Mask or IV anesthesia induction?

Anesthesia can be inhaled through a mask or injected through an IV. In this video, I explain the rationale that anesthesiologists use to determine which route is best to deliver anesthesia to patients.

0:00 Start
0:45 Induction
2:25 Mask benefits
2:50 Mask drawbacks
5:17 Pediatric patients
6:00 IV induction

Music:

The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.

#Anesthesiology #Residency #MedicalSchool

[amandaz]

So far I’ve been given both options (for context I’m 20). I tried a mask once and it felt like I was being smothered or suffocated so never again. The iv feels natural, like ur eyelids feel heavy and u fall asleep. It wasn’t traumatizing bc it was my choice, it wasn’t forced on me.

[starfishgurl]

As someone with sensory and auditory processing disorders (both autistic spectrum disorders) as well as anxiety I’m so glad you made this video because the thought of anesthesia being induced by a mask has been absolutely terrifying to me in the past and was one of the biggest reasons why I was afraid of needing surgery but hearing that IV induction is a much more preferred option was a huge relief to me! I’m actually one of those people for which IV/needle insertion is sort of a euphoric experience and I love watching when possible as a result so I’d absolutely love that option for surgery. I have deep veins but they’re really good veins for giving blood so I can imagine that they’d also work quite well in the opposite direction (provided that they don’t infiltrate like they did whenever I tried giving platelets). Great video!

[MagierT]

Its oddly comforting seeing people in the comments speaking about their feelings about having the mask vs. having IV induction. Being a cancer survivor, I've definitely been through many procedures that required me to be put under. I was mortified by mask-induced anesthesia because of the scent of the mask, the taste of the fumes; it made me panic every time! Even as a child, I vividly recall asking to get poked so that they can use IV induction--a LOT faster and more comfortable!

Even to this day, if I think deeply enough, I can STILL smell the scent of those masks!

[ds]

Always straight and to the point and always educational.

[dmc]

If I ever match into anesthesia, I'll offer my patients a third option for being put asleep: hearing my life story 😴

[treywhite]

I’ve had many surgeries, and have long been confused between why the “preference” from mask to IV suddenly changed… Now I know, it’s just because I’m an adult, and kids tend to hate needles! I used to have to BEG my pediatric doctors to let me get anesthesia through an IV because of a terrifying experience I had with the mask as a toddler (I’m still afraid of ALL masks). I really appreciate your videos, Max!

[KurtisWilson]

Pediatrics would be lucky to have you, I hope you get in where you want. Not only do you have the knowledge and skill for it, but I have a feeling you've got an arsenal of cheesy jokes and fun scrub caps to get a kid smiling, laughing, and comfortable before their surgery. Thanks for another great video Max.

[ratlord_ali]

Really appreciate the mention of needle phobia being a valid reason to consider mask induction in adults. I find a lot of healthcare practicioners tend to consider needle phobia an issue of maturity, and tend to not be understanding or accommodating for adults. As someone with PTSD triggered by IVs, it can be frustrating to have my issues not taken seriously as a factor to consider in administering my care. It's nice to see it mentioned as a legitimate potential concern.

Also, just generally really appreciate these videos. I find them very useful, both as a student in a healthcare field, and as a patient working on desensitization therapy.

[dr-ozone]

I needed several surgeries as a kid and can still remember my first experience with mask induction, as it was horrific. For 20 long seconds or so before going to sleep I felt like I was drowning and unable to communicate at all. I could feel the excitement phase you described as my heart started to race and my body started to move uncontrollably. On subsequent procedures I requested the IV experience, despite hating needles, because it beat the alternative. I really think a proper study should be done to test the assumption that mask inductions are less distressing for pediatric patients, because my own experience as well as many of the comments I'm reading here might suggest otherwise.

[tinycatfriend]

I had a traumatic experience with anesthesia as a kid. i'd never liked masks due to undiagnosed autism/sensory issues, and the doctor told me he wouldn't use one but did at the last minute anyway. this video helped me understand why he might've done that. it makes me happy to hear how dedicated you are to children's comfort, and recognize how critical it is for them and their future treatment! my situation was an odd case, so i thought i'd talk about it so anyone here might learn from it. you can't mitigate every possible traumatic thing for a pediatric patient, but you can try your best. that's more than enough. :)

[surgeon]

Honestly when I had my surgeries at the children hospital they used to give us numbing cream and it was an excellent way to get kids to feel comfortable with iv insertion so much so that now as an adult needle iv is my preferred method and I don’t even notice that they have even put it in

[tohdohsibir]

I'm also going to specialize in pediatric anesthesia. So great to have you among our ranks, you're gonna be awesome. Caring for kids is the best!

[somewhrntm]

Versed is a WONDERFUL calming agent prior to general anesthesia! I’m a BIG baby for needles, and have high anxiety. All I can say is, Versed makes me not give a crap and completely takes the anxiety away prior to surgery. Thank you Lord!

[mdoss]

As someone who's been through the ringer as far as medically. The trauma from this mask still gives me ptsd. I have awful memories of my parents holding me down at age 6 and I was screaming while the mask was over my face.

[thekathrynwest]

I have really bad anxiety around IV's and while getting my wisdom teeth out, I'm so thankful they gave me IV anesthesia. I was out like a light and didn't even realize until they were waking me up. It was definitely helpful to me to not be able to remember anything that happened besides the 5-10 minutes of just having to sit there with the IV in my arm prior to the surgeon coming in

[MTKD]

I’ve had many surgeries in my eighteen years of being alive. I always got so nervous with the mask method and it always made me feel tingly and voices were distorted. But starting in like 2015, I started getting IV stuff and it was so much calmer and more relaxing

[olingecko]

As one of those extremely phobic adult patients, my friend who was my CRNA offered me mask induction. However, once she told me that she could give me a better anxiety meds through an IV, I relented and I'm thankful for that.

[GMPHX]

I do not remember the name of the anesthesiologist that took care of me in early 2024, but I remember both the mask and the injection, in 5 seconds I was out not feeling anything!!! Totally wonderful care!!!

[PaulApplegate]

Just a quick comment to say that you're a very good youtuber. You can keep a layperson glued to your videos. I'll assume you don't get the glory of a trauma surgeon or a ER doc, but you do a hell of a job explaining the ins and outs of anesthesia. I wish all doctors were as informative as you are.
I wish you the best of luck in your career, and I sure would feel at ease with you as my anesthesiologist. I grew up kinda in the area. Colts Neck NJ so I've heard of your hospital.

[graceunverzagt]

Several years ago (was considered an adult at the time…. I think), I had a procedure where they put me to sleep with mask (and I’m guessing iv anesthesia). I STILL have traumatic memories from that induction. I don’t know if they didn’t dose it right or what, but it took forever to actually go to sleep, and in the mean time, I felt completely out of body, but awake. Thankfully it did take effect fully before the procedure so I didn’t have memory of that. The next surgery I had awhile after that (I have had a lot of surgeries), I just remember getting iv anesthesia. No mask. It was almost immediate that I was out. SO much better.