anesthetic and the heart

[Oosik]

I read something on another board about a UW saying that she thought a general anethetic was bad for the heart.

My fiance and I had been talking about dentists (her teeth are pretty nice) and she said she could not take anesthetic because of her heart. This scared the crap out of me, and had me wondering if she had a heart defect. Is the "bad for the heart" thing common in Russia/Ukraine? Should I not read anything into her comment?

Not that it would stop me from marrying her, I fell in love with her and people with health problems deserve love too.

[catzenmouse]

Oosik,

 Did you ask her why she thought this? Or better maybe, who told her this? It is fairly common for FSUW to believe something a friend said as gospel without checking it out.

Ken

[TigerPaws]

Oosik,

 Did you ask her why she thought this? Or better maybe, who told her this? It is fairly common for FSUW to believe something a friend said as gospel without checking it out.

Ken

  In my experience this is a very common problem and perhaps worth further discussion?

 

[Oosik]

I don't know where she heardit from, but I'm hoping that it is just something that gets thrown out when someone can't afford to pay for anesthetic.

My god, can you imagine fillings w/o numbing?

Yeah, we look to the FSU for weak women.........

[BC]

When we last went to the dentist here they asked if we had ever had an allergic reaction to local or general anesthesia..

I wonder why..

Some do have allergic reactions.

I remember having injured my eye and it hurt like hell..  the doc put in a few drops of what was essentially diluted cocaine.. I was higher than a kite for a while.. my heart got a lot of excercise.. I laughed all the way home... Don't think I was allergic though.. LOL

[andrewfi]

There is a difference between having a needle in the gob for a filling and a general anethsetic.

General anethsetic DOES carry risks and is the reason why there is a class of specialists who provide general anethsesia and why in many countries it is used only rarely.

http://www.dentalfearcentral.com/general_anesthesia_dental.html

The complications of general anethsesia include, heart attack, stroke, bain damage and death.

[philb]

As the link Andrew posted states, the vast majority of dental procedures that require something more than a local anesthetic utilize what is commonly called IV conscious sedation. 

All forms of anesthesia carry some risk.  These risks increase for the elderly and infirm obviously.  Severe and life threatening complications are rare in a normal healthy adult, but can and do occur for a variety of reasons.  Prior history of difficulty with anesthesia either in the patient or their immediate family is one indicator of increased risks.

When having the option, I would always opt to receive something other than a general anesthetic. (Local, Spinal, Nerve Block etc.).   At least when there is an experienced clinician present to administer one of these.  Also, even these forms of anesthesia are not without risk.

[Oosik]

I was wondering if there was a Ukraine "sour grapes" syndrome.

Momma can't afford to pay for anesthetic, so she tells the kid "it's bad for your heart". Doc doesn't want momma mad, so he says "da".

I do know if someone has a heart murmer they should not be knocked out.

[Bruno]

I was wondering if there was a Ukraine "sour grapes" syndrome.

Momma can't afford to pay for anesthetic, so she tells the kid "it's bad for your heart". Doc doesn't want momma mad, so he says "da".

I do know if someone has a heart murmer they should not be knocked out.

Not long time ago, medical care was fully free in FSU... So, it was not a money problem for the Momma...

[Oosik]

True, but then it was a money problem for the state. Were the docs told to discourage it for monney savings?

[philb]

I was wondering if there was a Ukraine "sour grapes" syndrome.

Momma can't afford to pay for anesthetic, so she tells the kid "it's bad for your heart". Doc doesn't want momma mad, so he says "da".

I do know if someone has a heart murmer they should not be knocked out.

This is just a guess on my part. The safe administration of a general anesthetic is very dependant on technology.  Is there a higher incidence of complications in the FSU do to the fact that technology is sometimes lacking?

A heart murmur does not necessarily disqualify you from receiving a general anesthetic nor does it necessarily increase your risk for complications.  This would depend on the specific pathology of the murmur.  Anyone with an abnormal EKG (if this is the first time one is done) or anyone with an EKG that has changed from a prior exam should have their EKG reviewed by a cardiologist prior to receiving anesthesia.

[jb]

My wife tells me that there was never a shortage of drugs in Moscow in  the bad old days of the Soviet Union.  Any doctor worth his bone  saw would have had ample access to all the pain killers you could ask  for.  The problem was the drugs were very strong and might knock  you out for a week.  Perhaps a parent might not want their child  to go through that ordeal. 

You might reassure your g/f that Novocaine is a mild synthethic and will only last a few hours, and it's perfectly safe.

[andrewfi]

I think that people are becoming a tad confused here!

General anethsetic is 'strong medicine'. It does have a risk associated with its use.

Local anethsetic is pretty much risk free and is freely available in dental surgeries in most countries, including those of the FSU.

The use of a general anethsetic is expensive, but that is not why it is not commonly used in most of the world. It is not used because it carries more risk than is justified by its benefit.

It would only be an ignoramus who did not factor the risk of complications (which include heart issues) into their treatment choices. It seems to me that the women that some of you guys marry know more and are thus less ignorant than some of those posting specious economic justifications for a sensible concern and choice!

[Lysander]

I couldn't help but comment, having a bit of expeience in the topic.  There are certainly a number of risks involved with a general or  regional anesthetic, as well as sedation.  In a modern setting  with proper equipment and a trained staff, serious complications are  extremely rare. But risks are increased in patients with heart or  vascular disease, renal failure or any number of other coexisting  conditions.

But in the absence of a rare complication, modern anesthetic agents are  not in and of themselves toxic to the heart, though they may affect  heart rate and blood pressure during their use.

Local anesthetics, if inadvertently given intravenously or in large  doses, can cause severe (and sometimes fatal)  heart dysrrhythmia  or seizure. But this is extremely rare and I wouldn't worry about it  going to the dentist.

[andrewfi]

Point taken Lysander, but which would YOU sign up for if you were having a filling? A general anesthetic, or a localised one, apart from the cost implications?

It seems to me that general anesthetic is done so that dental patients can be unaware of what is happening to them and is thus a treatment for the symptoms of fear and anxiety rather than a response to a medical need.

[Lysander]

I'd certainly choose local anesthetic  over general  for  almost any procedure where its possible (can't do a heart transplant  under local )...not so  much for risk as for avoiding such problems as nausea, sore  throat,  and just feeling out of it the rest of the day.

Indeed the chances of a complication from a local at the dentist's  office are remote...more likely to have an accident driving there and  back. (some people do have allergies) The doses a dentist uses are too  small. Some surgeons will use  higher doses of local during a  procedure in the O.R. (a face lift for example) and there is risk  associated with it. A collegue of mine had the misfortune to experience  it first hand....a cardiac arrest right after the plastic surgeon  infiltrated the face with local for a face lift.....very frightening.  Fortunately, the patient was none the worse for wear.

And I agree I would be very cautious about allowing a dentist to administer "laughing gas."

[Lysander]

I'd also add that your right about GA being more prevelent here than in  Eastern Europe (and in FSU as well I imagine) a lot of things are done  under local that in the U.S. would be unheard of. My ex-girlfriend's  brother had his tonsils out under local...no one would even consider  that here,  though it works just fine.

I remember as a resident a case presentation where a C-section was  needed and the situation made GA or regoinal extremely dangerous. A  resident from Russia suggested doing it under local....and was shot  down at once, because no one had ever heard of such a thing. Though  given the situation presented, it was actually a good idea.

[andrewfi]

Just a thought here.

If I had no part in paying for the procedure, or if whatever the procedure was the cost was the same, as a scaredy cat I might prefer a general anesthetic. I might perceive the risk as being low, the benefit that I was unconscious during the procedure and there is no cost impact to me.

Under the US medical system, the situation is not far differnt for many people to that described above. It makes prescribing expensive treatments much easier, but the cost to the American society as a whole is huge.

In the UK, for example, dental treatment is rationed by cost, and the patient usually has to contribute a variable amount according to the overalltreatment cost. We have been educated to know that a local anesthetic is effective (indeed still needed when GA is used!) and the large cost associated with GA is not necesary and I surely do not want to pay it! Here in Estonia, and pretty true in the FSU in general, the situation is much the same. If we want it, we can pay, but who wants to pay?

I begin to better understand why American medical professionals are so well paid and the attitudes of some posting in this thread.

This is not about shortage of resources in the FSU, but about abuse of resources in the US, abuse that happens becasue apart from a fixed deductible from an insurance policy, it matters not to the patient what is done; the doctors and hospitals profit and they tend to encourage a system of over prescribing and specifying that becomes the lower level of acceptability for the patient!

[Lysander]

Not sure why you would single out medicine. American society, having  more resources at its disposal, will use more. Just as Americans (and  Western Europeans) eat more food, drive bigger cars, consume more gas,  live in bigger houses than their FSU counterparts, they also consume  more medical resources. They have much higher expectations from their  health care providers and  (in America) have greater access to  legal recourse when they are not met.

Like any other resource, medicine tends to be used less sparingly when its abundent.

Sometimes their expectations are unrealistic; "I want perfect  diagnosis, pain free surgery, zero complication rate," etc. Other times  they are eminently reasonable; access to advanced imaging, strict  attention to sterilty, etc.

[andrewfi]

Well, we were referring to medicine, so talking about profligacy in respect of cars, or food, would not be relevant.

But, there is a huge difference between the US and Europe in terms of costs and relative efficiency of medical services and of course, such metrics as lifespan and infant mortality do not run in the favour of the US, notwithstanding the amount of money spent by Americans.

But the point was simply that in a system that, cheap, or costly, where the client has little interest or control in the cost of the product or service, then he will tend to always choose the most costly, most intricate version of that service, even if the benefit is not real, or is far to the right of the diminishing return curve. Thus the average American, paying a fixed insurance deductible on his insurance will choose to do everything and anything, egged on by his doctor and hospital; but will still complain about the overall cost of his insurance. Most European systems involve the patient in the resource allocation/cost of his treatment and thus we consume fewer resources for similar or better health care.

The developing countries of the FSU have yet to re-attain western European levels of care, although, I have to say, I have few qualms about undergoing medical treatment in Estonia. For the ordinary person in Estonia, it is likely that the lifetime cost/benefit ratio of local health care is better than that in the US. The real differnces only occur at the margins, where treatments where costs outweigh benefit might be hard to come by, at any price, whereas in the US they are, but the buyer does not pay the economic cost.

[LostInIllinois]

I read something on another board about a UW saying that she thought a general anethetic was bad for the heart.

General anethetic used 30 years ago would stop the heart in a certain percentage of the population.  I understand that in the US, they have newer ones, but in the FSU, their healthcare may use the old stuff.

 

 

[Son of Clyde]

I had one of those "procedures" people over 50 must endure every 5 years.

I was dreading the anaesthetic for days and when they poured it into the iv I was dizzy for about 20 seconds and woke up in the recovery room. I remembered nothing.

Can anyone tell me what that stuff was? I wish someone would start selling it over the counter.