What the Heck- Anesthesia Nerd Words!

Surgery has a way of turning everyday people into instant experts on medical vocabulary. Someone says “propofol” or “intubation,” and suddenly you are nodding along while silently thinking, what does that actually mean? We keep it simple and honest by playing a quick game of “What the Heck?” where we challenge a pro comic to pronounce the term and tell us what the heck it means!

We start with PROPOFOL, the fast-acting anesthetic many people recognize by its “milk of amnesia” nickname, then move into the practical reality of INTUBATION and airway management. We break down what a breathing tube does, why it matters, and why the rule about not eating before surgery is about preventing aspiration, not just checking a box. We also talk about emergency situations and rapid sequence induction, when anesthesiologists have to secure the airway quickly and safely.

Then we tackle EPIDERALS, spinal anesthesia, and the confusing “spinal tap” label, including what the dura is, how medication is delivered, and why you should mention prior back surgery. To round it out, we explain the LARYNGOSCOPE and video laryngoscope, plus SUCCINYLCHOLINE, a paralytic drug that sounds scary until you understand how it helps intubation when used correctly with sedation and monitoring.

If you have ever wanted a clear, low-stress guide to common anesthesia drugs and procedures, this one is for you! Subscribe, share with a friend who has surgery coming up, and leave a review, then tell us which term you want us to decode next.

This episode was produced by Angie Debelak.  Post production editing by Ben Hill Sound.

The Needles Group
Experience elevated coastal living in Marco Island & Naples. Connect with The Needles Group today!

Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.

Transcript

Game Setup And Listener Challenge

Speaker 0:10

All right, knock knock howdy folks, Dr. Ben back here again. Now is a portion of the podcast we call What the Heck Is That? Medicine has a lot of uh funny terms and words with many syllables, which aren't good for orthopedic surgeons. And so I would like to test both the listener and John on their medical knowledge on what the heck is that. Dr. Justin here is gonna give Dr. John and you, the listener, a word. And I want you to pronounce it and tell us what you think it means. And listener, put in the comments what you thought the word meant, and uh we will go over how accurate uh that was. And so we'll see how close you are to the actual uh definition. Or it might be like that game Balder Dash. Did you guys ever play that game Balder Dash? I did, yeah, I grew up a little bit. Yeah. You have this word and then you make up a definition for it and try to convince people that's the right. So John's gonna play Balder Dash with some of these words here. All right, listener and Dr. Justin, John, are you ready to play what the heck is that? I I think I am.

Propofol And Allergy Myths

Speaker 1:19

Here's word number one, folks. Propofol. What do you think that is? Or I think this is one of the drugs that you use to assist with anesthesiology. So it's it's the uh other names for like you know, milk of amnesia or Michael Jackson juice or because it's it's it looks like milk. It's white. It is, yeah, it's white. It's it's actually an emulsion, it's a lipid emulsion, so it looks white. It looks like milk in the syringe. I haven't seen any other drugs that's white like that, is it? The only one I know of is called uh clav clavidopine. It's a really short-acting uh costume channel block we're used to drop blood pressure, but that's really I could use that low chance of uh mixing those up. All right, it's all right. Does it come in like whole and two percent or the it's all whole. All whole. It's all whole. It's about as whole as it gets. Actually, it's uh one percent, technically. Oh, one percent. Okay, really. Uh low-fat propofol for me. CC. See, it's one percent. Can you can you buy propofol at like a Walgreens? Uh no. Okay, I don't think so. Michael Jackson had a special connection. It didn't work out too well for him. And I'm lactose intolerant, so is it still okay? The milk milk of amnesia is okay for the lactose intolerant? No, I've never had patients say that. Okay. Ironically, it actually is like an egg protein. This is getting into the weeds, but some people have with egg allergies will have problems with it, but never actually seen it before. So having an actual allergy to it is super, super, super rare. I've never actually seen it before. Listener, make sure to tell your anesthesiologist any allergies you have before surgery. Very important. Be honest, your anesthesia people. PSA. All right. That was one. Listener, did you know what propofol was? Okay. I'm excited for word number two. Yes, here we go.

Intubation And Why Fasting Matters

Speaker 2:59

All right. Word number two, John, is intubation. Intubation. What the heck is that? I've heard the word intubation, period. Okay. When they're under? When they're under, okay. Listener, what do you think? Intubation, when they're under. And then we'll get the answer here from Dr. Or pre-under. I don't know. Pre-under or under. Underwear. Oh, you just made me say underwear. Oh. Uh intubation is well, there's different types of airways that we use. Basically, when you're under anesthesia, sometimes if you're really deep, like under general anesthesia, you don't breathe very well or at all on your own. So intubation is the process where you put a breathing tube down into your uh trachea or your windpipe to breathe for you. Got it. Um not every anesthesia requires that. Sometimes we'll use different types of airways, like an LMA or um just some nasal cannula. There's different other options, but that's when we put a breathing tube all the way down into your breathing tube. Your trachea. At first, I'm not gonna lie, our production team has really good handwriting. I'm not making fun of them, but they have this thing that it looks like it's an accent mark. So I felt I felt like it was in Spanish, like intubación. That's when you're in uh Tijuana, you get that intubation. I say that for mission trips. Yeah. Mission trips. Doctors without borders. But sometimes those airways are tricky, in all honesty. And sometimes the airway could go into the esophagus leading to your stomach, so that's not good. Yeah, getting the right tube. Food tube, air tube. I'm trying to dumb it down for the orthopedic surgeons here. So yeah. Air tube good, food tube bad. There is some technology too, I've seen, like with a camera that you can make sure you're going into the uh windpipe or the trachea. So what's an NG tube? I've heard some. Yeah, NG is nasogastric, so it goes from your nose to your stomach. So you can put it up the nose and go down your stomach. You can also do orogastric OG tube, but that goes down the food tube. Not the air. Okay, okay. And important in anesthesia too is that the um any contents in the stomach do not come up and go into your airway aspiration. People ask that a lot, like, well, why do why can't I eat before surgery? And that's really why. So when you when you get put to sleep, that the some of the muscles that kind of keep the food down can relax. And so you know, potentially food can come from your stomach and come up the food tube and get into your air tube. That's a bad idea. That's like go to the ICU, get intubated like that, stay there for days to weeks. Listener, do not lie to your surgeon and anesthesiologist about when the last time you had something to eat before surgery. Very important. Yep. Sometimes someone had recently eaten, but it's an emergency surgery. So can you talk to uh any precautions you would take if we have to do the surgery and not wait eight hours to keep them from Yeah. Sometimes, yeah. Someone gets in a car wreck on their way home from Chick-fil-A and the food's you know, their stomach's full of food, and we just we have to get that breathing tube in very fast. We do what's called a rapid sequence induction. So instead of just taking our time, getting you off to sleep and putting in that breathing tube like it in a controlled, you know, slow way, it's more like a, hey, let's hurry up and get that breathing tube in. Luckily, on the end of that, it's called an endotracheal tube or an ET tube. We put that down through the uh in your mouth, sometimes nose, uh, in your mouth, but in your airway, into your trachea. There's a little kind of balloon on the end that inflates and keeps it there. That balloon can actually keep the gastric contents in the food and stuff from getting down. Oh, it acts as like a blockage. Yeah, it seals it off. It's not perfect, but it's it's the best. That's cool. Cool. All right, listener. We're learning all sorts of stuff today on what the heck is that. Our

Epidurals Vs Spinal Taps

Speaker 6:27

next word, Dr. Justin for John, is it's an epidural. Uh good pronunciation. Oh, yeah. Epidural isn't it basically I want to say a pain reliever. Yeah. So uh because like I've like a pill? It could be intravenous or it could be a pill, couldn't it? I don't know. Okay. And I think it's to prevent pain. Because I've I know a lot of like ladies who are going into labor will ask for an epidural. So I heard giving birth hurts a little bit. I don't think uh we'd have a very lower population if men were in charge of giving birth because we're not as tough. No, we are not as tough. All right, so Dr. Justin, what is what the heck is that? What's an epidural? So the the most common time for people to use the term epidural is when they are talking about labor because we will use epidural anesthesia um to help with labor pain. Really, epidural means upon the dura or yeah, what's the dura? So that there's coverings to your brain and spinal cord called the dura matter. There's different layers of meninges that they call basically it encases your whole central nervous system, your brain and spinal cord. When we're doing epidural anesthesia, we put a um we can put medicine just outside that dura, usually going through your back. Um and we can um the most common time that we're doing it is for labor. When we're doing it for labor, um, it goes through your lower back, your lumbar spine, and we can put medicine in that dural space, right outside the dura. Yeah. And the medicine kind of diffuses through and helps with your pain. How do you put that medicine in there? Can you tell the listener? Yeah, so we so we go through with it, we kind of numb it up first, we'll put a needle in, and then through that kind of bigger needle, we put a really small, looks like fishing line, it's called a catheter, really smith, really, really thin tube. And then we put that in, we can tape that in, the needle comes out, but then the tube stays in, and we can give medicine through that to numb up the spine from that point down. So like numbing medicine. Right, yeah. It's it's local anesthetic and opioid like fentanyl, things like that. Nice. Okay. Yeah, there's we can do like uh you might have heard of epidural steroid injections. Some pain doctors will do the same space, but they'll put like a one-time injection of steroids to help with back pain and sciatica and that kind of thing. So, what's a spinal tap then? Very similar. Isn't it in a movie? Yeah. Um, people get confused a lot, and understandably, because they're very similar. I do lots and lots of spinals, but uh usually a typically a spinal is it's a different layer. So instead of being upon the dura, you actually go through the dura into where the cerebrospinal fluid is. And that's that's why it's called a spinal tap because you can either do it therapeutically and give medicine to make you numb for surgery, or you know, for C-sections, we do that all the time. I heard it's more serious too, because you are going through that dura. Yeah, it's you have to use a lot less, you know, a lot less medicine because you're right there where the spinal cord is. Yeah. So it's a little bit trickier. People will debate which one's easier or harder, but they're just kind of a different technique, but very, very similar because it's going both going through the back, the low back. Got it. Um spinal tap is usually what people say if they're just getting CSF fluid back, like for to see if you have meningitis or see if you have different typical nervous system diseases or things. So um, same technique, but when I get into the spinal space like that, I'm getting medicine usually. I'm not usually just holding medicine. That's different doctors, usually a neurologist or an ER doctor that does that. Okay. And listener, tell your anesthesiologist if you have any back surgery. That would be important to know. And then if after an epidural spinal, if you're getting a headache, right, Dr. Justin? Yep. It's one of the complications that can happen. Because that uh CSF cerebral spinal fluid can leak after, and so we need to know if you're having a headache after. Yep. Okay. Well, good. Epidural, what the heck is that? All right, I'm excited for our next word on what the heck is that. This is one of my favorite words. Okay. John here is going to tell us what the heck is this word? A laryngoposcope.

Laryngoscope And Seeing The Airway

Speaker 10:22

Uh Larengoscope. Okay. How do you do on pronunciation first? Pretty dang good, yeah. Pretty good. Okay. And what the heck is that? Well, I think of uh laryngitis, uh, which is if in the throat, is that a camera that goes down your throat? So we there's different types of laryngoscopes. Some people call it laryngoscope. I can't say laryngoscope, doesn't it? Okay. Like GIF and GIF. Exactly. Um there's different types of them. Typically you have either direct laryngoscopy, which is looking at the vocal cords just with a there's a little usually an L-shaped tool you kind of see in movies where you it puts you put it in the mouth and kind of move the tongue out of the way and can move the tissues out of the way so you can actually see the airway, the trachea, so you can put the breathing tube in there. We also have video laryngoscopes. You can have alluded to that to that earlier to intubate with Glidescope or McGrath, are different brand names that make them. But feel free to sponsor. Yeah. Hashtag sponsors. Hashtag sponsors. So the video laryngoscope can be like you sometimes prefer a more difficult airway. You can put that in there and you can see the the vocal cords and things on a screen. So then everyone in the room can see it, and not just the person that's cool. So it's basically the tool that you use to put a breathing tube in. Mm-hmm. And it's uh there's a blade, there's kind of curved or straight. And you have to lift up the covering called the epiglottis to expose the vocal cords and then use this tool, the laryngoscope, to put that ET, endotracheal tube between the vocal cords. Yeah. If any companies want to provide these to the podcast, I would like to see what it looks like. Absolutely. I should have brought stuff. Yeah, go to drbencomedy.com. I like it. All right. So we know what the heck is that? Laryngoscope. I feel

Succinylcholine And Paralysis Safety

Speaker 12:04

like this next one is gonna be like reciting a dinosaur name. I've never heard of. It's the longest word, it's the trickiest word. I'm excited. All right, I'm excited to hear what the heck is that. All right. Dr. Justin, listener at home. Dr. Justin has provided John with a word of what the heck is that? How do you say this word? Can I buy a vowel? Yeah, can I this sounds like something you'd call a mean French Oui, oui! is it suction is it suctional chloline? Pretty dang close. Suction and choline. What do you think that is? I'm thinking of choline. I've it's gotta be some sort of I'm gonna say uh medicine. Suction. Okay. If it is a medicine, what kind of what would you use it for? What what do you think it treats or oh boy, that's where I get confused with I I didn't take Latin. So uh you're doing really well. Yeah. I'm actually I'm I'm I'm I'm I'm dead on this one. Yeah, I don't really know. Uh actually it's it's funny you said that because without him, I think you would be. Without that. With with that and without you, you would be. Speaking of you know, intubation and laryngoscope, succinylcholine is a paralytic medicine that is used to paralyze people. That sounds scary, but we use that to kind of relax the body or the muscles. And in this particular, we use it to intubate. So you give it before before intubation, after sedation, because you don't want to be paralyzed while you're awake. That's a big no-no. Once you're off to sleep, we give that to relax your vocal cords and relax your body so that we can get that breathing tube in without you moving around or your vocal cords. Okay. And if this were administered to you without someone managing your airway, I think you would be. We would have a bad day. I would have a very bad day. You would have your very last day. Be a bad, yeah, be a not a good last day. I don't think there is a good last day. Or this just turns sad. All right, succinylcholine.

Wrap Up And Comment Prompt

Speaker 14:05

All right, listener, if you uh guessed any of those and have any funny responses like John, we'd love to hear what you thought each of those words meant. Please put those in the comments. Dr. Ben and Friends.