The power of our drugs never ceases to amaze me. Take muscle relaxants, for instance. By delivering as little as a teaspoon of a drug like rocuronium or vecuronium, we anesthesia providers can literally paralyze YOU for your surgery. This comes in pretty handy when your surgeon does not want you to move during your operation!
The Indians of South America have known about muscle relaxants for a long time, using curare dartsto “poison” their prey. Actually, how it works is by paralyzing all of the muscles of the hunted animal, including those of respiration, thus leading to their death through asphyxiation.
So, why does your surgeon want YOU paralyzed? Well, not for all surgeries, but for certain types, it’s critical that all of your muscles are completely flaccid. Why? 1) it makes it so much easier for the surgeons to find what they are looking for; and 2) it avoids (and virtually eliminates) any sudden or unwanted movements by YOU during the surgery. Doctors do not like to operate on a moving target!
[ Of course, general anesthesia that requires muscle relaxation involves a whole lot more than just paralysis. YOU are administered intravenous (IV) or inhalation agents to make sure that you are asleep, and pain medications, often narcotics, are also given to insure your comfort and analgesia. ]
So, how do we achieve this state of TEMPORARY immobilization? We give you this medication through your veins; this is one of the reasons why you have an IV. As the duration of these drugs does not last forever, we will dribble in more of it as the surgery requires. Different muscle relaxants have different durations of action, and we can choose among them according to the needs of the surgeon and the length of your surgery.
Miraculously (although it’s not a miracle at all but something very scientific and calculated), YOU regain your ability to move by the end of the case. In the hands of the skilled, competent, and experienced anesthesia practitioner, these two events will be timed perfectly. Certain drugs we give can get rid of any lingering effects of the muscle paralysis, too. There are no magic wands, but I must tell you that giving these drugs (actually administering all types of anesthesia) can be both wondrous and humbling. The tremendous responsibility, respect, and conscientious care that must be ever-present in the anesthesia provider is not something that we take lightly.
Your surgeon will fix your problem, and your anesthetist will keep you alive. And sometimes not moving.