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Thursday, May 23, 2013
Is an IV required?
Is it possible to get anesthesia somehow without an IV? Can I get it in a gas form? I am terrified of needles....and I am not looking forward to getting an IV. Please help.
You can get put to sleep without an IV. This is called an inhalational induction. You breathe a mixture of anesthetic gas - sevoflurane is the best agent available today - and oxygen, sometimes with nitrous oxide. Over a period of 1 to 5 minutes general anesthesia can be achieved. This is the method used in small children, but is rarely done with adults. The gas is not all that pleasant to breathe so after trying it you might actually decide that an IV is not the worst thing in the world.
Small children can't readily be made to cooperate for a needle, but as an adult you should be able to master it, especially if you're given some oral premedication 45 minutes to an hour beforehand. The premed will get you relaxed.
Another trick used with children is to apply a mix of local anesthetics to the skin site of the needle insertion which over an hour or so numbs it up so that the needle is hardly felt at all.
Finally, you can get general anesthesia from an intramuscular injection of a drug like ketamine, or midazolam. So, no IV, but still a needle.
With any of these non-IV methods of inducing anesthesia, the IV can be inserted once you're unconscious. Presumably you're not going to mind at that stage.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University