatment, and anticipating anything unexpected.

For a few years now I've been working at Bergman Clinics exclusively. I see this as a great advantage, for now I can focus completely on all the customary procedures here.

14. Will you stay at the table during the entire operation?

In the Netherlands we have a flexible two-table system. This means that the anesthesiologist is taking care of the anesthesia in 2 operating rooms at the same time; so he cannot be present at the operation all the time. However, there will always be an anesthetic assistant present, a specially trained nurse, who will continuously assist the anesthesiologist and will stay with the patient. It is comparable with flying: there is a pilot (anesthesiologist) and a co-pilot (anesthetic assistant).

15. Have you ever been under anesthesia yourself, and if so, how did you like it?

Yes, certainly, and I loved it. What I did not like too much is that I had to fast before my surgery. I really missed my breakfast!

II eat at the restaurant here at Bergman Clinics every day, and I can assure you that your first meal, when you're conscious again, will certainly taste great. Thank you so much, Lucas, for your clear answers!

Surgery manual

Dr. Schröder is happy to inform you about the surgical treatment of your neck or back condition. He also discusses the possible complications of the procedure with you.

After you've carefully weighed up the pros and cons of the surgery, you can decide for yourself whether you consider your condition serious enough to operate.

View the surgery manual

  • Instructions for after you have left the clinic

    Once you leave the clinic:

    • Make sure that someone comes and picks you up in a car, and refrain from driving yourself
    • Make sure that you recline your car seat
    • Make sure that you are not home alone for the first few days following the operation
    • Allow the wound to heal for the first 2 to 3 weeks
    • You are allowed to shower, as the nurses will give you a waterproof plaster to cover your wound before you leave the clinic
    • You must not drive for 3 weeks, but you will be allowed to sit in the passenger seat while someone else drives you around
    • You are allowed to do whatever you feel up to, as long as you keep listening to your body and stop doing whatever it is you are doing whenever your body tells you to stop

    Your doctor, nurse and/or physiotherapist will provide you with more information on how to look after yourself following the operation.

  • How long will I have to stay at the clinic?

    Depends on the nature of the operation

    The duration of your stay with us will depend on your situation and on the type of surgery you are undergoing. If everything goes according to plan, and if you are undergoing a minor back or neck operation, you will only have to stay with us for one night. If you are undergoing major surgery, such as a spinal instability operation, you will generally have to spend a few nights at our clinics.

  • Swelling after surgery

    Swelling reduced after 2 to 3 months

    After the operation, your wound will swell, which may be painless but may also be a little uncomfortable due to your skin being pulled so taut. Generally speaking, the swelling will subside of its own accord within 2 to 3 months of the operation, and the skin will grow less thick.

  • Medication after surgery

    Following the operation, you will be given painkillers for as long as you need them. You will receive these painkillers in accordance with a set schedule. It is vital that you take your medication at the scheduled times, even when you are not experiencing any pain. In this way, your body will build up a steady level of analgesia.

    Most people will be able to stop taking painkillers a few days after undergoing back or neck surgery. If your painkillers somehow fail to provide you with a sufficient level of relief, we recommend that you notify a nurse as soon as possible. If you were on morphine-like medication prior to your operation, we advise that you gradually cut down on your medication after the operation, if your level of pain allows you to do so, in consultation with your GP. Acute withdrawal may result in adverse events.

  • Post-operative pain

    If you are experiencing an excessive amount of pain, you will receive additional painkillers

    The level of post-operative pain differs from person to person, and from operation to operation. Generally speaking, major lengthy operations will prove more painful than brief minor operations. At our clinics, all patients receive proper painkillers following surgery, as a result of which very few of our patients ever experience a great deal of pain. In consultation with yourself, we will determine your pain score, both at the ward and once you are home (we will call you to discuss this with you). If your pain score is too high, you will be given additional painkillers.

100% insurance covery

Nearly all treatments performed by Dr Schröder are covered by health insurance. This is true for the following conditions: neck hernia, spinal hernia, lumbar spinal stenosis and cervical spinal stenosis.

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Dr Schröder's blog

Dr Schröder regularly publishes new articles on his blog. Read all about spinal hernia, neck hernia, spinal stenosis, neurosurgery and other related subjects.

View all blog posts

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  • 12. Dozing off

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  • 10. Sherlock Holmes and Dr Watson

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