3,530 Posts
This is just my $0.02, but some people come out of anesthesia badly. I would like to think that your patient wasn't intentionally being combative. I work on a psych unit and more often than not, when pts get combative, there's a reason behind it - either their psychotic, or anxious, or scared, etc.
Agreed. I'm just a nursing student, so I'm not offering any professional opinions here, just my own experience.
My pre-pubescent son has been under general anesthesia twice. The first time in short-term recovery in the hospital, he was very happy-go-lucky--nearly euphoric. The second time in recovery at the outpatient office, he was angry, belligerent and every other word was a cuss word (something he doesn't do), and he kept trying to get up and leave, requiring both me and the nurse to physically restrain him.
This child is the most mild-mannered kid, and he seemed perfectly coherent, albeit not his normal self. It's funny what different types of anesthesia can do to a person. :)
1,041 Posts
You've not seen many people wake up from sedation, I"m guessing? My mild mannered DH went completely berserk during an oral surgery procedure. I could hear the whole thing, sounded like there were bears in the back duking it out. Instruments clanging, roaring & screaming. In a few moments the dental assistant came out and told me they had had "a little difficulty". That was the understatement of the year. See, DH had told them NOT to give him any nitrous oxide because he had a previous negative experience with it. Well, you know what happened. Even though DH was conscious, he was not in control of his reasoning and started lashing out at anyone and anything within reach. He nailed 2 dental assistants and pretty much tore the room apart. At the time they couldn't do anything with him, he was just insane! Once they stopped the nitrous and turned on the O2 he quickly regained control and of course, he was MORTIFIED. Thankfully, the staff and doctor took it with grace and finished up the procedure without incident.
You never know how someone is going to react to sedation or anesthesia. My son pukes his guts up for hours, it doesn't matter what they give him or how long he's under. I"m talking 8-12 hours. And he's not awake during that time either, so aspiration is a real concern. He had sinus surgery a few years back and slept for 18 hours straight. He vomited so much they finally had to just admit him to run IV fluids--he slept through all 8 episodes, including 3 that resulted in complete bed changes.
Everybody's different. Just because a patient appears to "know what's going on", he may not *Understand* what's going on around him. Sedation skews your perception and it lowers inhibitions. Kinda like too many margaritas.
pinkiepie_RN
998 Posts
This is just my $0.02, but some people come out of anesthesia badly. I would like to think that your patient wasn't intentionally being combative. I work on a psych unit and more often than not, when pts get combative, there's a reason behind it - either their psychotic, or anxious, or scared, etc.