Anesthesia Tidbits

cover maskI’ve been asked to list some interesting tidbits about anesthesia that might fit into someone’s story. Here are a few…

  • Skip the Truth serum – various anesthetic drugs, primarily barbiturates (pentothal/thiopental, amytal, nembutal, etc) have been tried. None works particularly well. Rarely used in the US (at least admitted to being used), and information thus gleaned is not likely to be admissible in court.
  • Have a Redhead undergo surgery with a criminal surgeon 
    • Redheads need more anesthesia – about 20% more. Has to do with the gene that makes them redheaded in the first place.
    • Intraoperative awareness with recall – happens about 1 to 2 times / 1000 general anesthetics. Recall ranges from sounds or voices, to full-blown pain and inability to move. Likely 10 times as many patients have intraoperative awareness, but don’t recall it afterward. Even without specific recall, awareness can lead to post-traumatic stress disorder. At particular risk are patients undergoing cesarean delivery, cardiac surgery, and trauma victims.  So have your redhead learn something they shouldn’t under anesthesia, from the nurse anesthetist or surgeon…though in a way that the scrub tech and circulating nurse don’t overhear as well. Sort of like the movie, Awake, but hopefully with some medical realism.
  • Stealing narcotics in the hospital – much harder than it used to be, but if your setting is 1990’s or earlier…the culprit could exchange narcotics in an infusion bag with saline (salt water), then use the infusion on themselves (or their victim). They can check out narcotics from the pharmacy/drug machine, draw the drug out of the vial into a syringe for themselves, then either lie on the medical record that it was administered to a patient, or return a saline-filled syringe as “waste.”  These syringes are occasionally tested so there is a small risk.
    • As occurred in Carol Cassella’s Oxygen, replacing the narcotic with a drug that lowers heart rate can help with the ruse, even though the patient’s pain doesn’t improve, their recorded vital signs do.
  • Killing with inhaled narcotics – like in the 2002 Moscow theater hostage crisis. A highly effective morphine derivative distributed through the ventilation system killed almost 200 people. If you want some to live, give them a syringe of Narcan to inject themselves with right before the chemical release.

Others you’d like to see??

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6 thoughts on “Anesthesia Tidbits

  1. JL Lora

    I love these! All these are great. I never knew or even heard about red heads requiring more anesthesia. I did know what Narcan was but from you! You’ve talked about it before. And omg, how scary it must be to feel all that pain while you’re under but be helpless to it. Oh the awesome stuff that makes thrillers, thrilling!

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  2. Kaye George

    I had that awareness during my first breast lump surgery when I was 16! I couldn’t move, but I heard them discussing where to cut. One of them said, “Be sure and not get too close to the nipple so she can wear an ordinary bra.” I had visions of harness/halter-type contraptions I’d be doomed to and I think I just passed out. It all worked out OK, but was terrifying at the time. I never thought of it for a plot point, but it would work great! Thanks for the thought.

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