Hacker News Reader

Comment by tptacek | Hacker News Reader

Sure. That makes sense. You gave me enough keywords with that comment to look up electrical cardioversion and pain, and so now there's something new that I'm scared of (kale for dinner tonight!) (thanks!).

But that's actually something different than what I'm asking. I have no trouble understanding why I wouldn't want to remember a pain "similar to that of surgical incision". Similarly: I wouldn't want to remember an unanesthetized incision!

But before learning that surgical patients were routinely given midazolam to zap their memory, my impression was that surgical patients were completely zonked out by general anesthesia, and so there'd be no need to zap their memory, because they weren't going to consciously experience the incision in the first place.

Now I'm like, is all of general anesthesia a scam, and we're all enduring horrible pain, and we just don't remember it? J/K ONLY SERIOUS.

View on HN

Midaz can be used as premedication before induction of general anesthesia, but it's not an induction agent itself. If you're getting general (as opposed to "twilight") anesthesia, once you're induced, you should be unconscious (to the best of our ability to understand consciousness).

I'm medicine, not anesthesia, so I don't use these agents all day and therefore referred to cardioversion which is more in my domain. Cheers!

I am noting with interest and a small amount of alarm the abruptness with which you've ejected yourself from this thread after my suggestion that all of anesthesia is a huge scam. :)

FWIW, unlikely. I specifically remember being asked to count down from 10, going like 8 7 6 ... 5 wait I feel weird and sleepy. That is, my first thought after being woken up was the next number in sequence.

It seems unlikely that would be the case if the time inbetween was spent thinking 'oh my god this hurts so much' rather than just blacked out.

Were you given a benzo specifically to erase your memory of the events? Because this thread is about the fact that many (maybe most) surgical patients are.

(Let me clear, I'm being deliberately silly about all this. I do not think there is a huge anesthesia conspiracy. I am, at the same time, seriously skeeved out by having my memory deliberately tampered with.)

> Were you given a benzo specifically to erase your memory of the events?

I don't remember! :P

Offering tptacek a dose of midaz: There is no thread.

I asked an anesthesiologist this question and am transcribing from memory (hehe), so I may have screwed some things up.

The answer to your question in is no, you aren't suffering enduring horrible pain while under general anesthesia. That doesn't mean you won't experience things you would rather not remember. Some examples: 1) patient may experience burning sensation from propofol (induction agent) entering the body 2) patient may see something disturbing before general has kicked in (e.g. a big saw before an orthopedic procedure) 3) in certain cases (e.g. emergencies) or due to human error, patient may not be fully under pre-surgery, e.g. patient may remember breathing tube being inserted.

The high level answer for why you are given midazolam (at least in the US) is because anesthesia is a "patient satisfaction" service and giving it increases patient satisfaction.

Reply on news.ycombinator.com