Intubation whilst awake.

[Samazeuilh2]

I have a triple bypass coming shortly and one of the things which I fear the most is being intubated when I have awoken from anaesthetic, i.e. being intubated whilst awake. I’ve heard that this can even induce PTSD in some people. It sounds absolutely terrifying and could be accompanied by hallucinations, AF etc.. Has anyone had experience of intubation whilst awake? What was it like? Potentially how long is it left in?

[CDreamer]

You obviously have a very vivid imagination to create that fear for yourself but please don’t even go there - when you start thinking of these things your brain thinks you are living it and your body reacts accordingly and stress levels soar. Positive thinking that it will not happen and all will be well works.

My understanding is that conscious intubation is most common in ICU or A&E when people have had severe trauma, not in planned surgery. One of the drugs you are given in surgery is one that causes temporary amnesia - so you don’t remember anything even if you do respond to commands after anaesthesia is given.

Because of my situation I had light sedation for several procedures instead of GA meaning I was awake for most of the time but in all cases I was given amnesia drugs so I wouldn’t and didn’t remember anything. In my case I had heavy sedation whilst being given TOE and although I was awake and conscious for most of the procedure and remember quite a bit of it, no trauma, no pain and certainly no memories of the TOE - felt the after affects later - scratchy throat and dry cough - but no memory at all of the procedure itself.

On this subject I hope you do not get any replies.

Best wishes

[BobD Volunteer]

Fully agree with CDreamer.

My only comment is that having had an endoscopy under sedation, whilst I vaguely remember not not looking forward to it I have no concrete memory and would not be worried about having to have another.

[Tommyboy21 in reply to BobD]

Me too Bob,with endoscopy. Slightly remember looking at the TV screen No way could I have taken just the spray though.

[dedeottie]

CDreamer is right ! Don’t think about something that is highly unlikely to happen anyway. I am an over thinker as well so do know the pitfalls. Meditation and even hypnosis has helped me to put a curb on overthinking.

I also had a toe under sedation and concur that although I knew what was happening at the time enough to obey instructions, I have no memory of the procedure. I only remember what was said and happened prior to the moment of sedation.

All the best

Jane x

[BobD Volunteer]

I know I have come to as they withdrew the intubation as I remember seeing it dissapear but no memory of feeling it. Vague memory of being told to breath out? Lets not add to already unnecessary worry eh?

[SeanJax]

instead of thinking about this stuff of GA, please do not forget to ask your surgeon to clamp or suture your left atrial appendage and follow the protocol to avoid Afib post opened heart surgery. It saves you a lot of recovery time and start thinking about cardiac rehabilitation and insist to have arteries as graft instead of veins as I already explained the reasoning. Good luck again. You will be OK.

[RussJun55 in reply to SeanJax]

Actually something similar has happened twice with me – coming out of GA in surgery recovery while still intubated. The first time was frustrating – in part because I was totally unprepared for it. The second time was more tolerable because I had a conversation with the anesthesiologist about how to communicate with the recovery nurses if that were to happen again (which, of course it did). I suggest that you raise your concerns with your surgical (and recovery) team in advance. Good luck.

[Samazeuilh2 in reply to SeanJax]

I took your advice asked about clamping the left appendage but got only the rather vague reply that they would consider this depending on “what they saw on the day.” I havent had any detailed feedback yet other to say that the operation was successful. They said the left atrium wasn’t enlarged and that the underlying rhythm (they used a temporary pacemaker) was sinus. I will probably be switched permanently from Sotalol to Bisoprolol. They used a “mammary artery” (?) for one of the bypasses and took the others from the legs. Haven’t uncovered them yet so I’m not sure what they are. Once again, thanks for your really informative output on this -it has been greatly appreciated

[BobD Volunteer]

Of course not. Lots of different operations and procedures. I'm the reason NHS is in such a state!

[Hylda2 in reply to BobD]

Do they shake a collecting tin at you when you enter the ward too Bob!

[Ablation7]

I can see why you would be afraid of that. You are usually kept fairly sedated when intubated. My Mom was given propofol and was pretty out of it when she had open heart surgery. Maybe confirm with the team that you will be kept calm and comfortable. Good luck!

[Mrsvemb]

As I understand it you are still in the Basildon Cardiothoracic unit. Talk to the doctors and nurses about your fears. They will be able to reassure you and put your mind at rest. I am sure that you are over thinking this.

Don’t listen to some of the comments on here. Ask the experts who are dealing with this every day.

My neighbour had the same op in Basildon last year. He is over 80 and was done as an emergency following cardiac arrest at home a week before. He is very positive about the entire experience and certainly has no bad stories to tell.

Please talk to the nurses or doctors in the unit.

I have just seen that you also posted on BHF. Hopefully, the excellent replies from people who have had this procedure will put your mind at rest. Now just try and relax.

[Samazeuilh2 in reply to Mrsvemb]

Well, I had another nasty scare last night: my temperature mysteriously went to 37.9 C for no apparent reason. You can probably guess the concern. I did a lateral flow which was negative. It seems to have gone down this morning but they will give me a full blood test which they say is definitive. My temperature taken just now was 36.4 which hopefully is a good sign

I only got two hours sleep after the procedure and none last night. Hence I’m exhausted. There are lots of electronics sounding on the ward. I normally sleep well, but because of the electronics and patients snoring and talking in their sleep I got an hours sleep maximum. At a couple of points I’m sure I heard voices saying “Laura” as I awoke (the name of a friends wife) and some odd whispering sounds I hope I am not going stark raving bonkers !

[Mrsvemb]

Hospital wards and sleep don’t go together, especially where there is a lot of beeping equipment and others snoring.

Within the next week you should be home. The procedure is behind you now, so just concentrate on your recovery.