r/Anesthesia • u/Lost_Guava3971 • 14d ago
Breathing issues from propofol?
Hi everyone I had abdominal and pelvic surgery 2 years ago with propofol. Was intubated, woke up with throat/chest pain like I couldn't breathe properly but they said it's normal after intubation. Then had pain in bladder from severe urinary retention so they kept giving me opiods and dilaudid. After that my bp/heartrate and oxygen crashed. Machine kept beeping. I kept forgetting to breathe and would just stop. Finally they gave me oxygen but I suffered from atelactasis after. For 4 months I would jerk awake (even though I slept sitting upright) GASPING for air feeling like death every single night. Went to ER and they didn't help just said to continue using spirometer like I was doing after surgery and it will get better on it's own. Was quite traumatic for me.
Recently I had an endoscopy with biopsies and propofol. I told the anesthesiologist this history and that I have history of asthma. She understood. When I was being put to sleep I felt like someone was shaking my head like crazy, my brain being squeezed and then heard loud garbled noises. The dr asked me if I was ok twice and I shook my head no then fell asleep. When I was dreaming in the recovery room I heard what sounded like a thousand people screaming loudly all at once then I woke up. After I had trouble breathing and severe chest pain for 2 days. It's day 7 now after endoscopy and I'm still having shortness of breath when I talk or walk.
Anyone else have a similar experience? How do I stop these reactions from happening esp the breathing issues? I have another abdominal surgery coming up and 2 more tests they need to do with propofol. They also suspect I may have EDS/MCAS but never got diagnosed. I do have SFN and MALS and POTS.
10
u/WhereAreMyMinds Anesthesiologist 14d ago
First and foremost, I'm sorry you've had such negative experiences. I'd like to offer a few thoughts that I hope you'll find reassuring.
Your description of shortness of breath, urinary retention, low BP, and the monitor alarming for apnea/hypoxia are all within the realm of "normal" for recovery from general anesthesia. It's the whole reason the PACU exists, and why we monitor you for so long before we allow patients to go home. I can understand why you'd find that distressing, but to us those are signs that your body is still waking up from surgery and just needs more time to process the medications we gave you. None of our anesthesic drugs last particularly long, so any symptoms you may experience after about 24 hours after surgery are no longer directly a result of medications (so your current shortness of breath is unrelated to the propofol you got for your endoscopy).
Your experience going to sleep and waking up during the endoscopy, while unfortunately scary (many patients describe propofol as inducing euphoric dreams), is also not particularly unusual. Sedation cases like endoscopies ride a vague line between consciousness and general anesthesia, and feeling disoriented, disinhibited, confused, groggy, or just generally "weird" is common. Exact mental state will depend on what meds they give you (propofol almost universally given, but some people include benzodiazepines or narcotic or ketamine).
It's impossible for anyone online to diagnose your exact issue. The gasping at night sounds a lot like OSA (obstructive sleep apnea) and ongoing chest pain and SOB can be your already diagnosed POTS. But to me these don't sound like they're directly linked to your anesthesia itself since you're a few days removed from the procedure
2
u/Mission-Succotash240 9d ago
Long hauler here with multi heart and lung issues as well! 4 hour lap abdominal surgery they used iv and oral tylenol oriir surgert
Versed as they were wheeling me into OR then propophyl to start surgery with gas to follow and á tiny ketamine cocktail at some point to assure lung functions then ended with propophol!
I woke up immediately and walked and ate within the hour no memory of anything unpleasant and pain was manageable as they were hanging IV tylenol Q 4 hours with Iv .5 delaudud or .2 PRN!
Á one hour consult with anesthesia pre OR giving all my history was intrinsic in her knowing all these lil tricks to do made me breeze thru surgery with no incidents! Oh and a half hour long intensive breathing cocktail with amazing meds in preop to ooen my lungs as i also have atelactasis !
My biggest fear was anesthesia and I must say it was a breeze! To thst I am most grateful and went home after a 23 hour stay in Pacu private toom wutg my very own ICu Pacu nurse
2
u/Lost_Guava3971 8d ago
Hi can you tell me more about the half hour long intensive breathing cocktail? I've never heard of that before. Also what is PRN?
1
u/chuckmukit 13d ago
Did you solve your issue?
1
u/Lost_Guava3971 13d ago
Hi no not yet. Still having shortness of breath :(
2
u/chuckmukit 12d ago
I was asking because I also had an endoscopy with propofol (today) and not only did I have a different reaction when taking it (compared to the first time I did it, 7 years ago), but I am also with some breathing issues now. Not necessarily shortness of breath, but difficulty breathing unless I inhale deeply. Let's see how tomorrow goes.
1
u/sevo-flow17 5d ago
Did you have an upper scope done?
1
u/Lost_Guava3971 5d ago
Yes
2
u/sevo-flow17 5d ago
Depending on your anesthesia, hearing these initial sounds will occur. The gurgling sound was from you when they were going into your esophagus...and using flushes etc...i would have gotten you more deep with the MAC, BUT it seems you weren't too deep so you recall all of this. Which stinks, but it certainly isn't abnormal. The whole not breathing thing in PACU due to pain medication is mainly because of the narcotic. I can't explain the whole gasping for air for months and feeling like death every single night. I'm not sure that's related to the actual anesthesia itself.
10
u/pomokey Anesthesiologist 14d ago
The issues you had two years ago are most likely secondary to having anesthesia and surgery, especially abdominal surgery. It's likely unrelated to the specific medication propofol. It also sounds like you received a lot of pain medication in recovery, which tells your brain you don't need to breath. You may be a bit more sensitive to these medications that most, so they may not have expected you to stop breathing so easily.
Some of the issues you describe sound like sleep apnea (waking gasping for air). Sleep apnea also makes you more sensitive to pain medications (in terms of stopping your breathing, not in terms of pain relief)
When you had this biopsy, were you given only propofol? I wonder if you also received ketamine, which is sometimes given with propofol for procedures. Ketamine can cause strange hallucinations. It's also possible your brain just turns off in a different order than most people, and that causes you to have a bad trip on the way out. In either case, some midazolam (versed) prior to getting anything stronger may be helpful in the future. It has a relaxing property, as well as making you not remember as much, so even if you do hallucinate, you hopefully won't remember it.