# What do they call it if you can't wake up from anaesthesia?

**URL:** <https://boards.straightdope.com/t/what-do-they-call-it-if-you-cant-wake-up-from-anaesthesia/340645>\
**Category:** Factual Questions\
**Created:** [January 19, 2006, 11:47am UTC](https://boards.straightdope.com/t/what-do-they-call-it-if-you-cant-wake-up-from-anaesthesia/340645 "2006-01-19T11:47:09Z")\
**Posts on this page:** 9\
**Page:** 1

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**Author:** ![Kitt](https://avatars.discourse-cdn.com/v4/letter/k/7ba0ec/32.png) [@Kitt](https://boards.straightdope.com/u/Kitt)\
**Post date:** [January 19, 2006, 11:47am UTC](https://boards.straightdope.com/t/what-do-they-call-it-if-you-cant-wake-up-from-anaesthesia/340645/1 "2006-01-19T11:47:09Z")

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My husband has had minor surgery a couple of times (ER) when he was a kid. Both times he failed to wake up after anaesthesia, and suffered cardiac arrest, I am told due to his heart muscles being paralyzed. Apparently this condition is not serious, and he just needs to be injected with something to prevent this from happening again under anaesthetic. Can anyone tell me what this condition is called, and what the stuff is that must be injected. Just in case I have to explain it to doctors in a future ER situation…

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**Author:** ![Rick](https://avatars.discourse-cdn.com/v4/letter/r/9f8e36/32.png) [@Rick](https://boards.straightdope.com/u/Rick)\
**Post date:** [January 19, 2006, 12:59pm UTC](https://boards.straightdope.com/t/what-do-they-call-it-if-you-cant-wake-up-from-anaesthesia/340645/2 "2006-01-19T12:59:33Z")

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> [@Kitt](#):
>
> Both times he failed to wake up after anaesthesia, and suffered cardiac arrest, I am told due to his heart muscles being paralyzed.

If not promptly treated, the technical term for this condition is dead.

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**Author:** ![Mindfield](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mindfield/32/19759_2.png) [@Mindfield](https://boards.straightdope.com/u/Mindfield)\
**Post date:** [January 19, 2006, 3:13pm UTC](https://boards.straightdope.com/t/what-do-they-call-it-if-you-cant-wake-up-from-anaesthesia/340645/3 "2006-01-19T15:13:15Z")

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I don’t know what the condition is called, but I believe the stuff they inject is epinephren (adrenaline).

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**Author:** ![Kitt](https://avatars.discourse-cdn.com/v4/letter/k/7ba0ec/32.png) [@Kitt](https://boards.straightdope.com/u/Kitt)\
**Post date:** [January 20, 2006, 5:44am UTC](https://boards.straightdope.com/t/what-do-they-call-it-if-you-cant-wake-up-from-anaesthesia/340645/4 "2006-01-20T05:44:34Z")

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Thanks. If it will help, I think the reason for his heart stopping was explained as the stuff in the anaesthetic that paralyzes the muscles cannot be broken down by his own system, as with most people. So he needs to be injected (before being taken off support) with a substance that will break this down. Otherwise, as you said, after being taken off, it’s adrenalin! Any doctors?

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**Author:** ![KarlGauss](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/karlgauss/32/3713_2.png) [@KarlGauss](https://boards.straightdope.com/u/KarlGauss)\
**Post date:** [January 20, 2006, 6:33am UTC](https://boards.straightdope.com/t/what-do-they-call-it-if-you-cant-wake-up-from-anaesthesia/340645/5 "2006-01-20T06:33:28Z")

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I think you may be talking about pseudocholinesterase deficiency. [Here is a very detailed link](http://www.emedicine.com/med/topic1935.htm)which, in fact, may not be too helpful given its high-level discussion.

I really do have to sign off now but hope the link will be a start. When I come back, depending on what others have added, I may be able to offer a word or two.

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**Author:** ![Kitt](https://avatars.discourse-cdn.com/v4/letter/k/7ba0ec/32.png) [@Kitt](https://boards.straightdope.com/u/Kitt)\
**Post date:** [January 20, 2006, 6:47am UTC](https://boards.straightdope.com/t/what-do-they-call-it-if-you-cant-wake-up-from-anaesthesia/340645/6 "2006-01-20T06:47:18Z")

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Thanks Karl. From the article is seems like a good possibility. Wow, so he’ll have a heart attack if exposed to cocaine? Now I’m pretty thankful we’ve never experimented with drugs 😛

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**Author:** ![Sevo](https://avatars.discourse-cdn.com/v4/letter/s/ed655f/32.png) [@Sevo](https://boards.straightdope.com/u/Sevo)\
**Post date:** [January 20, 2006, 3:41pm UTC](https://boards.straightdope.com/t/what-do-they-call-it-if-you-cant-wake-up-from-anaesthesia/340645/7 "2006-01-20T15:41:35Z")

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> [@Kitt](#):
>
> Thanks. If it will help, I think the reason for his heart stopping was explained as the stuff in the anaesthetic that paralyzes the muscles cannot be broken down by his own system, as with most people. So he needs to be injected (before being taken off support) with a substance that will break this down. Otherwise, as you said, after being taken off, it’s adrenalin! Any doctors?

How about an anesthesiologist?

Granted, I can’t tell you much via examination by proxy by SDMB, but based on your description of the problem, it sounds like your husband has what is known as a “pseudo-cholinesterase deficiency”. We commonly use a drug called Succinycholine to paralyze patients for intubation and surgery. In normal people this drug is broken down within 5 minutes by a protein in the blood. In some people, like your hubby, the protein is either missing or different–he never notices it except that it doesn’t break down the Succs like it should. These people can be paralyzed for hours.

We as anesthesiolgists get into trouble when we expect the Succinylcholine to be gone (for example, after an hour in the OR), but the patient is still completely paralyzed.

Anyway, if your husband has forgotten the specifics, there is a test to determine if his cholinesterase is the normal type or the alternative type. The test is called a “Dibucaine number”, and it might be worth it to know whether or not this is truly the condition he has for future reference.

Here’s s’more info at eMedicine.  
[http://www.emedicine.com/med/topic1935.htm](http://www.emedicine.com/med/topic1935.htm)

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**Author:** ![Sevo](https://avatars.discourse-cdn.com/v4/letter/s/ed655f/32.png) [@Sevo](https://boards.straightdope.com/u/Sevo)\
**Post date:** [January 20, 2006, 3:43pm UTC](https://boards.straightdope.com/t/what-do-they-call-it-if-you-cant-wake-up-from-anaesthesia/340645/8 "2006-01-20T15:43:22Z")

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:smack: Just read Karl’s post. He posted the same link as me. And the same info.

Guess I should read the thread more carefully before posting…

Sigh…

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**Author:** ![St.Urho](https://avatars.discourse-cdn.com/v4/letter/s/8e7dd6/32.png) [@St.Urho](https://boards.straightdope.com/u/St.Urho)\
**Post date:** [January 20, 2006, 11:09pm UTC](https://boards.straightdope.com/t/what-do-they-call-it-if-you-cant-wake-up-from-anaesthesia/340645/9 "2006-01-20T23:09:34Z")

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> [@Mindfield](#):
>
> I don’t know what the condition is called, but I believe the stuff they inject is epinephren (adrenaline).

Epinephrine is a mainstay of Advanced Cardiac Life Support (ACLS) treatment for cardiac arrest.

> [@American Heart Association](#):
>
> Epinephrine hydrochloride produces beneficial effects in patients during cardiac arrest, primarily because of its -adrenergic receptor-stimulating (ie, vasoconstrictor) properties.41 The -adrenergic effects of epinephrine can increase coronary and cerebral perfusion pressure during CPR.42 The value and safety of the ß-adrenergic effects of epinephrine are controversial because they may increase myocardial work and reduce subendocardial perfusion.43

I’ve also heard that epi will increase the fibrillation threshold of the heart, but I’m not sure how well established that is. So, if he did go into cardiac arrest, he most likely did receive epinephrine. However, it was not as a reversal agent for the anaesthesia. Here’s a link to the [American Heart Association](http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-58) Guidelines for Emergency Cardiac Care.

St. Urho  
Paramedic
