Why turning off anesthesia is more complicated than flipping a switch - Reaction to Glaucomflecken



Dr. Glaucomflecken’s video about an anesthesia on/off switch is not only hilarious, but also hints at a significant challenge in the …

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30 thoughts on “Why turning off anesthesia is more complicated than flipping a switch – Reaction to Glaucomflecken”
  1. Quick question: I once heard that 2L/min flow is normally used in America and I noticed that you had that setting in your video so I was wondering if what I heard is correct.
    In my clinic we try to do 0,5L/min whenever possible 'cause we wanted to minimize the enviromental impact we have with our anaesthesia. Do you notice the trend to low flow anaesthesia in your hospital as well?

  2. I'm going into surgery again in only a few weeks, and your videos are so reassuring. They make me feel much more assured that my comfort and safety are pretty much guaranteed (until recovery lol) and that I'll be in good hands. Every anaesthesia and surgical team I've met have been amazing though, even when I'm a severely anxiety riddles mess.

  3. Thank you Max for the videos you do. I work as an OR Tech retired and enjoyed it very much. I have a question, I have had many surgeries, two of them in particular my TKR after surgery developed low BP and respiratory arrest in the recovery room and remained in the RR due to over load in ICU. For my THR my BP dropped to 89/44 and respiration of 79. I need a LTHR soon and I am very nervous about going under after these two scares. What questions in your opinion should I ask my anesthesiologist. Thank You for your videos.

  4. I'm sure that is why they need to know if a person uses recreational drugs. These people may need extra medication to get the person to be sedated.

  5. How do you sign out the use of sevoflurane? Anesthesia records document all the other narcotics, but not seen that, the only thing recorded was %inspired and %expired minute by minute when intubated, then on CPB, no ventilation so how is anesthesia maintained without propofol or being ventilated? Or gas used documented?

  6. Recently had a five hour surgery, no co-morbidities , healthy. Took me more than three hours to wake up. Released from hospital with legs that could barely support me for another few hours. Should I be concerned if future general anesthesia necessary?

  7. Hey Max, loved the informative video! Have you ever had a case where you turned off the anesthetic an hour or so before the surgery is expected to get done, and then there’s a complication and you’ve had to restart the process? Would that create any complications on your end?

  8. Love your videos Max.

    I would like to see you make a video/videos on the 3 inhalational gasses, along with what you like and don’t like about them, and which ones you prefer for different types of procedures.

    It also might not be a bad idea to discuss their pungency as well, though I know that Des is too pungent and irritating for induction.

  9. In an ICU setting I've taken care of a patient where they were receiving drips of 75mcg of prop (maxed), 1.5 mcg precedex (max), and 8mcg of fentanyl….and it wasnt working even though IV access was great and hemodynamically stable… would versed gtt on top of all these other sedations would be a great idea?… no PMHx just polysubstance abuse.

  10. I'm a bit of a difficult patient, but not on purpose. I always have to have more Lidocaine than expected when I go to the dentist for cavities/etc, and I woke up during eye surgery

  11. Love this! Communication is key when performing equine anesthesia. We rely heavily on 20-30 minute warnings for end of surgery to stop CRIs of lidocaine which if not discontinued can lead to severe ataxia in recovery. We also need our heads up to give additional drugs such as acepromazine and xylazine which vastly improve recovery quality.

  12. I'm a pharm tech and refill the Pxyis (thing on left behind him with a computer on top). To say an anesthesiologist has a switch for every problem is crazy. Y'all have a ton of drugs to keep track of.

  13. When propofol is titrated with BIS/real time EMG, the 100-fold individual variation in the dose to achieve the same numerical level of sedation becomes apparent but not with your 1-2 mg/kg standard dose.
    This opioid free abdominoplasty patient received 4 hours of propofol sedation & this is what her wake up looked like less than 5 minutes after propofol discontinued… https://www.youtube.com/watch?v=ixrHw7urFKk
    No pain, PONV or delayed mental function.
    According to your concept she should have taken much longer to emerge.
    You were probably taught, as was I, abdominoplasty can only be done with profound muscle relaxation from GA, spinal or epidural.
    This is what the same patient looks like (2009, pre-EtCO2 standard… room air, spontaneous ventilation) with subcutaneous tumescent anesthesia…
    https://www.youtube.com/watch?v=ixrHw7urFKk&t=3s
    You're a very smart guy with a great success in YouTube, but you still don't have all the answers. Not bad for an anesthesia resident though. Mazel tov!

  14. An anesthetist I worked with years ago in a small remote hospital and was obligated to circulate as well as be the ER Nurse, told me anesthesia was like flying a plane, danger on take off and landing, and not too much issue in between. As I watched her accidently deintubate a child during a T&A , and start screaming, I got her point, the scrub nurse got her a new tube to insert. She terrified me ever after, because of her panicked screaming.

  15. I looove the anesthesiologist I had for a majority of my surgeries. He always makes sure to talk me through everything like an adult (I was quite young when I had him) and address any questions. I remember he also explained to me that I need to let other anesthesiologists know that intubation is really hard with me.

    Also I had terrible nightmares once under anesthesia and he asked me how it went and told me he tried a different one for me to see if it’s better. I was like OMG NOOO NEVER AGAIN!

  16. As a registered veterinary technician I really loved this video. In veterinary medicine, animals are usually maintained on inhalent anesthetic prior to waking up. I found it interesting that injectable anesthetics are used in humans prior to waking up. Perhaps injectable anesthetics will one day be used in that way in veterinary medicine.

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