Rectal Anesthesia and Sedative Enemas before surgery

Back about 1955 I can remember being taken to the hospital for tonsil surgery. Shortly after a soapsuds enema with the wonderful old-time white enamel can and soft rubber tubing I was taken to the preop area and told I was to receive another enema. I felt no fear since no gas mask was put on my face. This gentle enema came from a smaller container. Once the enema tip was inserted, the fluid felt so incredibly smooth and warm entering me.

The doctor said "Now, hold this in for a minute." The mere act of holding in something that felt so slick and filling was such a wonderful experience. I can vividly remember those words, because that is the last I recall until awakening in the hospital bed after surgery.

The fluid in the last enema was an olive oil/ether combination, which I learned later in life was a common form of anesthesia used in the 50s, a favorite for use with children, many of whom were used to enemas and put up no fuss when given the gentle anesthesia in that manner.

The point of this story is to say that experience left me with a deeply-held emotive attraction to enemas and rectal stimulation. I still enjoy warm enemas and gentle prostate massage for health and pleasure.

A note to forum readers..I would be interested in knowing if any readers have experienced that form of enema anesthesia as a youth, and did it impact your emotional connection to enemas later in life?

I've read somewhere that back in the fifties doctors would put people under by giving them anesthesia through an enema. Has anyone experienced that personally or know more about how it works like what drug they use or how they make the patient hold it in when their asleep? Why isn't it done anymore? It seems like a great way to go under! : 😄

Rectal anesthesia was for primarily for children.

It's efficacy and onset was unreliable.

The answer to the question about "how to get themn to hold it while alseep, and I do hope Susie agrees with me, is the in the amount injected was a very small dosage of anesthetic. Hardly enough to need a release. By design it was to be absorbed.

I've no real idea, but I suspect it was tried, because "ether" usage often had residual effects of nausea,

As Susie said, it was notoriously a POOR choice. One reason was that it affected the bowel for many days afterwards, often requiring regular enemas, with longer recovery time in the hospital. Walt

I know they still give pain killers through the use of suppostories, I got offered this when I had an operation recently but swiftly declined! Although they probably did it as I was asleep for over 8 hours, operation only took 2, reacted a little too well to been knocked out lol! In them 8 hours think how many times the could have shoved things inside me!

That reminds me of the time I was getting out of surgery. The nurse gave me a suppository (phenagren) to calm my nausea, which had sedation as a side effect. From what I remember, it was rather large and inserted deep into my rectum, where there was a mild burning sensation, but I was out cold in no more than five minutes and remained so for the rest of the afternoon.

I would imagine that being drugged by enema is even faster, since it can absorb right away without needing to wait for it to melt.

Kevin,

Powerful pain meds can indeed be be subscibed in suppository forms. Uusally for gastrintestinal surgery recovery. Some general patients cannot take such meds orally, and some have various reactions to IV meds. Like drug addicts, whose arteries and veins are hardened. That can occur in aged patients as well.

Indeed, "phenegran" is a atrong anti-depressant, they doe have some pain relieving effects, but is not listed for pain relief use. Unlike glyccerin, of bisocodyl suppositories, these do not stimulate bowel movements, and in post surgical patients they shouldn't.

Walt

Walt--

I've only ever used suppositories for constipation (I still do, once or twice a week) and hemorrhoids (I used to, on and off, before getting surgery) and never really thought of them as drug delivery devices.

What if the person has a full rectum? I fasted for 24 hours before my surgery so that probably wasn't a problem, but I would think that reliability would be a problem in a patient who didn't, just as with drugs by enemas. Does the patient have to have a bowel movement/enema beforehand to make sure it gets absorbed?

Hi Kevin,

I can only offer a layman's opinion. Unless the patient is severely "impacted," I would think a full rectum might slow down, but not stop, absorption. I also think there are many factors for surgeons to consider in deciding pre-op, and post-op needs. What part of the body are we operating on? How long will the actual surgery take? What is the patient's general condition otherwise? Age would be a factor.

I've had 5 major surgeries in my life. I mean those that required full general anesthesia. The last one surprised me. My prostate removal came 14 years after my last my last such operation. I mean, they are going to open my abdomen, and I was NOT given a suppsoitory, or an enema?

I will say to all of you males: IF you are ever scheduled for a biopsy of your prostate, do NOT rely upon the "fleet" that will ordered at home, either the night before, or that morning, Take a good common enema instead, in the MORNING. I took the fleet, and when the biopsy was finished, I was left with a ROYAL MESS. (This biopsy is done through your rectum. It is also more painful than the doctor will say it is to be. Walt

Walt, et al.: Phenergan is the Wyeth Labs. brand for promethazine HCL. I was a sales rep. for Wyeth for a few years. This drug is not an antidepressant. It has several uses: antiemetic (stops nausea), antihistamine, sedative, has some antitussive effect. It causes a very dry mouth, but many hospitals use it as a "potentiator" in conjunction with other meds. That means it makes other meds. work better; often a narcotic pain reliever is given with Phenergan for a stronger effect. It is available is tabs., liquid, injectable and suppository. Suppository use is most common for nausea, when the patient is too sick to swallow antiemetic meds.

I almost had one done. The urologist did do a prostate ultrasound, but he determined that it was most likely chronic prostatitis that raised by PSA levels. The ultrasound probe was a little bit bigger than a thumb and therefore pretty uncomfortable. Had he suspected cancer, he would have used it as a guide to do the biopsy.

jimmyt44-what other drugs can be given in suppository form? Is it important to have an empty rectum for these meds to work?

I am still interested in knowing more about rectal anesthesia (if they personally experience it, what drugs they use, what kind of enema syringe,...)

My girlfriend had her wisdom teeth removed surgically (incisions thru the cheek not thru the mouth) She was on some pretty heavy duty painkillers and due to the concern for nausea she was prescribed an anti nausea suppository, which I suppose was Pheneregan. I didn't pay any attention to the packaging, was more interested in administering it to her! By the way, it worked.

I was born in 1958 with Spina Bifida and before a minor surgery was given anesthesia rectally. I was always getting enemas because chronic constipation is a side effect of SB but I recall getting a number of enemas while in the hospital that was more then usual. I was then told when I got down to the operating room I would be given a 'small enema' that would make me go to sleep. I must say I was actually thrilled that I wouldn't have that mask put on me with the gosh awful smelling fumes. The actual enema was a large piston syringe with a red rectal tube attached. The enema tube was inserted and I remember feeling it going in and was out like a light. Woke up in my room later that day and didn't feel anything like I usually did after surgery (I had dozens over the years). Even though as a kid I didn't like having to get enemas I had hoped that this was going to always be used but alas it was the first and only time.

Greg

Hi Greg,

How much liquid do you think was in the syringe? Did it feel different from a regular enema?

Also, was this common practice at the time, or was there something special about the surgery that made rectal anesthesia necessary?

Back in 1968 when i had my hernia repaired i was only 7 years old. The night before the surgery a female nurse came into my room and put me on my right side (it was the only way since my bed was up against the wall) and gave me an exquisite enema. Then after expelling first into a bedpan and the rest into a toilet, a male nurse shaved my privates for the surgery. The next morning i was put onto a gurney and rolled to another floor. Just outside the OR doors the nurses rolled me on my side and a small injection of liquid probably about 5cc was squirted up my butthole. I was rolled onto my back and the gurney started moving through the double doors. I remember suddenly feeling like i had to poop, but I never did get to see the inside of the OR as the anesthetic was nice a quick. I'm not sure if i let the liquid out or not but that was the last rectal anesthesia I ever had.

My mother was a state registered nurse but the most sexually inhibited person I ever knew but she had several nursing books printed in the twenties and thirties. One of these devoted an especially large chapter to enemas and it described just about every variation. There was an instruction on how to administer an anesthetic enema. The patient was put on their side and asked to lie quietly while the nurse inserted a rubber catheter into their rectum and then organised a slow drip type feed into their bottom. The article instructed the nurse to keep an eye on the patient as they would become unconscious within a fairly short time. The enema was not one that had to be returned but remained in the patient who, I presume, was then wheeled off to the operating theatre maybe with the enema and tube still in place.

@susie, yeah i even asked the male nurse why he's shaving "down there" since there's no hair! i can still remember his wide grin and laugh, and then he said there's hair it's just very tiny. it was the oddest thing that i can ever remember having done.

In the US rectal "anesthesia" is not practiced. There are some drugs with dedative properties that are adminstered rectally ie: Phenergan for nausea and drugs of this type which calm down the body and produce a sedating effect. Let's face it its 2010 and absorption? which is uncontrolled via the rectum is not the best way to administer a drug for anesthesia. Might sound fun but not to safe.

I know all the surgeries that I went through, I never hid have any rectal anesthesia. Even, my last one, which happen to be the more severe one. That one I just remember, going into the OR early afternoon, given the mask. Waking up sometime the next day. From what I was told, the overall surgery took over 6 hours to complete. All the others, I was just given a slow drip.

I remember my mom talking about her hospital experience with the delivery of my younger sister in 1961. We kids were interested as my mom gave us a step by step run down. She talked about getting shaved and a soapy enema shortly after arriving. As she labored she said she was given another small enema that she had to hold. She said they kept asking her if she was feeling sleepy yet. Before long, she didn't remember anything else until she had awakened and there was my sister. She said it was a C-Section because my sister was too large for a normal birth.

That was my first indication of rectal anesthesia and my mom later told us it was fairly common back then. Discussion of enemas was pretty common in our house. I think she was trying to make the point that adults got enemas as well as kids and that they weren't a big deal. They sure were to me!

I am a pediatric anesthesiologist and today we don't normally use enema anesthesia. We just use masks or IV's

But on one occasion we did about 3 years ago to a 14 year old boy

If you want to hear the story blast me a message. I personally think if I was a child I would want it rectal instead of forced to the mask.

Unfortunately I didn't had your luck! When I had my tonsil surgery, I was a 4 yo child, and the anesthesia with the gas mask is one of my worst childhood memories...

For my tonsillectomy at age three, I vividly recall my own experience as similar to that of TaniaClister and fought desperately to keep that metal ether mask away from my face. My form of childhood revenge came upon recovery when I threw up in my room and the attending nurse was quite upset.

More recently, I've been informed by a friend who is a nurse that anesthesia administered as an enema for surgery is less toxic for the liver and does not require the additional mix of drugs used in post-surgery recovery. She advised that form could be requested as a possible option. I would certainly consider that and invite any knowledgable insight.

Sounds like rectal pentothal. It was used at one time for kids and even nervous adults. This did not eliminate the need for other anesthesia. Pentothal will produce unconsciousness, but it has no analgesic properties and is not a true anesthetic. Most all will have received an inhalation agent after falling asleep. The very big drawback to the drug was the large dose (about 5 X the IV dose) needed due to poor absorbtion per rectum. Eventually (during the surgery) all the drug would be absorbed and the liver had to clear it; pentothal has a very long half life (36 hrs), and patients would be snockered for up to a day or more.

Today, there are oral drugs with quick recovery that are given orally to children, and are much more pleasant during recovery.

Actually there were several rectal route drugs available. Both Penothal® (no longer available), and Brevital® could be given that way, in fact at least into the 1970's Abbott Laboratories had a Penothal formulation intended for rectal use. The other commonly used drug until the 1960's was Avertin.

Avertin in still used today for laboratory animals. Avertin is a chemical cousin to Chloral Hydrate. However as Vito pointed out, none of these drugs had significant analgesic properties, so an inhaled anesthetic was used once the patient was 'out'.

These have largely been replaced by inhalation agents like Sevoflurane, which is much more potent than Ether, non-flamable, and has a relatively pleasant odor. These agents are potent enough that a single deep breath is often all it takes to produce unconsciousness.

In certain circumstances both Valium and Versed are given rectally to control seizures. They are also sometimes used to provide sedation.

The main disadvantage of rectal administration of all of these drugs is absobtion subject to large variations, and it is very difficult to adjust the dose, With IV and inhaled agents, this is far less of a problem, and not subject to anything like the variability seen with rectal administration.

Thank you, mattheww50 and vito, for your kind replies with the information you have given. I know the nurse who gave me the thought was well-intentioned and it's good to have more information to go on.

Interesting - back about 57 I over heard my mother talking on the phone to her friend who's young daughter had just been given an enema to put her to sleep before going to surgery. I remember being very interested.

Was hospitalized many times so not sure of date but it was probably '64 or '65 that I received anesthesia administered through an enema. I recall being taken to the 'Treatment Room' for an enema. This was a time that children were kept in a 'ward' and their might have been over a dozen other kids in the room. I would still occasionally receive a bedside enema and they were the worst because everyone heard and some saw what was happening. The trip to the 'Treatment Room' wasn't unusual for me since I received an enema almost daily but remember a big deal being made about this enema 'working' since I was told about getting another enema in OR that was going to put me to sleep. After a long enema session and subsequent wait I was taken to the OR and the solution was in a syringe. I was amazed that it wasn't nearly the amount that I would get and thought this will be no big deal and it wasn't. The tube went in and I went out. Waking up I had few of the ghastly symptoms I would normally have upon waking up and was actually hoping this would be used in the future. Sadly it was never used again. . . . . I don't believe the procedure I had that day in the OR was a very serious one.

Maybe I should ask for that before my surgery on Thursday. It might save me the tedium of waiting and answering constant barrages of questions, I could just doze my way through waiting time. My partner will be with me, I bet he'd love it if that happened.

I just remembered how, years ago, when the assorted terrorists in Afghanistan were captured and put on planes to Guantanamo (and other places), to keep them trouble-free, they were blindfolded, given forced enemas laden with a knock-out drug, diapered, then tied down for the long flight.

http://www.freeexistence.org/us_extradition.html - three-fifths of the way down the page, see the paragraph headed "Extraordinary Rendition."

There are many sources that document this.