Basically I'm due to undergo some pretty hefty surgery in the next few months, and have been told that because of the nature of my asthma and how unstable it is, that it would be unwise for them to give me a GA and want to do my op under epidural. Problem is, I'm completely terrified of the idea of both the epidural and being awake during this. When my mum was having me, her epidural was inserted into the wrong place and she was pretty much paralysed for 3 weeks. I know the chances of it happening again are slim, but this has left me pretty much terrified of the things. I also don't want to be able to hear what's going on around me, specially seeing as it's orthopeadic related and surgeons have a tendency to use DIY tools...
I know that the chances of me getting them to change their mind, owing to the fact that I am so unstable and have ended up quite poorly with my chest. But has anyone else had an epidural for surgery with any form of asthma? And if you did how did you find it during the surgery and post op when you were recovering?
I had shoulder surgery under GA about 18 months ago in Cardiff. I had an art line fitted so they could closely monitor my lungs and they operated on a day which my resp con was in the hospital just encase. Unfortunately it all went a bit wrong about 4 hours into the surgery I started retaining co2 and was needing extra 02 so my resp con was called and an itu doctor. The surgery was stopped and I ended up being left ventilated for an extra 6 hours. However I woke up feeling fine - just confused about the time, why I was in ITU, and why I had so many drips!
I've also watched a few ortho surgeries and as you say they quite often involve standard tools in your dad's toolbox or worse - tools your dad wished he had in his tool box. Not gunna lie it's not my cup of tea and I wouldn't want to be awake while someone was doing that to me! I'm assuming the ortho con has discussed it with your resp team? Your resp team maybe happy for you to have GA? I guess it depend on all sorts incl what exactly your having done? Also have you discussed your fears with both teams?
Good Luck Vicky!!
Alice x
not had to have any surgery myself so cant really offer much advice - my initial thought would be that given that they wont want you to get distressed and panic - also not good for the lungs - they may be happy for you to listen to music or watch a film on an ipod or laptop or something. it might need to be cleaned and stuff but i suspect that its possible - and certainly worth asking about just in case!
Sorry you need an operation.
I have had several operations on my lungs, which obviously need you to be asleep. As others above have said, the most important thing is discussion between the surgeon, the anaesthetist (who will be the most important person in managing your condition during surgery), and your respiratory consultant.
In my case, I was admitted onto the resp ward a few days before surgery and started on aminophylline infusion and IV antibiotics. These continued until several days after the op. they didn't proceed with surgery until they knew they had a bed available in ITU, should I need to be vented for longer (as happened to Ally), and I remained in HDU for a day longer than usual so they could be sure my condition was stable. As it happens, I had no problems at all!
As others have said, it might well be that your resp consultant and the anaesthetist are happy for you to have a general, with sufficient precautions put in place. Alternatively,they will be very used to handling worried patients under local. There will be plenty of drapes up so you won't see anything, and they might also be prepared to give you some light sedation to take the edge off your anxiety?
Good luck!
Im like you a very unstable asthmatic and had 2 Abdo operations both classed as emergencies and both under GA's. The first I had an attack as I was waking up and ended up in ITU, looking back I think it was due to no extra steriods and being woken up and exhubated to quickly causing bronch spasms. The second they used the drugs give you when tubed in ICU the white stuff and it was left to come out my system so I woke up slowely. Before the op I was given nebs and extra steriods and during hte operation was on aminophylline. A bed was mine in ICU but just stayed in recovery for longer.
You could ask for sediation on top of a epidural and as it will be planned more time to make sure you are at your best but resp consultant should be the main person in deciding what to do
Hi ya
I recently worked in an orthopaedic hospital. Many operations are done under epidural. You could, as already mentioned, ask for sedation to be added in. The patients that had surgery with epidural often had a quicker recovery.
Try not to worry, have a chat to the anethatist (can't spell), they are the ones that have better knowledge. I hope it all goes well for you. Explain your worries, they do understand you're anxieties.
Lisa x
Don't worry, I had a total hip replacement 7 years ago with a spinal anaesthetic. I mentioned to the anaesthetist that I didn't really fancy listening to the bone saw and he said that they would give me a sedative. Once the epidural was in place they gave me the sedative and I had a sleep so although I was not under a general anaesthetic I had no idea of what was going on. The recovery afterwards was a million times better than with a general. I am due to have some gynae surgery in a few months and will again be having a spinal due to my asthma. I have some worries about the surgery, but not about the anaesthetic. Best of luck.
Hi,
I had an epidural for a C-section and apart from some funny tugging sensations I felt nothing at all and I can honestly say given an option between GA (which I've had twice before the epidural) and epidural, i'd have an epidural any time.
The recovery and how you feel in yourself is way, way better with an epidural.
I recently thought I was going to need orthopaedic surgery myself and actually asked them if I could have it done with an epidural rather than GA!
I think you can take in an ipod and headphones or similar to listen to while the surgery is being done so you can drown out any horrible noises too.
Take care
x
I've had two operations under epidural and I have to say that given the choice I would always go with epidural as you recover a lot quicker and it's a lot less stressful on the body than GA. In some countries they prefer to do ops with epidural especially on elderly people who would not be able to put up with GA. I know of someone who had a hip replacement with epidural and watched it ! Generally they don't let you watch your own op - they put a little curtain up ! In my last op with epidural (knee surgery) the anaesthetist was sat by my head monitoring everything and talking to me - he thought I was stressed because my heart rate was so high but I wasn't, it was probably excitement, but he kept offering me tranquillising meds !
I had shoulder surgery done under a nerve block as my asthma is always bad after GA, the nerve block however blocked some of the nerves to my chest/lungs and I really struggled for a short while until I became used to it. My recovery was so much quicker and my asthma was fine after which was great. I would avoid a GA at all costs but I then had to undergo an GA to remove my appendix this could not obviously be done any other way. As I was coming round I went into a asthma attack and had to have numerous amounts of medication oxygen etc and stay in 1 on 1 care for a while instead of going back to the ward. Very very scary and this the case after every GA I have had. If you can face it go for the epidural it will also help with the pain relief immediately after the op. Hope this helps. Good luck for your op. Oh yeah the anethatist also took pictures of my nerves while doing the nerve block (massive needle and wire in my neck, arm and chest) as my nerves were not in a usual place 1 in a million or something like that, im resigned to the fact I am just complicated haha
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