12. Dozing off

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!