Social Question

SmashTheState's avatar

Would you use general anaesthetic if you knew how it really worked?

Asked by SmashTheState (9603 points ) December 22nd, 2011

No one knows exactly how or why general anaesthetic works. It doesn’t make you sleep; sleep is a very specific brain state. While under the effect of general anaesthetic, you are completely awake. You just aren’t conscious. Probably.

There are some theories about how anaesthesia works. In one such theory, Sir Roger Penrose argues that anaesthesia freezes the proteins lining the microtubules in the neurons of the brain into a single eigenstate, collapsing the probability wave which is consciousness – in effect, causing reversible death. After dying, a new person is created from the stored memories of the person who died.

There are other theories, however. Another theory is that we are both conscious and awake while under anaesthesia, but completely paralyzed, and that the effect is to prevent the formation of long-term memory of our experience.

If you knew for a certainty that one of these models was in fact accurate – that it either causes death or that you remain awake and conscious through the entire medical procedure – would you ever again agree to take general anaesthetic?

(True story: I was recently in the hospital with a life-threatening infection. The nurses would come during the night to have these sorts of discussions with me, and I brought up this very topic with one of them. After explaining it to her, she stared at me wordlessly for perhaps ten to fifteen seconds while the horror of it dawned on her. When she could speak again, she said, “I… don’t think I’ll be discussing this with my other patients.” And left, shaken.)

Observing members: 0 Composing members: 0

56 Answers

ANef_is_Enuf's avatar

I don’t plan to have surgery unless it’s pretty damn important that I do so, so, weighing my options… most likely I would.

lillycoyote's avatar

I’ve had a couple of minor surgeries and was given the option of “going under” and declined in favor of deep tranquilization and a local because there is always a risk under general anesthesia and I didn’t think it worth the risk if there were options. I even always asked if procedures for my cats could be done under a local, if that was an option. But there are a whole lot of surgeries where there is no other way. What should people do? There no choice in many cases. You want a triple bypass under a local? Can’t be done.

Symbeline's avatar

Probably, if my life was at stake. I mean, what do I have to lose in that case? And such a case is pretty much the only reason I’d go under the knife for, so to speak. Or, I guess, lesser reasons that I may be convinced should be undertaken to avoid big problems later on. I know one person who was ’‘put to sleep’’, and she says that during that time, she had the most horrible nightmare. :/ (which seemed to have lasted about five minutes for her, but she was out for the longest time…so weird)
But yeah I probbaly would, although I would be damn nervous and scared as hell. :/

Boogabooga1's avatar

haha.
I had an awesome trip whilst under general anesthetic for nearly 2 hours.
Did I die and arise a new person? maybe yes…. but is that any different from awaking after a lucid dream? I believe I am a changed person after dreaming.
We change every minute of every day , lets not get our knickers in a twist about anesthesia.
Of course it changes us, but what doesn’t ?

King_Pariah's avatar

Every injury I have sustained I have only done local anaesthesia as well as for wisdom teeth removal.

lillycoyote's avatar

@SmashTheState I only just read your details. While Sir Roger Penrose is most certainly a brilliant physicist you should at least mention that his views on this matter are the result of his collaboration with the anesthesiologist Stuart Hameroff. I believe he was the one who brought the idea of microtubules to the attention of Penrose. Their research into consciousness is pretty interesting.

Male's avatar

Now that you put it that way…

augustlan's avatar

My first choice is no anesthesia at all. I’ve had my teeth worked on in all sorts of ways, a kidney biopsy (needle/core type), raised scars removed, and amniocentesis without the benefit of any anesthetic. I also gave birth to 3 babies with no epidural. If anesthesia is a must, I choose local when possible ( I had half a lymph node removed in my neck with just a local.)

But… when you have to have major surgery, you don’t really have much of a choice. I damn sure wasn’t going to have a hysterectomy without general anesthesia!

How I understand it to work is that you are paralyzed. Many people don’t realize you can’t even breathe on your own when you’re under. But it’s a risk you’ve got to take, sometimes, you know?

SmashTheState's avatar

@Boogabooga1 The wide consensus among philosophers is that we recognize self through the perception of a continuation of identity. The Ship of Thesus Paradox is about this very problem. If indeed we are a single entity with a single life, then that identity emerges from the perception of a single, uninterrupted perception of being. If anaesthesia acts to cause death, to eliminate the consciousness (remember, it’s not sleep, sleep is a very specific brain state, and not something which occurs under anaesthesia), then whatever entity emerges from the stored memories of previous experience on the other side is not you. You died on the operating table, and another entity very much like you took your place. I don’t know about you, but I am not sanguine about committing suicide so that some stranger can have my life in perfect health.

@lillycoyote You are of course correct. I probably should have mentioned that, but the focus of the question wasn’t specifically the quantum brain model.

@augustlan What if the effect is simply to paralyze you, leaving you completely awake and unable to move or scream while they’re operating on you – and then to prevent you from forming long-term memories of the experience? We know that there are drugs like Rohypnol (“roofies”) which do just that, prevent the transfer of short-term memory to long-term memory. Would you ever agree to use general anaesthesia if you knew for a certainty that this was the effect?

judochop's avatar

Bring on the general ana. If I wake up then awesome. If I don’t, I am mostly fine with that too. If it really aligned itself as a new you every time you woke up from it I bet it would be used to cure PTSD. Until then…I will just ponder I guess.

SmashTheState's avatar

@judochop There is a drug being tested right now which erases the emotional response associated with a stored memory, and which is in fact being considered for use in PTSD. Every time a memory is recalled, it is moved from long-term to short-term storage. If it is not re-saved in long-term storage, it gets erased. While the memory is in short-term storage, it can be modified and then re-saved, effectively changing the memory of an experience. There is a real possibility that anaesthetic could really be simply eliminating your memory of the horrific experience of being paralyzed and unable to tell anyone you’re completely awake while they’re cutting you open.

stardust's avatar

I’ve had to undergo general anaesthetic three times so far for different surgeries. Reading it from this perspective, I’d answer yes, as I’d probably have nothing to lose either way if I was to be in such a situation again and needed the surgery to live.

wundayatta's avatar

I’m big into recreational anesthesia. Now that I know it causes death, I am so much more excited about it! The more rebirths, the better! One of these days, I’ll get the hang of life.

wilma's avatar

I’ve been under general anesthesia nine times. ( I think nine, it may be more I sometimes forget.)
Each time I have felt I was a little bit stupider (for lack of a better word) when the surgery is over. It takes me a few weeks to recover my short and sometimes long term memory. I don’t like it at all, but when you need certain surgeries there is no other choice.

Once when being taken back to my room from the recovery room, I was talking about the color of the shoes of the OR nurse. I had never seen her feet, I was flat on my back all the time I was conscious. I was flipped to my stomach for spinal surgery after the anesthetic was administered and was on my back when I woke up in recovery. The surgery was done on one of those tables with the hole for your face. The only time I could have seen her feet was under the anesthetic during the surgery.

@SmashTheState I am very uncomfortable thinking about how the anesthetic might work, but I would not be alive today without at least two of my surgeries, and I would be crippled and paralyzed without a few of the others. I’m dealing with it as best I can.

JLeslie's avatar

I don’t understand people who are so cavalier about surgery under general I assume they must really have no clue what it entails, or how dangerous it can be. Of course sometimes it is necessary. Even more frustrating is I don’t understand why doctors love to put patients under, when local or a block will work just fine. They don’t even offer the options to a patient.

Earthflag's avatar

When I was about to get my wisdom teeth taken (which was a big deal because they wer going to cut my gums etc.), my doctor said I need general because I’m a chicken. And then I didn’t do general, and it was perfectly fine with morphine. It’s better without general, always, because they don’t care, and after the surgery you may have more pain than you would otherwise. Since they know you’re not “awake”, they are more aggressive on you.

CWOTUS's avatar

So, tell me: Is there anything that we humans do that isn’t dangerous “when you think about it”?

Let’s ask this question in a different way, shall we?

If you needed a life-saving operation that required total immobilization and were already in considerable pain, would you prefer to be strapped down on an operating table with or without general anesthesia? I’ve only been under twice in my life (and at five years of age the first time, I didn’t have a vote), but I wouldn’t strongly consider the operations that I had any other way for any other child. Knowing what I know now, I’d make the exact same choices that my parents made.

Leanne1986's avatar

Honestly, yes I would use it. As I have been under a general anaesthetic before I am confident that it did me no harm regardless of how it works.

marinelife's avatar

What choice would I have if I was undergoing surgery?

fizzbanger's avatar

This was my experience being put under for wisdom teeth: it felt like I blinked, and then suddenly woke up in a chair in a different room with a dry mouthful of cotton. It wasn’t unpleasant at all, just weird.

I have to “trick” myself into not thinking about procedures – I’d rather be unconscious and unaware, out of squeamishness and irrational fear. This is probably the case for lots of people. I can’t watch a needle going into my arm, and couldn’t think about how corrective eye surgery is done until after it was over.

the100thmonkey's avatar

I think, perhaps, that your definition of ‘consciousness’ is therefore in need of redefinition.

Consciousness is not something that ‘inhabits’ a body; it is the body.

whitenoise's avatar

I’ve been under anesthesia twice and the idea that I died and awoke from death twice seems pretty cool.

There once was a guy that was claimed to have done it only once and people are still impressed over two thousand years later.

Mariah's avatar

Because of the risks I already don’t use it unless I have to. When I have to, I don’t exactly have a choice, so if this is true it doesn’t change anything for me.

Really, too, it seems more a metaphysical problem than anything with a real tangible effect. I don’t feel like a different person after general anesthesia, so why does it really matter?

JLeslie's avatar

You aren’t dead really, it’s just that there is a machine breathing for you.

wundayatta's avatar

I feel a discontinuity of consciousness every time I go to sleep. Being under anesthesia feels the same as being asleep, as far as I can tell. I remember nothing. On rare occasions I may remember that I dreamed and on even rarer occasions I may remember what the dream was, but it is almost always this consciousness ceasura—just the same as going under anesthesia.

I love to think. I like to think about the nature of consciousness, but it seems to me that while these theories may have fascinating intellectual consequences, they mean nothing as far as life as we know it is concerned.

whitenoise's avatar

Of course you’re not dead. If you were, you wouldn’t wake up.

At least not in the sense of dead after death: a permanent cessation of all vital functions : the end of life. (webster)

JLeslie's avatar

@whitenoise I was writing to the OP. Sorry, I should have made that more clear.

whitenoise's avatar

@JLeslie just wanted to agree with you. :-)

SmashTheState's avatar

I must be a very stupid man, because a lot of the things which seem so incredibly obvious to everyone else are things I struggle with daily. For instance, concepts like identity, life, death, self, and the perception of the continuity of consciousness seem elusive to me, but everyone else appears to understand them very clearly. Perhaps someone smarter than me could take a crack at my ignorance?

Just as an example, it’s clear to everyone else that a disruption in the flow of internal narrative which constitutes identity isn’t death. Can someone explain this to me in words I can understand?

CWOTUS's avatar

I wouldn’t want to try.

whitenoise's avatar

Death is the end of life / alive. Life and alive, that is what you and your body are.

It depends how you view your life. Are you of the opinion that your soul and your body are different and can live / die independent of each other? Then I guess your body and soul can die seperately as well.

I feel my soul, life and physical being are inseparately one, a sort of trinity. None can die without the other dying. So…. when my body doesn’t die, I don’t, so there is no death.

Death is the end… irreversible ending of life.

MilkyWay's avatar

@Leanne1986 GA.
I would, because I don’t believe in any of the theories listed above. I’ve been under earlier this year, and I don’t hink I woke as a different person…

Coloma's avatar

I’ve been aware of this for years, the lack of explanation for the exact “how” general anesthesia works.

All I can say is that having major kidney surgery and a pin put in my shoulder after a horse wreck, well…I’ll take my chances any day of the week opposed to having someone give me a shot of booze and stuff a rag in my mouth before whipping out the surgical tools.lol

I’m a middle pather, have employed many holistic medical options, and have even used medical hypnotherapy but, if I get hit by a bus you better believe I want the general when they are pinning and stitching me back together again.

Mariah's avatar

@SmashTheState, in my mind death isn’t something you can come back from. Sure it is possible to be resussitated from “legal” death (no pulse, etc.) but when that’s the case I don’t think the person was “really” dead. I agree with @whitenoise; death is permanent.

CaptainHarley's avatar

There’s a relatively new anesthetic drug in use which acts by not allowing the brain to create memories longer than about a second. They used it on me when I had a colonoscopy. When I had an operation to remove my gallbladder ( I had stones ), they stopped my breathing during the operation because the act of breathing makes for too much movement in the torso.

As to general anesthesia, which would you rather… be totally out of it ( regardless of the mechanics ), or feel them slicing into you? Hmmm?

CaptainHarley's avatar

@Mariah

A wonderful little book! I bought a copy for each of my children, and a child’s version for each of my grandchildren:

http://www.amazon.com/Heaven-Real-Little-Astounding-Story/dp/0849946158

That is, if you’re not one of those people who close their minds a priori. : )

nikipedia's avatar

Agreed—reversible death ain’t death. I’m fine with having my eigenstate collapsed, as long as I get it back at some point. Most people enjoy a temporary loss of consciousness. I know I do.

Forgive me for also making a pedantic distinction. You referenced a study above that used propranolol to modify memories. That is very different from memory loss due to anesthesia. Our lab actually studies both of these phenomena and published the first study to use propranolol in humans to modify memory. Propranolol and other beta-blockers modify the emotional strength of a memory—you probably remember Tuesday, September 11, but not Tuesday, September 18, because the first had an emotional component. The idea is that beta-blockers can make the memory of September 11 more like the memory of September 18.

But memory loss due to anesthesia is much more powerful. These drugs can prevent memories from being formed in the first place, but they can also retrogradely erase memories (within a very short window). Propofol, for instance, can completely remove any explicit memory of an event that took place very recently (within the last few seconds to minutes) or an event taking place after administration.

Interestingly, though, it does not eliminate implicit memory

filmfann's avatar

My wife had surgery last week, and she was under a general anaesthetic. Are you saying I am now a widower, or married to a clone?
She came out of it fine. Her friend had the same surgery yesterday, and she was unable to leave the hospital yesterday, because she was so nauseous from the anaesthetic.
In short, this shit is scary enough without listening to your argument.

CaptainHarley's avatar

If true, this has staggering implications for the future of ( what to call it? ) “resurrection?” “Recusitation?” “Reanimation?” “Cloning?” It also raises the question of what, exactly, defines a person, a personality, consciousness,

Ron_C's avatar

If I am going to be cut open (it’s happened occasionally) I want to be out of it as far as possible. I don’t really care if I die and am reanimated. I just don’t want the pain. I remember thinking “this is going to hurt” when I was being awakened after my last operation and fought very hard to stay asleep. I would just as soon stay “dead” until the pain goes away.

deni's avatar

I always knew it was kinda a funky thing. I’ve only had it once, when I had a plate and screws put into my broken foot. THe other option was to do some thing that makes you totally numb from the waist down but you’re awake….that didn’t sound too exciting either, I don’t want to be paralyzed by some freak accident! So, though I don’t know how it works and apparently no one else does either, I’d rather use it in situations where something like that is necessary than just feel them sawing into my foot, or risk paralysis. I feel like if it was that untrustworthy of a method, you’d hear about all the times it went wrong. Or maybe I’m out of the loop on that. But I don’t think so. I’ll just try my best to avoid needing it in the first place by not stumbling drunkenly off anymore curbs.

6rant6's avatar

I don’t care what the “real explanation” is. I only care about my perception of what’s going on which I would extrapolate from others’ experience.

Oh, and the not dying in a permanent kind of way would be good, too.

augustlan's avatar

@SmashTheState Even if I knew for sure that what you describe is how it really is (awake, but paralyzed and unable to remember the event), I would still opt for general anesthesia when necessary. As long as I don’t remember it, it has no perceivable effect on me. I’m okay with that. That said, it would be more difficult for me to make that choice for someone else (like my child). I’d still do it if she really needed it, though. It’s a cost/benefit type of thing.

flutherother's avatar

If I’m going to have my appendix removed I would rather not be present while it happened. Perhaps the entire Universe is annihilated every instant only to be miraculously put back together again the next. Who knows?

lillycoyote's avatar

@flutherother Exactly. And perhaps the entire Universe is annihilated every instant only to be miraculously put back together again the next. Who knows? And as long as you wake up from your surgery alive and well, and with a Demerol drip, who cares?

CaptainHarley's avatar

@lillycoyote

Ah, Demerol! Demerol makes the world go away and gets it off my shoulders. First time it was used on me was when I couldn’t pass a kidney stone for awhile. It was like I was laying on a beach somewhere and a small, delightfully warm little wave slowly washed over me and I went floating away! Wheeeee! LOL!

wilma's avatar

@CaptainHarley…I’ll have what he’s having…

SavoirFaire's avatar

Neither theory bothers me. If the Penrose theory is true, then it’s basically the Humean view that personal identity is an illusion in the first place. We change second to second, each conscious state is a manifestation only of our current molecular arrangement, and the notion that they are unified into one continuous being is merely another part of the manifestation.

If the alternative theory is true, then my options are to go through the pain once, or to go through the pain over and over again (once for real, the other times through memory). It is obvious to me which scenario is preferable.

JLeslie's avatar

@CaptainHarley They have been using amnesiac drugs for a very long time. And, for your colonscopy I would assume they gave you Diprivan. I don’t know about any new drug, but if you know the name I would be very interested actually.

CaptainHarley's avatar

LMAO @wilma !!

@JLeslie

I’m sorry, but I don’t remember the name. All I know is that even though you can follow instructions, you don’t remember things from one second to the next. I remember the doctor telling me that people try their damndest to get their hands on it for use in… certain situations! LOL!

JilltheTooth's avatar

I never in my life thought I would say this, but I have to agree with @6rant6 on this. My perception of what happens to me in this circumstance is more important to me than the theories presented by others, here. If I overthink it, every single day in my normal life I flirt with death, by making choices that I know could be fatal. I drive a car, I walk on sidewalks next to busy streets, I fly in commercial aircraft, I eat food that I have not grown or prepared myself. Stepping out of my house is potentially lethal because I might slip and fall and crack my head on concrete. I have had general anesthesia a number of times and I am neither “cavalier” nor careless, but I am still alive and happy. Go figure. Living on the edge is still living…

augustlan's avatar

I’m curious, @SmashTheState… would you refuse to go under to correct a serious medical problem?

SmashTheState's avatar

@augustlan I already have. I recently spent two and a half months in agony with revolving infections – not something desirable for a diabetic – from impacted wisdom teeth, rather than risk the possibility of general anaesthesia.

SavoirFaire's avatar

@SmashTheState Why show so much attachment to something you think is an illusion?

wundayatta's avatar

@SmashTheState My condolences on your stupidity. But of course, as you surely know, the issue is not one of having greater understanding of abstract concepts than you do. The point is that no one really needs to have a deep understanding of the meaning of these terms in order to lead a perfectly fine life. Further, most people don’t see how a better understanding is going to materially change their lives.

Your stupidity, if you insist on calling it that (I wouldn’t, for the record), is in thinking that the unpacking of these concepts means much to anyone in a purely theoretical way. Theory only makes a fair minority of people cream in their pants. You are surely one of them. You know full well that no one else cares as much as you do. Perhaps you meant to ask a different question?

Carol's avatar

@SmashTheState Man, I bet those nurses ran for their lives not knowing if you were dangerous or not.

Answer this question

Login

or

Join

to answer.
Your answer will be saved while you login or join.

Have a question? Ask Fluther!

What do you know more about?
or
Knowledge Networking @ Fluther