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What do anesthesiologists wake you up?

Anesthesiologists play a critical role in monitoring patients during surgery and ensuring they wake up safely afterwards. In this article, we’ll explore why and how anesthesiologists wake patients up after surgery.

Why Do Anesthesiologists Wake You Up After Surgery?

There are a few key reasons why anesthesiologists need to wake patients up at the end of a surgical procedure:

  • To restore consciousness and cognition – General anesthesia causes a reversible loss of consciousness, so patients need to be woken back up once surgery is complete.
  • To resume breathing – Anesthetics often suppress natural breathing, so anesthesia providers must wake you up to get regular respiration going again.
  • To assess neurological function – Waking the patient allows the anesthesiologist to evaluate whether there is any residual anesthesia impacting mental status or cognitive function.
  • For patient safety – Patients need to be awake and alert to protect their airway, maintain adequate ventilation, and prevent complications like aspiration.
  • To manage pain – Once awake, patients can communicate any pain they are experiencing so it can be addressed with medications.
  • To facilitate recovery – Being awake and oriented helps patients start the post-anesthesia recovery process and transition to the post-op environment.

In summary, patients must be woken up after surgery so normal physiology can be restored, any anesthesia-related effects can be reversed, and the patient can be monitored to ensure a smooth emergence from the anesthetized state.

How Do Anesthesiologists Wake You Up After Surgery?

Waking someone up from general anesthesia is a careful, stepwise process anesthesiologists are specifically trained to manage. Some key aspects include:

  • Turning off anesthetic agents – The anesthesiologist will first discontinue any intravenous medications or inhaled gases maintaining the anesthesia.
  • Providing respiratory support – Oxygen and sometimes assisted ventilation may be delivered to help restore normal breathing patterns as the patient regains consciousness.
  • Monitoring vital signs – Heart rate, blood pressure, oxygen levels and other parameters are closely watched for any changes or instability.
  • Observing consciousness – The anesthesiologist assesses the patient’s level of consciousness and responses as anesthesia wears off.
  • Verbal stimulation and touch – Light tactile stimulation or verbal cues may be used to arouse the patient and speed the return of consciousness.
  • Reversal medications – Drugs like neostigmine or sugammadex can be given to reverse the effects of muscle relaxants and speed recovery.
  • Pain control – Analgesics may be administered to prevent or treat any surgical pain as the patient becomes alert.
  • Gradual wake-up – Stimulation and interactions are gradually increased as the patient becomes more awake to avoid an abrupt, jarring arousal.
  • Airway management – The patient’s airway patency and protective reflexes are assessed to determine if any airway adjuncts are still needed.

The goal is a smooth, comfortable transition from an anesthetized state back to full consciousness. This requires patience, good communication, and close monitoring by the anesthesiologist to prevent complications like airway obstruction, low oxygen, high blood pressure, or delirium as the anesthesia dissipates. A stepwise wake-up tailored to each patient helps ensure an optimal post-anesthesia recovery.

How Long Does It Take to Wake Up from Anesthesia?

The time it takes to fully wake up after anesthesia can vary based on several factors:

  • Type of anesthesia – Short acting agents like sevoflurane or propofol wear off more quickly than longer acting ones like ether or barbiturates. Using short acting drugs enables more rapid wake-up.
  • Duration of procedure – Longer surgeries require more anesthesia, resulting in a longer time to regain consciousness afterwards.
  • Medications given – Reversal drugs can accelerate wake-up, while analgesics or sedatives may prolong it.
  • Patient factors – Age, underlying conditions, and individual responses can affect how quickly someone recovers from anesthesia.
  • Anesthetic depth – Deeper levels of anesthesia result in slower emergence and wake-up afterwards.
  • Surgical stimulation – More painful procedures can delay arousal without adequate pain control.

Generally, most patients begin regaining consciousness within 10-20 minutes after surgery once anesthetics are discontinued. But full recovery of coordination, cognition, and awareness can take up to 60 minutes or longer following lengthy or complex procedures. The anesthesiologist assesses each patient individually to determine when they are sufficiently awake for safe transfer out of the operating room.

What Does It Feel Like to Wake Up from Anesthesia?

The sensations experienced when waking up from general anesthesia can vary significantly depending on the medications given. Some common feelings include:

  • Grogginess – Patients often describe feeling foggy, disoriented, or confused as anesthesia wears off.
  • Nausea – Post-operative nausea and vomiting are common side effects of anesthesia.
  • Dry mouth – Anesthetic gases can leave the mouth feeling very dry and parched upon waking up.
  • Sore throat – The breathing tube inserted for anesthesia often leaves the throat feeling scratched and irritated.
  • Shivering – Mild shivering is not unusual due to effects of anesthesia on temperature regulation.
  • Drowsiness – Lingering sedation from anesthesia medications can leave patients sleepy initially.
  • Weakness – Muscle relaxants used may cause temporary weakness or difficulty moving limbs.
  • Pain – Surgical pain may be experienced if adequate analgesia is not provided.
  • Blurred vision – The eyes may struggle to focus initially after anesthesia.

While the effects of anesthesia dissipate within minutes to hours, some people report feeling slightly “out of sorts” for a few days after surgery. Staying calm and still, using blankets for warmth, sipping fluids, and proper pain management can help smooth the wake-up process.

What Happens Right After Waking Up from Anesthesia?

In the initial period after waking up from anesthesia on the operating table, patients are carefully monitored and assisted while the anesthesia effects wear off. Typical care involves:

  • Oxygen therapy – Oxygen is administered via a facemask or nasal cannula to aid breathing.
  • Vital sign checks – Blood pressure, pulse, respiratory rate, and oxygen saturation are monitored.
  • Airway suctioning – The patient’s mouth and airway are suctioned to remove secretions.
  • Head of bed elevation – The head of the bed is raised to reduce aspiration risk.
  • Pain assessment – Doctors ask about and treat any surgical pain reported.
  • Nausea treatment – Anti-nausea medication may be given if nausea is present.
  • Limb movements – Patients are asked to move their arms and legs to check for intact neuro function.
  • Comfort measures – Warm blankets, pillows, and reassurance help patients feel comfortable and oriented.

Once patients are breathing independently, following commands, and physiologically stable, they can be transported to the post-anesthesia care unit (PACU) for close monitoring during the final wake-up process. Here they are monitored for complications like low oxygen, excessive pain, nausea, bleeding, or heart disturbances as the last anesthesia effects resolve.

What Problems Are Monitored for As Patients Wake Up?

Anesthesiologists carefully monitor for several potential problems that can occur during or after waking up from anesthesia:

  • Respiratory depression – Slow or inadequate breathing due to residual anesthesia effects.
  • Airway obstruction – The airway can become blocked by the tongue falling back in an unconscious patient.
  • Hypoxia – Low oxygen levels from impaired breathing or ventilation.
  • Hemodynamic instability – High or low blood pressure and heart rate abnormalities.
  • Nausea/vomiting – Post-surgical nausea related to anesthesia or surgical stimulation.
  • Emergence delirium – Confusion and agitation as anesthesia wears off.
  • Pain – Surgical pain needs to be treated to prevent complications.
  • Shivering – Can cause peripheral vasoconstriction and increase oxygen consumption.
  • Aspiration risk – Vomiting or secretions entering the lungs due to impaired airway reflexes.
  • Residual paralysis – Persisting muscle weakness from incomplete reversal of neuromuscular blockade.

Skilled anesthesiologists know how to minimize these risks through careful dosing of anesthesia, proper airway management, adequate reversal of muscle relaxants, pain control, fluid management, temperature regulation, and vigilant monitoring in the critical wake-up period.

What Can Patients Do to Help Wake Up Smoothly After Anesthesia?

While skilled anesthesiologists drive the wake-up process, there are a few things patients can do to help it go more smoothly:

  • Follow directions – Pay attention and comply with instructions from anesthesiologists and nurses.
  • Take it slow – Avoid moving suddenly or getting up too quickly after waking up.
  • Stay calm – Remain still and don’t try to rip out IVs or monitors.
  • Speak up – Report any pain, nausea, numbness or other concerning symptoms.
  • Sip fluids – Gradually drink small sips of water or juice if allowed.
  • Keep warm – Use available blankets to stay warm and prevent shivering.
  • Have patience – Know that feeling “out of it” is normal initially.
  • Stay positive – Having an optimistic mindset can help the recovery process.
  • Get rest – Focus on resting and recovering once fully awake.

Following directions, maintaining open communication, and allowing time for the wake-up process will help ensure optimal recovery after anesthesia. With cooperation and patience, most patients can expect to be through the worst of the anesthesia effects within 30-60 minutes after surgery concludes.

Conclusion

Waking up safely from anesthesia is a critical milestone after any surgery requiring general anesthesia. Skilled anesthesiologists carefully manage the wake-up process using staged monitoring, stimulation, ventilation support, and medication adjustments to smoothly bring patients out of the anesthetized state. While individual responses vary, most people regain consciousness within 10-20 minutes but may take hours to fully recover coordination and cognition. Typical sensations upon waking include grogginess, dry mouth, nausea, and surgical pain which are treated with supportive care. Close monitoring for complications like low oxygen or low blood pressure continues in the PACU until anesthesia effects fully resolve. With proper anesthesia care and patient cooperation, most people can expect to progress through emergence and wake-up without major issues, resume breathing on their own, and be ready to start the road to recovery after their procedure.