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Comment by spacedoutman | Hacker News Reader

I have a similar view on general anesthesia now, everyone i know(including myself) that has had operations have been permanently affected by anesthesia.

Turning yourself off breaks far more than doctors realize i fear.

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I'm not sure what you mean. I've been under general anesthesia a few times and not had any negative consequences. My dad has had multiple brain surgeries, and he's fully functional. Most people I know have been under at least once.

I think before you blame anaesthesia it's worth wondering what else happened to you on the table, or whether something else might be causing you the problems. A lot of other things happen during a surgery that can screw you up pretty badly. I'm pretty sure I was dropped off a table once.

Well, there's a small chance anesthesia can affect you negatively. Like all medical interventions, it can have side effects.

I don't think anyone would debate that. But if someone is going to go with a completely unverified "everyone I know" scare tactic about a common medical procedure, then I might as well respond with the fact that everyone I know hasn't had any problems with it. It would be completely different if they said they had suffered a rare side effect which only affected them. Instead, their point seems to be that it's widely dangerous, and their only evidence for that is a vague set of symptoms they experienced which, even more vaguely, "everyone" experienced "some of".

So we've departed from the realm of clinical analysis and entered the realm of hearsay and feelings. And on that level, such a claim cannot be challenged with facts or statistics. But what an irrational claim can be challenged with is equal assertions of irrational feelings toward the opposite.

In other words, I would challenge a rational claim with another rational claim, but I won't bother with that for people whose arguments aren't based on reason. In that case, it's best to throw out a hearsay claim in exchange for a hearsay claim, and save your facts for people who care.

The goal of winning an argument isn't to convince someone that they're wrong (if this person is even real or believes what they say), it's to show the flaws in their reasoning to whoever they're trying to convince.

Yes, some people are irrationally afraid of certain medical procedures.

I think if there was such a side-effect with such a commonly-used tool, someone would have noticed by now.

Would you be willing to share more details, instead of this rather vague claim? I've had three at least 2 hour long operations last year. I kind of wondered if I'd notice any aftereffects, but apparently didn't. Even waking up was pretty uneventful, consciousness just coming back like a light bulb being turned on again.

So either I am an exception, or your "everyone I know" needs qualification. In any case, I'd be very interested in what aftereffects you noticed, maybe that helps me reflect.

For me and others(in my circle with operations, 5) the waking up part is multiple hours of a drugged feeling, like you really aren't on the same planet anymore.

Currently have a family member in hospital and 4 days later they are still dealing with the effects.

I assume this is probably a regional/country issue, australian public hospitals are pretty sub-standard.

I mean, maybe what do you think about 4 weeks later? If I'm being put under I think more than 4 days is reasonable to expect my mind to recover. If I have a terrible flu I could be in a fog for as few.

However this is not to diminish your report specifically, just that in terms of what I care about long-term it is the >2 weeks effects

Anesthesiologist here: what you are referring to exists, but is rare and is not related to general anesthesia (equally likely in operations performed while patients are awake with regional anesthesia or under general anesthesia). It is more people with pre-existing cognitive dysfunction that are elderly do not handle the inflammatory milieu generated by surgery. You can Google “postoperative cognitive dysfunction” for more information.

Any phenomenon more widespread than the above is simply not supported by scientific studies to date.

I’m honestly a bit disappointed to find this comment on hacker news, as I feel the level of discourse here is usually higher. I wish you all the best and hope you recover from whatever you’re experiencing, but this is frankly fearmongering.

If I'm understanding the "inflammatory milieu generated by surgery" part correctly, does this imply that the cognitive effects would be equally likely if surgery were performed without any kind of anesthesia? (Or to put it another way: the anesthesia isn't directly implicated, it's just that anesthesia and surgery tend to go hand in hand...?)

Right, there are operations that are sometimes performed with minimal (or sometimes even 0 sedation) with just a nerve block (regional anesthesia) which impairs sensation locally (like you get when a dentist numbs up your mouth, but you’re still awake). They have the same rates of cognitive dysfunction afterward.

I know its not meant to be common, but literally everyone i know that has had to go under woke up not the same person anymore.

Honestly, i doubt its as rare as you think.

My bet is just poor training in my country.

Could you elaborate on specific effects?

Lots of replies to this comment so i won't reply to everyone.

brain fogs, migraines/headaches, memory problems. sudden attitude changes, lifestyle changes. divorces from a partner suddenly hating everything about the other partner. fatigue, mental fatigue. Just to name a few.

Not everyone i know has the same issues, some are worse then others. If its so rare i don't see how everyone in my small circle all got permanent side effects.

Thank you, some of the effects I felt, and I have even worse stuff, and even though I had been anesthetized multiple times in my life (also naturally with a concussion), but how could I prove cause and effect? There is no second me who did not go through the same procedures to compare myself.

Evidence?

there is litterature on that. you need to assume that no medical intervention has no effect, by default.

Oh yes, I'm in agreement with you there

Exacerbated by astonishing overuse for anything from a 2-minute endoscopy to a 15-minute hand surgery. The pursuit of “comfort” at the cost of fractional lobotomy.

One of the joys of private healthcare: I've seen general anaesthesia used to allow the patient to claim on their inpatient cover instead of their (exhausted) outpatient cover.

You're suggesting people undergo endoscopy without anesthesia? You go first, bud.

Which end are we scoping? Colonoscopy is often done without anaesthesia but tends to take longer than 2 minutes, so I'm not sure if that's what OC is referring to. It's uncomfortable, but that's ok. Scoping nose/mouth->stomach also doesn't come with any drugs, just some lube.

Conscious sedation, which is not the same thing as general anesthesia, is often used for endoscopy:

https://www.northerncarealliance.nhs.uk/patient-information/...

And sometimes it doesn't work. Patients are then given the option of going ahead without sedation, or rescheduling for general anaesthesia.

But even "general anesthesia" still has differing categories.

Surgery uses propofol plus a gas anesthesia for "general anesthesia", but it is considered "general anesthesia" even if only propofol is used.

Hmm, I got one and they used ketamine and an amnesiatic. Not considered general anesthesia but I don't remember a thing. This was in the US.

I've done it (it's standard in many countries). Honestly, it's a bit horrifying because you are completely at the mercy of someone else but it's bearable. Colonoscopy is definitely easier.

My only experience with global anesthesia was as a child waking up with a massive asthma attack unable to breathe so I try to avoid it.

> Honestly, it's a bit horrifying because you are completely at the mercy of someone else but it's bearable.

Probably not as horrifying as brain surgery or getting your eyes lasered.

very common. doing it routinely. you never heard of it?

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