Redhead Anaesthetics

On Anaesthetics Call recently, we were administering spinal anaesthetic to a female patient for Cesarean section. She was a friendly redhead who reminded me a lot of Eleanor from Rainbow Rowell’s Eleanor & Park. She told us a lot of things, like that we would have to take the para-median approach to the spinal (we didn’t need to) and how it was impossible to get an IV-line up on her hands (it wasn’t), so when she told us that she was resistant to anaesthetic, we felt kind of resistant. 

But fifteen minutes after the spinal, she still had sensation of her lower limbs. Thirty minutes later too. She had pins and needles, but otherwise normal pain sensation. It had been a perfect spinal performed by the registrar, and there was no doubt that she had been in the correct place. The decision was made to convert her to general anaesthetic, because this was an emergency list and we had a primigravida with foetal distress waiting for us too.

We probably should have suspected that something was weird when the normal dose of muscle relaxant didn’t make intubation any easier. Or, when her heart rate skyrocketed the moment the obstetrician made the incision.

It was incredibly difficult to maintain the Minimum Alveolar Concentration for her. Twice, she seemed to be “waking up”, gagging, and her arms flailing out. I have to admit that it was a very scary experience.

At that stage, the registrar told us of a study she had read regarding redheads and anaesthesia. It seems that the mutation on the melanocortin-1 receptor gene makes redheads less susceptible to anaesthesia, and they need on average 19% more anaesthesia than dark-haired individuals. The reason this isn’t taught in Anaesthesiology classes is that other studies have been confounding, stating that no difference exists between redheads and dark-haired individuals in terms of anaesthetic requirements.

But, for what it’s worth, I’ve witnessed a great amount of surgeries over the past few years, and the only time I’ve ever seen this phenomenon has been with this red-haired patient.

As for our patient: she did well afterwards, with no recall of the events.

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15 thoughts on “Redhead Anaesthetics”

  1. I find this extremely interesting… when I was drinking (an Alcoholic actually, dry 25 years now) I had to have a small op and they had trouble getting me to go under, apart from the fact that half way through the op I came round. The next day it felt as though a train had run me over…. I’ve only had one other small op since stopping drinking and went out so fast I think I surprised the Anesthetist and the next day I felt on top of the world… now do you think that being a heavy drinker can have an effect on the drugs that are administered, or have these drugs improved greatly overtime??

    1. Congrats on being dry 25 years – that’s super impressive.
      Actually, if I remember correctly, heavy drinking should make one require LESS anaesthetic, not more… so that is very strange. Since you had another op where you didn’t have the same problem, I’m going to guess that it was drug specific. There have certainly been some improvements with anaesthetic drugs over the years.

  2. I am a redhead myself and I know that I required additonal amounts of medication for my epidural during the birth of my son. In addition to that, I later had to have a D&C and my obstetrician was not surprised when I returned a week later with an infection. She stated that even though it wasn’t standard practice to prescribe prophylactic antibiotics, she almost did based solely on the fact that I was a readhead, and in her experience they tended to be more suseptible to infections post-surgery. We are also just more awesome in general 🙂

    1. Thanks for the confirmation – it’s incredible, I think. Not being more susceptible to infection of course, but just the fact that there really is so much variation among humans. I didn’t know about the infection part. We give antibiotics for almost all D&Cs, but I think that’s because of our country’s context as well. Thanks for sharing!

  3. We learn it almost as a fact, that red-heads are resistant to anesthesia! It’s kind of surprising to me that you don’t… We had a few red-heads in our class and during the entire anesthesia block, they got teased about it all the time!

    1. Really? That’s so interesting. I should ask our professors why that is – although I presume it is because of the other studies that showed no statistical significance. But after that experience, I’ll never forget it again. Poor redheads – as if they don’t get enough grief from their peers 😉

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