Local anesthesia ineffective during eye operation

[stephanie1977]

Greetings!

I just had my two cataract operations done and now ready for a bleb needling in the eye with a scarred up bleb. The cataract op with the bleb eye went really well. The other no so good..the lens was hard and dense and I had 4 stitches. The stitches were absolutely excruciatingly painful. The local anesthesia didn't work. It was AWFUL.Now the surgeon wants to do the bleb needling with general anesthesia. Does anyone else have problems with local anesthesia not working on your eyes?? I never heard of anyone like me!

[muddledme]

Hello stephanie1977,

So sorry to hear about your painful experience. Did you ask for more anaesthetic ? As it usually works very quickly indeed. Maybe the pain was due to the longer operation and the anaesthetic had worn off.

My first laser therapy was completely painless and I was amazed that the second one was not. I kept thinking that he must soon be finished so said nothing, this did not help !

At the suture stage at the end of a shunt op I began feeling pain so indicated this and was immediately given some more anaesthetic. I was very impressed by the almost instant response.

Please do tell your surgeon up front before he starts , they do not want you in pain as you are then more likely to move ! Also wave or hold your arm up if you need a top up of anaesthetic during the op.

Best wishes

[stephanie1977 in reply to muddledme]

Thanks Muddledme,I definitely got the feeling that the local anesthesia wore off because the stitches were about 45 min into surgery. My doctor insisted that they gave me the maximum dose of local plus sedation. I didn't press the issue because I didn't want her to feel like I accusing her of wrong doing. It's hard when you need to trust your specialist no matter but somehow feel let down.

[muddledme in reply to stephanie1977]

If it was my surgery and the same surgeon then I would still ask again before and if necessary if you need a top up at any stage. Perhaps Glaucoma UK Helpline would have some ideas.

[RunnerWithPG]

Hi, Earlier this year, during the trabeculectomy on left eye, probably about 45 minutes in, my anaesthetic started to wear off. I told the surgeon, and he just gave me some more anaesthetic drops. Like muddledme's experience, they kicked in straight away. I had a needling a few weeks later, and only had anaesthetic drops (no injection), that was fine. I expect anaesthetic wears off quicker on some people, so presumably you'll just need a top up like I did.

[stephanie1977 in reply to RunnerWithPG]

Hi ,I don't understand my situation, when it seems everyone else just asks for more anesthesia to top off as you all say. My surgeon was very aware I was in so much pain and afterwards she said she felt very bad about it. I will try to talk to her again as she already told me that I was on maximum anesthesia...whatever that means. I think I will try to talk to an anesthesiologist. I just want to know the reason for my painful time.

[RunnerWithPG in reply to stephanie1977]

I guess one thing you could get clarification on. When your surgeon says you had maximum anaesthesia, what exactly do they mean? For my surgery, I first had anaesthetic drops, and then an anaesthetic injection into my eye. My "top up" was with drops - they didn't inject further anaesthetic.

[KayGeeBee]

Hi stephanie1977, I can only report a similar experience to the others' above, with pain increasing after about 45 minutes while they were stitching (which took ages) after my first preserflo insertion. When I reported this they apologized and gave me more drops which acted immediately. Are the stitches in a different/more sensitive/more problematic area for a cataract than we had with our blebs I wonder?

I've been in theatre three times now and on the last two the sedation knocked me out completely, so I wonder if your sedation really was at maximum.

[stephanie1977 in reply to KayGeeBee]

Thanks everyone,I go on Wednesday to get the stitches taken out. So I will ask the doctor what did she actually meant by maximum anesthesia. She also said she will make sure I have enough anesthesia when taking out the stitches! 🙈

[YoungontheOutside]

I’m so sorry you had this experience. I did not have quite enough anaesthetic for my first cataract operation. I can’t say it is excruciating, but it did hurt. As soon as I said that the surgeon gave me more anaesthetic, which kicked in straightaway.

[Anonoms]

Do you by any chance have red hair? People with red hair have a gene which means they handle anaesthetic differently to those without. They need more and it takes longer to kick in. healthline.com/health/redhe...

[stephanie1977]

Hi Anonoms! Wow that's very interesting! I dont have red hair but wish I did so I could understand why I have so much trouble. I finally had the stitches out from my cataract surgery and my Dr. gave me many anaesthetic drops but I still felt every tug, but it wasn't super painful . An assistant had to help hold my head steady at the slit lamp because I have a strong reflex to pull back. I'm sure my fear now has messed with my pain signals!

[Justinerose]

yes I went for a Trabeculectomy and the anaesthetic didn’t work, I felt everything. I when I was asked if I could tolerate another hour and a half of surgery, I burst into tears and left the operating table.

[stephanie1977 in reply to Justinerose]

Oh Justinerose that sounds just awful! 😞 How traumatic. My second cataract was as bad as that ... But I had general anesthesia for my trabeculectomy so that was best, but as for local anesthesia forget it. I also have to be extra dosed with local anesthesia for a dental fillings. Not sure what that's that all about. Perhaps you can do the trabeculectomy with general ?