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Anesthesia

Problems breathing in recovery room

05/30/2007

Question:

During my last 3 surgeries, all with general anesthesia, I had the same episode of difficulty breathing immediately upon awakening in recovery. I`d become aware of where I was, and try to breathe but couldn`t get air to go into my lungs, like my chest was paralyzed. Then I panicked and thrashed around, and the last 2 times something was put into my IV and there was immediate relief. I wonder if I`m sensitive to some of the drugs used and if it`s likely to occur with future surgeries? It was extremely scary.

My mother also had a similar episode during a surgery about 15 yrs. ago. Could this be a hereditary thing?

Answer:

Your description really does sound like the experience of being partially paralyzed. Very scary for you (and probably for those taking care of you).

This certainly could be hereditary. There is a condition called pseudocholinesterase deficiency in which the metabolism of a common muscle relaxant called succinylcholine is slowed. There are also a large variety of hereditary nerve and muscle conditions which would make you more susceptible to the effects of almost all the muscle relaxants.

Some patients cannot metabolize muscle relaxants effectively because of problems with kidney or liver function. In other people, there is an interaction between muscle relaxants and other drugs they may be taking.

Another possibility is a panic attack. Are you susceptible at other times to such feelings?

A final possible diagnosis is laryngospasm, in which a part of the throat constricts, sometimes in response to secretions retained in the throat during the period of recovery from anesthesia.

Your repeated problems certainly warrant a trip to your local hospital and a meeting with a senior anesthesiologist who might be willing to sit down with you, review any hospital records available, and try to come up with a reasonable diagnosis and a plan to avoid these kinds of difficulties the next time you have surgery. Good luck!

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Response by:

Gareth S Kantor, MD Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University