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Wednesday, September 3, 2014
Hardware removal from foot
For this minor outpatient surgery, the anesthesiologist wants to administer Versed, which in the past has knocked me out for a day and a half. I asked for remefentanyl, just a short dose to not feel the pain from the needle insertion. He seems to be against any disruption of his `usual routine`. Is my request outlandish?
This is a tricky one. Would you tell your surgeon how he should be tying his knots or where exactly to cut? Anesthesiologists are experts in applied pharmacology and, like surgeons, develop ways of doing things that work in their practice and that, presumably, have some grounding in science. Drugs are their tools. Telling the anesthesiologist that you want a particular drug will sometimes create difficulties because you are presuming to know something better than he or she does.
On the other hand, you have the right of autonomy. You should not be pushed into accepting a drug, or surgical procedure, with which you do not have confidence or where you don't fully understand the risks, benefit and consequences.
Sometimes all that's needed is a quiet chat with your anesthesiologist, outside the hurly-burly of the surgical suite, to explain his perspective and your concerns. If you've had a bad experience with Versed, or any other agent, there is almost always another way to do things.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University