Bonus: An Anaesthetist Reveals Everything You Need to Know About "Going Under"

One of my favorites, The experts with Jason Lauren. Your vessel specialists who specialize in very special things.

Hi, I'm Lachlan, and I'm an expert in antithesiology.

Let's hear from the expert.

All right, So I'm going to try and say this without stuffing it up. Here we go, Lucky you are an anetheist, No, an ethicist close.

I'm doing a lot better than most people.

Okay, let's see who can say an ethetist.

Yeah, that's good, Lauren.

Yeah, an ethetist.

Yeah, yep, yep, you got it there.

Okay, go to the odd one.

A nethetist.

Yeah, so we see it.

Professional anesthesiology. She is a little patronizing, but that's fine.

Lachlan Miles, good morning, Good morning, Lauren.

You're are expert today in what do you do?

That's a good question.

So I'm an anthist, or in the States, i'd be called an anesthesiologist, and we're responsible for keeping patients comfortable and safe during surgery, but also managing them around the time of the operation, before and after.

So you are the ones that keep us on that fine line between life and death.

Is that right?

Like we're unconscious, but you've got a monitor to make sure we're unconscious. We don't wake up in surgery, and we also don't go too far they.

One hundred percent.

My general line to patients is that the surgeon worries about the bit that they're operating on, and I worry about the.

Rest of you.

So our role is to keep you pain free, to keep you comfortable, and to make sure that you're not remembering anything that you're not supposed to during the operation.

But so save Clinton and I are both been wheeled in for surgery, Right does it come down.

I'm giving you an organ or.

Something for kidney Clinton?

I don't want your organs?

But like, is it the amount of drugs isn't measured by the patient's lifestyle and weight, Like how do you work out how much to give each patient?

Anesthes is half art and half signed.

So there's very scientific dosing protocols that we use based on your sex, your height, your weight, and also your age is a very important fact there.

But there's also.

Additional things like what's your lifestyle. So patients who drink some alcohol may smoke. We might need to alter the dose of drugs that give depending on these specific circumstances.

So associate professor, what are you doing while the surgeons at work? Are you monitoring the patient itself or computers or what are you watching?

So basically, anesthesia, to use an analogy, clean, it's a bit like flying a plane. So the most challenging times are takeoff and landing. But just because you're cruising at forty one thousand feet doesn't mean that you're not doing anything.

You're not sitting there playing snake no.

Not playing snake no.

The fact of the matter is that it's like flying a plane, but without an autopilot. So if you're flying a plane, you're constantly making microadjustments. You're making sure that you remain on course, you're making sure that everything's safe, and you're ready to respond to an emergency.

So we monitor the patient's airway.

Usually will secure the airway with a breathing tube during the procedure because you're so deeply unconscious that you can't maintain your own airway. We also make sure that we breathe for you, because you generally don't breathe under.

A generatn we breathe for us well.

One of the components about it's easier is that you want to make sure that the patient remains still during the operation. For obvious reasons, the surgeons don't really like audience participation on it. It's fairly safe to say. And so to do that, we need to give you a musclell accent. And this musclell accent basically stops any muscle that you would have voluntary control over, like you're breathing from moving.

Oh, it's like full body boto.

Yes, that's a great analogy completely. And so when you have this done, you can't move your diephram anymore. You can't physically breathe. So when we put the breathing tube down, we apply some positive pressure.

We can make the chest go in and out out as well.

Lucky, I've seen it in movies. How often do patients wake up mid surgery?

It's a great question, and often jays. This is probably the question I get most from my patients, because people are rightly terrified of it.

Oh yeah, I don't want to wake up to an open heart surgery and be like, oh, hey, gods.

But that's the anithetist's job, isn't it.

One hundred percent? And so there's two things that we do. The first is that the drugs that we give are very good. But in addition to that, there's a whole new family of monitors that have been around for the last fifteen years.

They go on you for it.

They basically measure your brain waves and they give us signals. We interpret the recording in front of us, tell us if we're giving you too much or too little, and that will alarm or generate a signal well before you actually wake up.

Oh, so you know now if it's looking like we're waking up correct.

So the actual instance of true awareness under an anesthesia, Lauren, it's not zero, but it's very low explicit awareness where my goodness, I was awake, I could feel everything, I could hear everything.

It's very rare.

We're probably looking at one in seven thousand or something along those lines.

So when you do wake someone up, we'll bring someone out. Does everyone speak gibberish?

Not necessarily depends on the top of vangy.

Have you got some good stories that I can? But it must happen from time to time and give you a laugh.

Usually on the way down is when you tend to get First.

Of all, I was gonna ask there neither I've had they often have different things that they get you to do, like countdown from ten, say the alphabet. Has anyone ever made the countdown? Or is it a bit of fun for you guys when you're like, oh, they think.

It depends on how much you want them to get to the bottom. So if you want them to get to the bottom, you get to the start counting, then you give the drugs. If you don't, you give them the drugs and then say now start counting.

Because never I always win. No one ever gets to zero.

All that tingly face you get or.

Question anyone feed themselves on the table, like can you control your bows when you were out?

So that should that's why, If that's why you have to do all this.

Before, that's one of the reasons. Certainly I'd be lying if I said that it never happened, James.

But it is uncommon.

And let's go back to that earlier part of the conversation where I said, I've given you and a drug that causes you to lose voluntary control of yeahs fault.

Of course it's not yours, not judging like they're saving us.

They're putting my head back together with all the students rolling and watching in nude on the table.

So it's always though, like an anesthetic makes you go to the toilet, it doesn't make you bear down. But if you're a bit backed up there and I relax you, I can't change the laws of physics, unfortunately, but it's something to be ashamed of, you know, a lot of this small children, it happens.

It happens when we're not under you clean up.

That's a different type of anesthesia. When you've had a few too many red ones. Now here's one for you. This is kind of gross, but it happens to me all the time. I'm a vomited and I had. The last anathodist who I had was like, no, no, no, trust me, I'll make sure you don't spew when you come out of this. And I was like, I'm telling you, every single time I wake up from an operation, I vomit. And he was like, you won't this time, and I

Depending again depending on the type of anesthetic you give, you know, and particularly young women are badly affected.

Lauren.

So it's not uncommon, not at all.

And there are certain things that we can do change the nature of the anesthetic. Give different drugs, give you drugs way you sleep, predicting that you're going to vomit when you wake up, to try and reduce the risk, and we can get the risk close to zero, but close to zero as eve unfortunately discover Lauren is not.

The same as zero.

And there will be patients every now and again that are agredably.

Resistant to our charms. And it sounds like unfortunately category but you've got.

The little funny hat on and you're throwing up on yourself and it's just a bad scene.

It's just really, it's really not good. We try and avoid it whenever we can.

One more. Have you ever had to do any epidurals?

Oh, tons, Yeah, it's a routine anesthetic technique. I don't do obstetrics anymore, but when I did do obstetrics, I used to do a lot of.

Them because I remember when we had Felix, our first one, the anetheesist clot was about to be called in for surgery and he's like, look, we wouldn't normally do the EPI this early, but he said the way. I describe it as if you're flying all the way to la why do economy to Hawaii and then do business?

Why not do business the whole way.

Oh, that's a great analogy.

So he gave it early and she was out.

I've had three marriage proposals after putting in.

Two while the husband was in the room.

To you, Oh yeah, well he's taken the pain away.

I proposed to him as well, and.

Tasting it's probably one of the best an ebceeterric epidural is probably one of the most rewarding things that you can do in anesthesia, because you do have a patient who is in terrible pain in front of you, and with a very simple, very safe intervention, you can take that pain straight away and make sure that they have as good a birth experience as they possibly can.

It was a tremendously rewarding part of my job.

Oh my god, you're so nice.

He's so skillful as well.

Bad news. I want Lachlan to tell me, all.

Right, we'll stick around, lockicks through pass something.

He's like, are you good at that board game operation? I'm terrible, but I don't know.

I'm great at the anesthetic part.

You just can't get the heart out.

But like I'm not, I'm not sure you'd want me doing that part of the operation.

Finally, Associate Professor Locker Miles, he is a anetheists.

There, you.

Think that.

I want to be nice to Jason's put me on the radio.

Thank you, well, we put you on the radio, Lucky.

Thanks for coming in, mate.

Thanks to the crew at Austin Hospital. They're doing an amazing job there.

You absolutely do an amazing job. Thank you for joining us.

No, thank you, Lauren. Lovely to be here, Lauren, Lauren wake.

I'm feeling good following them on the socials