Anaesthesia-help!

[Tabbycat]

Thanks, Pineapple, I hope your RTKR goes really well

 

[Lovestoread]

I had epidurals with sedation for my TKR's. To be honest, the thought of having an epidural scared me more than the surgery itself. It turned out to be no big deal. After previous surgeries that used general anesthesia, I was very nauseous. I woke up just fine after the TKR's. All I remember with the first was being told that they were going to put a tourniquet on my leg. Don't remember anything until recovery. With the second, they didn't say anything. I remember kind of looking around the OR and all the people…..then it was done!

 

[Glamg1979]

Hi @Tabbycat , I understand your fear 100% because the same thing happened to me when I had an endoscopy to remove a gallstone. Very traumatic!! I remember seeing the equipment coming out of my mouth and someone was slamming my head down to keep me from trying to get up. Unfortunately they pushed more anesthesia by IV and when I finally woke up I couldn't even speak! I was a zombie.
Anyway I talked to a anesthesiologist about this experience and was told that happens because it is hard to keep the patient sufficiently sedated during endoscopies and not compromise the airway even more.
I had a spinal for my TKR in October and it was absolutely the best. Dr. injected some sedation via my IV at the exact time the spinal needle went in therefore I was asleep in an upright position being held by the nurse. I woke up in recovery with a clear head and numb legs and NO pain.
I am having other knee done next week and am doing the spinal again. Very good experience!

 

[Tabbycat]

Hi Glamg1979, and thanks for sharing your experience. Before my endoscopy I do recall the doctor saying they could not give me so much sedation that my heart would stop beating or that I would stop breathing, so as you say, it can be difficult to keep you 'under'. I am sorry you had a difficult experience, it's very hard to forget about it isn't it? Josephine has reassured me that this would not happen with a spinal as its quite a different thing, and I will chat to the anaesthetist about it, but at the moment I still think I would be happier with a GA. I think it's fear of the unknown It's good that you had a positive experience last time and I do wish you all the best with your upcoming surgery . I will follow your progress!

 

[Josephine]

I do recall the doctor saying they could not give me so much sedation that my heart would stop beating or that I would stop breathing, so as you say, it can be difficult to keep you 'under'.

That is just so much tommy rot! The whole point of using sedation is that it doesn't interfere with respiration or the heart! That's why we can use it for people having joint replacements who also have heart problems or respiratory problems like asthma, COPD or sleep apnoea - because it's SAFE!!!

I think it's fear of the unknown

Of course it is. It's perfectly common for people to range between uncertainty and outright panic because of that fear. This is a big deal and you will be handing yourself over into the care of total strangers that you will probably not even set eyes on and letting them do things you have no idea about and that is scary. Only crumb of comfort I can offer is that these strangers do this several times a day, every day of the week. Or to put it another way, for you this is a big, unknown and scary deal, for them it's just another day at the office. But you can trust them. I used to be one of those unseen and unknown people in theatre and I took care of every individual that came into my care just as much as if they had been my own mother or father. They will too because they are professionals and know their job. So the only thing you really have to fear is the unknown and that will not be rectified until after the op.

 

[Tabbycat]

Josephine, thanks for your reply and for explaining about sedation. I still can't understand what happened but
there was something very "off" about the whole thing when I had the endoscopy. I was promised things which didn't happen (sedation,amnesia and pain relief) and in reality the opposite happened, the doctor was very cagey when I tried to talk to him afterwards, the staff seemed demoralised and the place was very uncaring and 'inhospitable' (not good for a hospital!). I was traumatised for ages. To make matters worse when I had a follow up with a surgeon in the pancreatic unit in Swansea, he told me the doctor didn't get enough of a sample to test, so I basically went through it all for nothing Time to put it behind me I think.

 

[tjcteacher]

I just felt silly I didn't know what GA was

 

[Tabbycat]

Don't worry, it took me a while to work out what was!

 

[JLP]

I had general anesthesia. They gave me something as I left the prep room and I do not remember being in the operating room or recovery room. Once I was in my room, I was alert. Not sure why my OS uses general but that was his protocol. I vomited once during the night after surgery but after that I was fine.

 

[Tabbycat]

I don't want to see the operating room either
I've had a GA three times, and the only time I was sick was when I was given morphine afterwards, I do have a sensitive stomach and don't react well to a lot of meds though.

 

[kneeper]

I don't want to see the operating room either

I actually found it interesting. In a way less intimidating to see it. I was very impressed in the preop area with what a well oiled machine it was and how the staff were kind and yet very professional. It really eased my nerves.

 

[sistersinhim]

I looked all around and was amazed at how small the operating room actually was. I scooted over to the table and I looked at the huge lights and then the next thing I knew I was in recovery. It's not scary at all.

 

[Tabbycat]

Ok, but I'm not taking any chances !

 

[charmed-life]

I had GA with my hip and the hospital gives a mixture of pain meds before surgery so you do not wake up in pain. Had spinal and two nerve blocks with knee and both ways worked fine


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[Tabbycat]

silty1, Celle, charmed-life
Thanks for your input. My fear, however irrational, is that sedation will not keep me 'asleep' the whole time, and I think @Josephine says somewhere on this site that some people are psychologically not suited to procedures where regaining some degree of consciousness is possible. I did have a return to full consciousness during an endoscopy, I will never know the reason, but Midazolam was used (is that Versed?). I would still be happier with a GA, and am hoping the anaesthetist will understand, even if he prefers the spinal for most patients. I believe that LIA (local infiltration of anasthaesia) is used so prevent waking up in a lot of pain. I haven't had any pre op classes yet, so maybe when I do, some of my concerns will be answered

 

[Somerset]

I have had four epidurals and three general anaesthetics. The epidurals, I was awake as they were for Caesarian sections. Loved them. Odd feeling yes, but not at all like a numb hand or arm. And the feeling comes back in a good way, not painful, just steady and gently.

The general anaesthetics, I had no problems with them either. For my shoulder arthroscopy, I had a general with a separate nerve block straight into a nerve in my shoulder, as that is a very painful procedure to wake up from apparently. No pain.

 

[Celle]

@Tabbycat
Your wishes should be taken into consideration. If you want to have a GA, say so, to both the surgeon and the anaesthetist.
If possible, discuss this with them before your surgery date.

 

[gizmotto31]

I went ahead with a spinal even with the fear of "waking up" during the procedure. The OS told me to tell the anastesiologist of the fear and ask then to give me extra sedative (why they don't give anyone the max is beyond me anyway). Despite telling 2 of the anastesiologists, I was in and out of consciousness the whole procedure. I remember being on the table and saying 4 different times "im waking up" which promted them to up the sedative and I fell back in twilight quickly. Another vivid memory is I did hear a lot of hammering, and another a doctor said my bone was very difficult to cut through. I brought it up to two of the surgeons the next day and they told me I was quite awake and asking intelligent questions most of the time lol. That I don't remember, but I remember the other stuff and was told prior to surgery that even if I did wake up, I would not remember anything.

I'm not saying this to scare you more. Just to be informed. I was still drugged enough that I did not care one bit and was calm on the table. Felt nothing whatsoever. It should be your choice though. If you are vocal about wanting a general, they cannot deny it to you. A few weeks before surgery, I emailed my OS with some questions, one was does he use spinal or GA. His reply was spinal unless the patient requests otherwise. I believe that would be the norm everywhere. I would try to reach out to your surgeon about it sooner than later to help alleviate some anxiety.

 

[Tabbycat]

Somerset, Celle, gizmotto31
Thank you all so much for reading my thread and for your replies. Gizmotto31, my surgeon mentioned 'spinal', so I think it is preferred, but you have prompted me to get in touch and state my preference. I see you had your TKR very recently, how are you doing now?
Thanks again,
Love, Tabbycat

 

[gizmotto31]

Tomorrow will be 2 weeks and I am doing pretty well. PT was very aggressive 4 days post op and my leg swelled, didn't do any exercises for about 5 days after. Once the swelling went down, the pain has been very manageable. I even went out yesterday to target in an electric cart which was a fun little outing from getting so stir crazy. I talked to the therapist about appropriate pain and pushing and we seem to be on the same page now. My only worry is my ROM. Flexion is 72 degrees and extension 3, feel that should be a little better but I am trying not to stress about it. Anyway, your surgery will be here before you know it! Just think about how much better you will eventually feel and what more you will one day be able to do and you will be just fine!