WEBVTT - How Anesthesia Works 0:00:00.760 --> 0:00:03.960 Welcome to you stuff you should know from house stuff 0:00:03.960 --> 0:00:12.479 Works dot com. Hey, and welcome to the podcast. I'm 0:00:12.560 --> 0:00:15.800 Josh Clark. There's Charles W. Chuck Bryant. There's Jerry, who's 0:00:15.800 --> 0:00:18.640 about to go to the hardware store any second now, 0:00:18.920 --> 0:00:23.560 which no, Jerry doesn't find that very funny. Yeah, I 0:00:23.600 --> 0:00:26.480 give the background there or to leave people wondering, well, 0:00:26.520 --> 0:00:29.760 we need a trash cannon and dimmer background. But we've 0:00:29.800 --> 0:00:32.920 been asking for I feel like months, but yeah, it 0:00:33.000 --> 0:00:35.160 can't be months because we haven't even been here that long. 0:00:35.680 --> 0:00:38.560 It's been like four days. But what what? What's the 0:00:38.640 --> 0:00:41.640 problem here? Why isn't there any movement on this? There's 0:00:41.640 --> 0:00:46.040 a home depot a thousand yards Crossromt. Yeah. I specifically 0:00:46.040 --> 0:00:48.800 didn't mention their name, but yes, it is the closest 0:00:48.840 --> 0:00:53.320 well in Orange big box hardware retailer. We could also 0:00:53.360 --> 0:00:57.280 support local business and go to an ACE instead, yeah, 0:00:58.160 --> 0:01:00.760 or we could just talk about and it's like we're 0:01:00.760 --> 0:01:03.440 supposed to. ACE is a big chain too, though, Yeah, 0:01:03.520 --> 0:01:07.000 but I think they're locally owned. Oh right, like Henry's 0:01:07.000 --> 0:01:13.240 ACE Hardware. Sure. I like, Yeah, it's good stuff, very helpful, 0:01:13.959 --> 0:01:18.120 very very knowledgeable staff, much more helpful. Than some of 0:01:18.160 --> 0:01:25.000 the other big Bucks their orange and blue. Okay, that 0:01:25.080 --> 0:01:31.440 was a great start to Uh, Chuck, Yes, do you 0:01:31.480 --> 0:01:35.440 know how to spell anesthesia? I haven't. I struggle. It's 0:01:35.480 --> 0:01:37.320 one of those And in fact, when you were out 0:01:37.360 --> 0:01:41.000 of the room getting your coffee, Jerry was asking how 0:01:41.000 --> 0:01:43.199 to spell it. I know, and I think she spelled 0:01:43.240 --> 0:01:48.720 it right or maybe missed a letter. And Jerry, I 0:01:48.760 --> 0:01:51.600 think she put an A where there was supposed to 0:01:51.600 --> 0:01:53.840 be an E. Oh well, I think that it used 0:01:53.880 --> 0:01:56.320 to be an accepted spelling. You know how in some 0:01:57.040 --> 0:02:02.720 uh distant times, the forties the thirties, which Jerry identifies 0:02:02.800 --> 0:02:06.280 with and like, anesthesia would have been spelled with an 0:02:06.360 --> 0:02:08.480 A E rather than just an E because there was 0:02:08.480 --> 0:02:12.680 another sound that. Yeah, it is a tricky one them. 0:02:12.800 --> 0:02:16.560 Uh okay, Well, then my next question, Chuck, do you 0:02:16.600 --> 0:02:20.680 know what anesthesia means? I do. Uh. It's from Greek, 0:02:20.720 --> 0:02:23.000 like a lot of medical terms, and this one stands 0:02:23.000 --> 0:02:27.560 for the loss of sensation. And uh, we'll talk about 0:02:27.560 --> 0:02:29.520 our personal experience as I assume, but I've never been 0:02:29.600 --> 0:02:36.040 under general anesthesia. Yeah the big Daddy, Yeah, fully under view. No, 0:02:36.320 --> 0:02:38.360 so neither one of us has had major surgery like 0:02:38.400 --> 0:02:43.320 that then no knock would yeah, because after doing some 0:02:43.360 --> 0:02:45.800 research on this, like, I don't know that I ever 0:02:45.919 --> 0:02:49.280 would want to It's scary, I mean. And let me 0:02:49.360 --> 0:02:52.560 just say also to anybody who is listening to this 0:02:53.040 --> 0:02:57.800 prior to undergoing a surgical procedure that requires general anesthesia, 0:02:57.919 --> 0:03:01.000 we don't mean to scare you know, but because it's uh, 0:03:01.040 --> 0:03:04.440 we'll talk about rate of death and and problems with it, 0:03:04.520 --> 0:03:07.720 which there are still but it's super safe now for 0:03:07.720 --> 0:03:10.440 the most part. But when you when you when I 0:03:10.440 --> 0:03:12.919 was reading this, I was like, man, what they're doing 0:03:13.080 --> 0:03:18.000 is is like bringing you toward death and then stopping 0:03:18.000 --> 0:03:20.600 at a certain point, yeah, and just letting you hover 0:03:20.680 --> 0:03:23.800 there then bringing you out when they're getting with a 0:03:23.800 --> 0:03:28.480 lot of like crazy heavy heavy drugs that are only 0:03:28.520 --> 0:03:32.080 slightly different from what they used in the like early history, 0:03:32.120 --> 0:03:34.040 which we're about to talk about. But it's really like 0:03:34.320 --> 0:03:36.600 it's it's kind of nuts that and they still don't 0:03:36.600 --> 0:03:39.840 know exactly how it works. And the reason why they 0:03:39.840 --> 0:03:44.400 don't know how it works, especially we understand local anesthesia 0:03:44.960 --> 0:03:48.680 and um twilight sedation, sure, well we don't understand is 0:03:48.720 --> 0:03:50.960 general anesthesia. And the reason why we don't understand because 0:03:50.960 --> 0:03:53.960 we don't understand how consciousness works, so how can we 0:03:54.080 --> 0:03:58.560 understand how unconsciousness works. Yeah, it's pretty weird, and which 0:03:58.600 --> 0:04:02.960 is what it works? Yes, it definitely does, and although 0:04:03.000 --> 0:04:05.920 there are some risks associated with it, it is far, far, 0:04:06.240 --> 0:04:11.640 far better than the alternative, which is no anesthesia, which 0:04:11.760 --> 0:04:13.760 was the way it was for a very long time. 0:04:13.800 --> 0:04:17.799 I mean anesthesia is a relatively recent thing. Or getting 0:04:17.800 --> 0:04:19.560 you super drunk, or hitting you in the head and 0:04:19.640 --> 0:04:23.440 knocking you unconscious, which is not so knocking you unconscious 0:04:23.480 --> 0:04:27.640 that qualifies anesthesia, but it's still not medical anesthesia. Giving 0:04:27.640 --> 0:04:33.680 you drunk, giving you morphine, giving you marijuana, jim some weed, um, yeah, 0:04:33.760 --> 0:04:36.359 rubbing stinging nettles on you to distract you from the 0:04:36.400 --> 0:04:39.440 pain of having your leg cut off, belladonna, using ice, 0:04:39.560 --> 0:04:42.840 all the stuff. These are so horrifics. These are narcotics. 0:04:42.880 --> 0:04:47.240 These are just plain old distractions, um, but they don't 0:04:47.320 --> 0:04:51.040 qualifies anesthesia. And the big difference, the the thing that 0:04:51.120 --> 0:04:57.120 was such a huge, huge progression forward um with anesthesia 0:04:57.400 --> 0:05:00.599 is that it doesn't just dull the pain. It dulls 0:05:00.680 --> 0:05:04.279 the pain, it takes away your consciousness and it also 0:05:04.320 --> 0:05:07.279 prevents you from creating memories during this experience, it gives 0:05:07.279 --> 0:05:10.560 you amnesia. So it basically cuts a chunk out of 0:05:10.640 --> 0:05:14.800 your lifetime that as far as your subjective experience goes, 0:05:15.200 --> 0:05:18.200 does not exist. It didn't happen like you were on 0:05:18.279 --> 0:05:20.920 the gurney going into the O. R room and you 0:05:20.960 --> 0:05:23.440 wake up and you're in the hospital bed and you 0:05:23.440 --> 0:05:28.080 have stitches, but there is nothing there in between, ideally 0:05:28.600 --> 0:05:33.039 for general anesthesia, right, And that's how we can conduct surgery, 0:05:33.080 --> 0:05:36.680 because before that there was surgery, but it was very 0:05:36.760 --> 0:05:41.200 rare and it was very very awful. Yeah, and when 0:05:41.200 --> 0:05:43.040 you know, we flew by some of those, but um, 0:05:43.080 --> 0:05:45.400 we did mention a lot of this, uh sopaphorics and 0:05:45.480 --> 0:05:48.360 narcotics that they use. They did knock you in the head, 0:05:48.400 --> 0:05:51.599 they did get you drunk. Um. In fact, in the 0:05:51.640 --> 0:05:55.120 mid forties, those were you know, opium and alcohol where 0:05:55.120 --> 0:05:58.240 the two go toss like and a towel to bite on, 0:05:58.400 --> 0:06:01.800 I guess, and just to make you like be able 0:06:01.800 --> 0:06:05.080 to tolerate the pain, which didn't really help. No, I 0:06:05.080 --> 0:06:07.839 mean I'm sure it helped. Uh, it dulled the pain, 0:06:07.960 --> 0:06:11.240 but it's not gonna do what you want, which is 0:06:11.279 --> 0:06:13.920 to kill it completely or knock you out. Or render 0:06:14.000 --> 0:06:19.680 you an asiatic an asiatic right, um. But the so 0:06:19.720 --> 0:06:22.720 the those were the two go to that they use. 0:06:22.800 --> 0:06:25.000 I mean there were other ones to like um blood 0:06:25.040 --> 0:06:28.839 lighting until a stupor or basically a coma was induced, 0:06:28.880 --> 0:06:33.080 like you lost so much blood that's pretty dangerous. But 0:06:33.279 --> 0:06:36.320 these were the These were the go to um pain 0:06:36.400 --> 0:06:39.800 killers for surgery, and they still didn't work very well. 0:06:39.839 --> 0:06:44.080 But what's weird is in the eighteen forties all that changed, 0:06:44.200 --> 0:06:51.440 like not one, not two, but three anesthesia is UH 0:06:51.839 --> 0:06:55.960 came into We're basically discovered for medical use, like almost 0:06:56.000 --> 0:07:00.440 all at the same time. Yeah, people now they basically 0:07:00.480 --> 0:07:04.800 say Crawford Long from right here in Georgia, University of 0:07:04.839 --> 0:07:09.680 Georgia graduate fellow bulldog. UH. He was the first. He 0:07:09.920 --> 0:07:13.880 performed a surgery removed a tumor from a neck from 0:07:13.880 --> 0:07:17.360 a mr A bentable in UH late March eighteen forty two, 0:07:17.840 --> 0:07:21.840 and also later did an amputation in a childbirth with 0:07:22.040 --> 0:07:25.920 ether and UM. He was he was the guy, but 0:07:26.160 --> 0:07:29.760 he was you know, it was pretty regional and people 0:07:29.800 --> 0:07:31.960 just didn't know about it. Basically. I all think it's 0:07:32.000 --> 0:07:33.960 the impression that he wasn't as much of a self 0:07:34.000 --> 0:07:38.840 promoter as Dr William Morton. Uh, yeah, he did um 0:07:39.840 --> 0:07:42.080 well William Morton in eighteen forty six. We might as 0:07:42.080 --> 0:07:43.880 well go ahead and say he demonstrated it for the 0:07:43.880 --> 0:07:47.600 first time in like a public surgical theater, right, and said, 0:07:47.600 --> 0:07:49.920 here is what I'm doing, and this is new and 0:07:49.920 --> 0:07:53.680 it's exciting, and I'm in Massachusetts on not some yokel 0:07:53.720 --> 0:07:57.440 in Georgia pretty much, and that's how he gained the acclaim. 0:07:57.480 --> 0:07:59.400 But yeah, I guess Crawford Long was able to prove 0:07:59.440 --> 0:08:01.960 that he'd done he'd used ether earlier. He's just like 0:08:02.200 --> 0:08:05.200 it just wasn't being a big shot about it. I 0:08:05.240 --> 0:08:07.720 was just using it. But you know, he discovered ether 0:08:08.200 --> 0:08:11.400 by hanging out with friends who were huffing ether at 0:08:11.400 --> 0:08:15.360 a party and supposedly he saw one guy run into 0:08:15.400 --> 0:08:19.800 a door and like cut his head open, and Crawford Long, 0:08:19.840 --> 0:08:21.520 being a doctor, was like, are you okay? And the 0:08:21.520 --> 0:08:23.200 guy was like, what are you talking about? With like 0:08:23.240 --> 0:08:26.480 blood spurting out of his forehead, and Crawford Long went, 0:08:28.200 --> 0:08:31.520 that's pretty funny. Uh. And he went on to uh 0:08:31.720 --> 0:08:35.360 tell Congress about it, as did doctor Charles Jackson, who 0:08:35.440 --> 0:08:37.120 said that he had done it before Morton as well. 0:08:37.160 --> 0:08:40.040 They both independently went to Congress. I was okay, man, 0:08:40.120 --> 0:08:43.320 I did that first. All right, it's a bit of 0:08:43.320 --> 0:08:46.600 self promotion. Ye, but Morton is the guy who gets 0:08:46.640 --> 0:08:49.160 who gets the credit. He's the one who really introduced 0:08:49.200 --> 0:08:51.480 it to the public. Well, it gets your credit as 0:08:51.480 --> 0:08:54.800 the first demonstrator. Yeah, he's the one that you hear 0:08:54.840 --> 0:08:58.320 of typically. Yeah, I would say Crawford Long though. Yeah, 0:08:58.320 --> 0:09:01.520 I guess you're right. Yeah. Lots of hospitals named after him, 0:09:01.559 --> 0:09:04.400 at least one here, although now no it's not cropfit 0:09:04.480 --> 0:09:11.080 Long anymore. Did they change it, yeah, to home depot um. 0:09:11.160 --> 0:09:13.920 So a little bit later on, there was a dentist, 0:09:14.160 --> 0:09:17.640 Dr Horace Wells, who used the first dude to use 0:09:17.720 --> 0:09:22.160 nitrous oxide bull teeth, and then chloroform was used by 0:09:22.240 --> 0:09:26.480 Dr James Simpson and these things. You know, you don't 0:09:26.520 --> 0:09:29.720 want to be using that though, it's toxic. So Dr 0:09:29.760 --> 0:09:32.800 Horace Wells actually is a pretty interesting story. It's where 0:09:33.160 --> 0:09:38.800 chloroform um and nitrous oxide converge as a beautiful place. 0:09:39.000 --> 0:09:41.800 So he tried. He extracted one of his own teeth 0:09:41.840 --> 0:09:44.400 on nitrous and was like, this is great. Did you 0:09:44.440 --> 0:09:48.160 read that history of Hippie crack article? Yeah, so this 0:09:48.240 --> 0:09:51.000 all came after somebody, a guy named Joseph Priestley in 0:09:51.040 --> 0:09:56.520 the eighteenth century synthesized nitrous oxide, and then very shortly 0:09:56.520 --> 0:10:01.960 after that, a teenage prodigy named Humphrey Davy started huffing it. 0:10:02.360 --> 0:10:05.400 And he actually had a box built for himself and 0:10:05.520 --> 0:10:08.000 was placed in it for over an hour once, just 0:10:08.080 --> 0:10:13.120 huffing nitrous oxide. That I am too, and he did 0:10:13.240 --> 0:10:15.680 because that's so dangerous. Yes it is, but this guy 0:10:15.800 --> 0:10:18.160 was huffing it like crazy. There must have been like 0:10:18.280 --> 0:10:21.440 some escaping or other air getting at something, but he 0:10:21.520 --> 0:10:24.520 huffed it for like an hour just for self experimentation. 0:10:24.920 --> 0:10:28.320 By the time Horace Wells tried it on a tooth um, 0:10:28.520 --> 0:10:33.280 there was a lot of confidence and understanding of nitrous oxide. Um. 0:10:33.360 --> 0:10:36.160 He was able to successfully remove his own own tooth 0:10:36.480 --> 0:10:40.360 when he demonstrated it. He didn't dose the patient properly, 0:10:40.360 --> 0:10:44.920 and the patient apparently cried out, and so Wells had 0:10:44.960 --> 0:10:48.959 staked all his reputation on this demonstration just failed utterly 0:10:49.120 --> 0:10:51.559 and ended up on skid row in New York. Went 0:10:51.600 --> 0:10:54.760 on a chloroform bender and ended up throwing acid on 0:10:54.840 --> 0:10:57.960 a couple of women. Was put in, yeah, was put 0:10:57.960 --> 0:11:01.199 in jail and ended up committing aside by slashing his 0:11:01.280 --> 0:11:04.400 fomoral artery with the razor from a shaving kit. But 0:11:04.960 --> 0:11:09.880 he was on chloroform, so he was anesthetized ironically when 0:11:09.880 --> 0:11:14.040 he died. Oh well that's good. Weird, Yeah, what it's 0:11:14.040 --> 0:11:18.200 strange history. But so the point is in in the chloroform, 0:11:18.440 --> 0:11:22.760 nitrous ox side in ether all emerged to form anesthesia. Yeah, 0:11:22.880 --> 0:11:24.840 and um, I mean it would have come around eventually, 0:11:24.840 --> 0:11:27.400 but it's not so different today. Like I said that, 0:11:27.559 --> 0:11:33.200 we're still using heavy duty drugs to knock people clean 0:11:33.240 --> 0:11:36.319 out and monitor them so they don't die from it. 0:11:37.120 --> 0:11:39.719 It's pretty crazy. Well, what one other thing about the 0:11:39.760 --> 0:11:43.800 introduction of anesthesia is that it took another fifty or 0:11:43.800 --> 0:11:47.600 so years before the medical establishment said yes, we need, 0:11:47.720 --> 0:11:50.280 we need to use this widely and and as part 0:11:50.320 --> 0:11:53.840 of standard and best practices. And part of that was 0:11:53.880 --> 0:11:57.559 because pain was seen as necessary. It was a sign 0:11:57.600 --> 0:12:01.360 that the patient was alive, was still idle. Um, there's 0:12:01.400 --> 0:12:03.560 a bit of a macho edge to it from what 0:12:03.600 --> 0:12:08.400 I understand. Uh. And then um, there was also a 0:12:08.440 --> 0:12:11.880 reluctance to draw attention to the fact that surgery is 0:12:11.960 --> 0:12:15.000 extremely painful. Yeah, because they didn't want people to not 0:12:15.600 --> 0:12:18.240 go to the doctor much. Yea. So it took like 0:12:18.320 --> 0:12:20.319 fifty years to catch on. So imagine being one of 0:12:20.360 --> 0:12:25.800 those patients where the modern medicine is well aware of anesthesia, 0:12:26.040 --> 0:12:29.920 but it hasn't adopted it yet. That's worse than being 0:12:29.960 --> 0:12:32.800 a patient before they understood there was such a thing 0:12:32.840 --> 0:12:35.480 as anesthesia. Yeah, Or imagine being because there was a 0:12:35.559 --> 0:12:37.920 lot of figuring it out along the way, you know, 0:12:38.000 --> 0:12:40.319 as far as dosage and stuff like that. Because so 0:12:40.600 --> 0:12:43.200 there are a lot of you know, unwitting guinea pigs. 0:12:43.200 --> 0:12:47.040 I guess there were Doc that hurts, don't take a 0:12:47.040 --> 0:12:51.120 little more that, or Doc, I'm dead, you know. Like 0:12:51.200 --> 0:12:54.640 you remember the castration episode we did, and they talked 0:12:54.640 --> 0:12:57.920 about how they would use opium as an anesthesia, but 0:12:58.080 --> 0:13:01.520 it was very easy to accidentally overdose the little boys 0:13:01.600 --> 0:13:04.840 when you were removing their testicles. I think the same 0:13:04.880 --> 0:13:07.120 thing happened when you were cutting off a man's leg 0:13:07.120 --> 0:13:12.160 in the Civil War. Wait, removing testicles. Yeah, for castration, circumcision. 0:13:12.160 --> 0:13:16.560 The castration said circumcision, man, We've we've done both. Yeah, 0:13:16.600 --> 0:13:19.560 But I thought I was like, man, I thought circumcision 0:13:19.640 --> 0:13:23.120 was something different. No, that's that means the circumcision is 0:13:23.160 --> 0:13:26.600 going horribly awry. Yeah. Man, we've covered some gruesome stuff. 0:13:27.240 --> 0:13:30.480 We really have, you know. All right, well, I guess 0:13:30.520 --> 0:13:33.160 we'll take a break here and talk about some of 0:13:33.160 --> 0:13:52.040 the different methods UH of anesthesia right after this. All right, 0:13:52.640 --> 0:13:54.320 before we broke, we teased you a little bit with 0:13:54.400 --> 0:13:57.160 the different types, and here we go. And up first 0:13:57.840 --> 0:14:01.800 is my favorite twilight sleep. UH. If you've had your 0:14:01.800 --> 0:14:06.600 wisdom teeth out or maybe an endoscopy. Um, there's plenty 0:14:06.600 --> 0:14:08.840 of procedures that use it. You might have had twilight 0:14:08.880 --> 0:14:14.440 sleep or conscious sedation or twilight anesthesia, and UM, I 0:14:14.520 --> 0:14:18.280 had some for when I had my my tooth replaced 0:14:18.440 --> 0:14:21.800 my front tooth. And it's always fun because it feels 0:14:21.840 --> 0:14:25.160 great going in. You just relish those like ten or 0:14:25.200 --> 0:14:29.280 fifteen seconds, and then it feels fun coming out because 0:14:29.400 --> 0:14:31.640 you know you don't know what's going on. It's more 0:14:31.680 --> 0:14:35.560 fun when you're picking up you're a loved one. Picked 0:14:35.640 --> 0:14:38.640 up Emily after her endoscopy and I went in and 0:14:38.680 --> 0:14:40.240 I don't know why I didn't think that my video 0:14:40.360 --> 0:14:43.240 going already, but she was like, I think everyone's throwing 0:14:43.280 --> 0:14:46.520 a party for me. Like what the people behind the curtain. 0:14:46.520 --> 0:14:49.160 They're throwing a party. I saw balloons and it was 0:14:49.240 --> 0:14:51.360 very cute because they're like so out of it. And 0:14:51.400 --> 0:14:53.080 when I came out of my wisdom teeth, I think 0:14:53.080 --> 0:14:55.720 I may have told this before, but I my friend 0:14:55.760 --> 0:14:59.080 told me that this particular doctor put bunny ears on 0:14:59.160 --> 0:15:01.600 you and took a picture because you're all puffed up 0:15:01.600 --> 0:15:04.160 and you have bandages around your face. And I was like, 0:15:04.480 --> 0:15:07.000 that's not gonna happen to me. I guarantee it. And 0:15:07.080 --> 0:15:10.600 I remember distinctly seeing the lady come in with the 0:15:10.640 --> 0:15:13.280 bunny ears, put them on my head and get the 0:15:13.280 --> 0:15:17.840 polaroid out and said smile, and I just went I 0:15:17.880 --> 0:15:22.080 gave a big smile, so that that actually, that's well, 0:15:22.120 --> 0:15:27.160 that's definitely twilight sedation, Yes, because you are out of it. 0:15:27.720 --> 0:15:30.320 You're but you're still conscious and you're still able to 0:15:30.360 --> 0:15:34.120 follow instructions. Yeah, but you don't know that. When you 0:15:34.160 --> 0:15:37.760 wake up, quote unquote, you feel like I did nothing happen, 0:15:37.840 --> 0:15:39.840 but they're like, no, you were talking to us and stuff. 0:15:40.640 --> 0:15:44.520 So weird. It is very weird. Um, the Twilight sedation, 0:15:44.560 --> 0:15:47.480 they used virtually the same drugs in a lot of 0:15:47.520 --> 0:15:52.480 cases that they used for general anesthesia, right, just smaller doses. 0:15:52.520 --> 0:15:57.360 So they'll use a sedative or something like that, like ketamine. Right, 0:15:58.080 --> 0:16:00.200 Like we said major drugs. I mean, if you've heard 0:16:00.240 --> 0:16:04.240 of you know, falling into a k hole. Uh, that's 0:16:04.280 --> 0:16:09.120 the same drug. Yeah, it's just crazy. That's like we're like, oh, 0:16:09.160 --> 0:16:10.800 back in the days, they use cocaine on people and 0:16:10.800 --> 0:16:16.720 that's nuts, right, Kee, big difference. Um. Yeah, so there's 0:16:16.760 --> 0:16:20.160 like ketamine there. They might use something like valium or 0:16:20.320 --> 0:16:23.320 at a van or something like that. Um. They'll probably 0:16:23.360 --> 0:16:29.320 also use the dissociative, which apparently disconnects your nerves from 0:16:29.360 --> 0:16:33.920 your brain. Yeah, that's what value is. Okay, that makes sense. Yeah. Um. 0:16:33.960 --> 0:16:37.280 And then also they'll use an analgesic, which is just 0:16:37.320 --> 0:16:39.640 another word for pain killer. So you've got all these 0:16:39.640 --> 0:16:43.880 strings working in combination, probably given to you intravenously, and 0:16:44.240 --> 0:16:47.880 you're a little bit wasted. But the point of twilight sleep, 0:16:47.880 --> 0:16:50.880 and the thing that that um, that separates it from 0:16:50.880 --> 0:16:54.280 other types of anesthesia, is that you are not so 0:16:54.440 --> 0:16:57.640 wasted that you can't breathe on your own, that your 0:16:57.680 --> 0:17:00.800 heart beat, your heart can't beat on its own, it 0:17:00.880 --> 0:17:04.240 needs to be you'll be monitored, but really they've given 0:17:04.280 --> 0:17:07.320 you such a low dose of this cocktail of chemicals 0:17:07.359 --> 0:17:10.720 that you're you're still able to do things like smile 0:17:10.800 --> 0:17:14.159 when the the dnnis put twenty years on you. Yeah to. 0:17:14.680 --> 0:17:19.320 I also remember, Um, when I woke up, I remember 0:17:19.320 --> 0:17:23.720 seeing a poster that said locomotive Lasagna on the wall, 0:17:24.520 --> 0:17:27.920 and Um, of course it didn't say that unless they 0:17:27.920 --> 0:17:30.760 went so far to like switch out posters to mess 0:17:30.800 --> 0:17:33.440 with you. I could see that because this didn't clearly 0:17:33.440 --> 0:17:35.480 had a sense of humor. It's putting bunny ears on people. 0:17:35.520 --> 0:17:38.320 It's like Tim Watley from Seinfeld. Yeah, but I was 0:17:38.320 --> 0:17:40.479 a little kid, you know. You know, I've never even 0:17:40.520 --> 0:17:43.199 had a drop of alcohol, so I've never had my 0:17:43.240 --> 0:17:46.080 head altered in anyway. So I was like, this is crazy. 0:17:46.200 --> 0:17:49.359 Did you start going to dentist every Friday at all? 0:17:49.520 --> 0:17:53.399 Fifty wisdom teeth removed? You're like, I know there's another 0:17:53.400 --> 0:17:56.159 one in there. Uh. The only uh. The other good 0:17:56.200 --> 0:17:58.399 thing about UM the Twilight Sleep is it's not going 0:17:58.440 --> 0:18:01.840 to have the after effects is general like, um, probably 0:18:01.840 --> 0:18:04.920 won't be nausea, have nausea or dizziness or vomiting. Maybe 0:18:04.920 --> 0:18:07.760 a little bit like they will give you a prescription 0:18:07.840 --> 0:18:11.520 probably but um, you probably want need to use it, right, 0:18:11.800 --> 0:18:15.760 you know, Yeah, anti nausea stuff. So that's uh, that's 0:18:15.880 --> 0:18:19.119 twilight sleep a k A procedural sedation. I don't know 0:18:19.160 --> 0:18:21.360 if we ever called it that. That's the clinical term 0:18:21.400 --> 0:18:25.200 for it. Twilight sleep is the prettier name for it. UM. 0:18:25.320 --> 0:18:28.880 Then there's also a local anesthetic, which is the other 0:18:29.520 --> 0:18:34.000 common type of anesthesia UM, where basically a is a 0:18:34.080 --> 0:18:37.520 small area or a specific region of the body is 0:18:37.760 --> 0:18:41.280 um basically numbed. Yeah, that's when you get the worst 0:18:41.320 --> 0:18:43.439 thing that can happen to you in life, which is uh, 0:18:43.680 --> 0:18:46.520 shots into the gum, a needle in the gum in 0:18:46.560 --> 0:18:50.240 the dentist, which is why the dentist will frequently use 0:18:50.400 --> 0:18:56.080 a topical um. A topical anesthesia. It helps a little, right, Uh, 0:18:56.680 --> 0:19:00.400 so that they'll it will numb your gum when they 0:19:00.480 --> 0:19:03.000 put the needle in. Yeah, they'll put like that gel 0:19:03.280 --> 0:19:04.600 and that will them in a little bit. Or if 0:19:04.640 --> 0:19:08.120 you're getting sometimes like an ivy in the arm, they'll 0:19:08.160 --> 0:19:11.200 spray it with the cold stuff and that all helps, 0:19:11.280 --> 0:19:14.159 for sure. It does. You'll still feel the pressure of 0:19:14.200 --> 0:19:16.800 the needle going into your jaws, but you don't feel 0:19:16.840 --> 0:19:20.440 the pain, right and the the reason why these things 0:19:20.480 --> 0:19:25.320 work is, Uh, they a local anesthetic actually goes to 0:19:25.560 --> 0:19:29.520 the area it's delivered to and blocks the nerve receptors. 0:19:29.560 --> 0:19:34.040 It actually keeps your potassium and your sodium ions um 0:19:34.080 --> 0:19:38.440 from firing, right, which means that it's not conducting electricity, 0:19:38.640 --> 0:19:41.320 which means that your nerves aren't capable of passing along 0:19:41.359 --> 0:19:43.920 the sensation of pain to your brain. They're just shut down. 0:19:44.680 --> 0:19:47.920 That's what a local anesthetic does. And if you pay attention, 0:19:48.200 --> 0:19:51.600 the local anesthetics all in an ain and for a 0:19:51.600 --> 0:19:54.440 pretty good reason, like light decane or no vocaine. Even 0:19:54.480 --> 0:19:57.600 they don't use novocaine that much anymore. Um. It's a 0:19:57.640 --> 0:20:01.280 derivative of cocaine, and cocaine has a topical numbing effect, 0:20:01.560 --> 0:20:03.959 and they used to use it to do that, right. 0:20:04.520 --> 0:20:07.879 And then they said, why is everybody showing up to 0:20:07.960 --> 0:20:11.240 the dentist all the time? Uh? And then they said, oh, yes, 0:20:11.280 --> 0:20:13.520 it's because of the cocaine. So let's figure out a 0:20:14.160 --> 0:20:16.760 a synthesized version of it. And they came up with 0:20:16.840 --> 0:20:19.640 no vocane, lydocane all that, UM. And they stopped using 0:20:19.640 --> 0:20:22.879 no vocane apparently because there were a lot the potential 0:20:22.960 --> 0:20:27.080 for adverse reactions was greater UM, but people still do 0:20:27.240 --> 0:20:32.960 have allergies to UM local anesthetics once amount, but it 0:20:33.000 --> 0:20:36.320 turns out it's not the local anesthetic itself. It's not 0:20:36.400 --> 0:20:39.200 the no vocane, it's not the lydocane. What it is 0:20:39.200 --> 0:20:42.880 is UM. When you use a local anesthetic, it has 0:20:42.960 --> 0:20:46.400 the effect of vasodilation, which means that it makes your 0:20:46.920 --> 0:20:51.280 blood vessels relax, which lowers your blood pressure UM, which 0:20:51.320 --> 0:20:54.640 is good, but it also is not so good. So 0:20:54.760 --> 0:20:58.720 they add epinephrine, which is a vasso constrictor, and it 0:20:58.760 --> 0:21:02.639 actually makes the local anesthetic work better. So if you 0:21:02.680 --> 0:21:05.720 get a local anesthetic, you're getting the local anesthetic like 0:21:05.760 --> 0:21:09.800 Clyda cane mixed with epinefrin and a preservative to keep 0:21:09.800 --> 0:21:12.520 the epine and fresh. And it's the preservative that you're 0:21:12.560 --> 0:21:16.160 having the adverse reaction to. Yeah, and again just a 0:21:16.200 --> 0:21:21.080 well balanced cocktail to give you exactly what you need. UM. 0:21:21.760 --> 0:21:23.800 Local is gonna wear off in a few hours, It 0:21:23.840 --> 0:21:26.600 depends on how much you have UM. When you leave 0:21:26.600 --> 0:21:28.600 the dentist, you know you'll still have your mouth numb 0:21:28.680 --> 0:21:31.000 for a while, and they always want you not to 0:21:31.040 --> 0:21:34.200 eat or talk too much because UM. You can accidentally 0:21:34.200 --> 0:21:37.600 bite your tongue in your cheek and not know it, uh, 0:21:37.720 --> 0:21:40.359 which actually happened to me recently, and I did bite 0:21:40.359 --> 0:21:43.680 my cheek man a lot, Yeah, bled a little bit too. Yeah, 0:21:44.200 --> 0:21:46.879 I'm fine. So it's such just um, it's such just 0:21:47.040 --> 0:21:51.479 dental that you're gonna get like a local anesthetic. You 0:21:51.520 --> 0:21:54.480 could also be given a local anesthetic for what's called 0:21:54.560 --> 0:21:59.960 awake brain surgery. But yes, so in some some type 0:22:00.040 --> 0:22:02.960 some brain surgery, you need to be conscious. You can't 0:22:02.960 --> 0:22:06.639 be unconscious. They need to keep track of what the 0:22:06.680 --> 0:22:08.399 brain is doing and they need it to be in 0:22:08.400 --> 0:22:11.720 a conscious state. So they will give you some drugs 0:22:11.720 --> 0:22:15.240 where you're not necessarily like you you might be sedated 0:22:15.440 --> 0:22:17.479 in the like you might be on a little bit 0:22:17.520 --> 0:22:19.520 of valium or something like that, but you're not. You're 0:22:19.560 --> 0:22:22.159 still conscious, you're still able to respond to questions. But 0:22:22.240 --> 0:22:24.280 they give you a local and aesthetic because they take 0:22:24.320 --> 0:22:27.080 the top of your head off and work on your brain. 0:22:27.160 --> 0:22:30.200 I think it's in Hell Raiser there's like awake brain 0:22:30.200 --> 0:22:32.760 surgery is shown. Yeah, I think I've seen that in 0:22:32.840 --> 0:22:36.000 another movie too. Um. Yeah, because they need to be 0:22:36.000 --> 0:22:38.959 able to ask you things like in the nuts, can 0:22:38.960 --> 0:22:42.960 you believe that your brain is exposed that crazy. Oh 0:22:43.040 --> 0:22:48.280 it is weird. Um are we onto regional? I believe? Uh? 0:22:48.440 --> 0:22:52.480 Local regional anesthesia is sort of like local, but it's 0:22:52.520 --> 0:22:55.480 covers a wider area of your body. Um. So like 0:22:55.560 --> 0:22:58.639 if you need your whole leg numbed for an operation, 0:22:59.480 --> 0:23:01.600 um and just like a small portion of your leg, 0:23:02.200 --> 0:23:05.639 that would be regional. Uh. It's also called a nerve 0:23:05.720 --> 0:23:08.760 block basically because they're just taking a single nerve or 0:23:09.000 --> 0:23:11.600 bundle of nerves and blocking that. Right, they're going after 0:23:11.720 --> 0:23:13.439 like one of the big dad he's rather than a 0:23:13.520 --> 0:23:17.119 little one. But again localized. Um. Like if you know 0:23:17.160 --> 0:23:21.200 women who have given birth, sometimes we'll get an epidural uh, 0:23:21.280 --> 0:23:25.240 and that's what that is. It is injected via catheter 0:23:25.560 --> 0:23:29.480 into the epidural space in the lower back. But that 0:23:29.800 --> 0:23:34.480 doesn't necessarily mean uh, directly into the spine, which also 0:23:34.560 --> 0:23:38.000 can happen with a spinal block, right into that cerebro 0:23:38.080 --> 0:23:41.240 spinal fluid, which is about as direct as you can get. 0:23:41.640 --> 0:23:43.440 And if you get a c section or maybe hurning 0:23:43.480 --> 0:23:46.520 a surgery, and that's when they want you awake again, 0:23:47.280 --> 0:23:51.440