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Anesthesia Options

Discussion in 'Knee Replacement Pre-Op Area' started by babette12, Jun 12, 2018.

  1. babette12

    babette12 junior member
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    I'm seeing references to spinal nerve blocks, etc. Are you telling me this surgery is done under anything *but* a general anesthesia?! I want to be OUT during this surgery. Looking forward to your clarifications! /Babette
     
  2. Celle

    Celle FORUM ADVISOR Forum Advisor

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    IT's very common to have knee replacements under a spinal anesthetic. But don't worry, you won't be awake during the surgery (unless you ask to be).
    You will also be given a strong sedative that keeps you asleep during the surgery. You won't wake up until it's all over.
    Anaesthetics - spinals, femoral blocks, GAs and everything else
     
  3. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I requested general anesthesia because I have low back issues and I didn’t want any needle in my back. The anesthesiologist said ok, no problem.

    I also had some kind of block in my thigh.

    It never occurred to me that I might wake up mid surgery so I didn’t have that to worry about.
     
  4. DEL2018Jun-1

    DEL2018Jun-1 new member

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    My hospital orientation team said that in addition a spinal block, they use "twilight sleep", which I think it may be more a euphemism for Procedural Sedation, and which may use a few different painkillers or sedatives depending I presume on the preferences of the anesthesiologists and surgeons. It refers to anesthesia that may be less deep than typical "general anesthesia" to result in shorter recovery and fewer complications.

    My concern is that with all the hype about the opioid crisis and concern with the data regarding how many folks begin their addictions with prescribed drugs, that the nurses will be timid about pain control post surgery. My orientation included hints of this attitude.

    I realized in a previous hospitalization that when they ask you, while you're lying still in bed, "How is your pain?" and you review their charts that top with "worst possible pain," which you would imagine to be like bouncing naked down a cactus-covered, rocky cliff, and so answer, "Oh, maybe 3 or 4," and they give you two Tylenol. Then when you sit up or roll over and it hurts so bad it brings tears to your eyes, you realize you should have thought ahead and said 8.
     
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  5. lovetocookandsew

    lovetocookandsew supremo

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    I found this pain scale, gave it to my OS and told him this makes more sense than those pained faces scales

    pain scale.jpg

    I told my OS I want to be out like a light with zero chance of waking and hearing or seeing anything. If they can do that using a spinal and some other anesthesia instead of a general, I'd be okay with that. If there's any chance of waking, I want a GA. He's got that written on my chart and told me to also remember to discuss it with the anesthesiologist. I'd discuss it with your OS and see what he has to say. I know many places are using just a spinal these days, partly to get patients awake sooner so as to get us home sooner, which is good in some cases, but would never fly with me-I even have them put me to sleep for a colonoscopy!
     
  6. DEL2018Jun-1

    DEL2018Jun-1 new member

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    I had to have my last colonoscopy be completely undrugged because I had no ride home, but I kind of enjoyed the way the Doc gave me an enthusiastic tour of my guts. I learned so much and it didn't hurt any more than a meal from a particularly greasy spoon.
     
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  7. Mutti3

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    No thank you, “knock me out” . Had epidural and General anesthesia for my knee replacement.
    No problems.
     
  8. RonL

    RonL junior member

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    I had a spinal for both me knees. The first time the anesthesiologist had a bit of trouble finding the right spot. Took about six tries before she finally got it. I did wake up part way through, had a little chat with the anesthesiologist, listened to some sawing and hammering then went right back to sleep. When I had my other knee done nine months later same thing. I had a different anesthesiologist but same trouble finding the spot. He started in the lower back worked his way half way up my back, then down to the lower back again. He said he had read the report from my last surgery, but it was never mentioned that my spine was quite deep. He used a longer needle and got it on the next try. None of this ever hurt, all I felt was a little pressure.
    Both my left and right TKR's took 3.5 to 4 hours, he did a lot of straightening on both legs.
     
  9. SusieShoes

    SusieShoes FORUM ADVISOR Forum Advisor

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    I had both knees done and the spinal was great. I told the anesthesiologist I wanted to be out for the surgery and she said I would be. I remember being rolled into the operating room and getting on the table, and... nothing after that. I magically woke up in the recovery room with a clear head and two new knees. It was the best anesthetic experience I’ve ever had. With general anesthesia I’ve woken up feeling the tube being pulled out of my throat (not fun), wanting to vomit (not fun), and fog-headed for hours after.

    Choose what anesthesia you’re most comfortable about using. :thumb:
     
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  10. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Maybe a little funnier than yours, cook, but this is mine!

    PS 1-vert.jpg
     
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  11. lovetocookandsew

    lovetocookandsew supremo

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    @Josephine I agree.....that's pretty funny. I may even print it out and have my hubby post it in my hospital room.......
     
  12. DEL2018Jun-1

    DEL2018Jun-1 new member

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    I recall an interesting Radiolab Episode about pain scale efforts, one being someone imagining making an equation with how many years of your life would you give up to be relieved of a particular pain. Interesting psychological exercise and story, but an impossible device.

    Pain is so subjective and reporting it so dependent on a person's orientation to the world and communication style, that it must be very hard for medical staff to make rational decisions about the use of analgesics. As a person on the autism spectrum, I tend to be very literal, and literally have no idea what someone means when they say something like "it feels like a hot poker jabbed in my eye" because I have no idea how that feels (it hurts no doubt), and frankly neither do they. Some folks are philosophically stoic, others are entitled whiners, how could a nurse know which of those folks just woke up in their recovery suite?
     
  13. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Trust me, we can tell! There are many signs we can observe to give a pretty good idea of where a patient is on the scale. Asking them to define it this way is just a way of making them feel involved.
     
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  14. kneeper

    kneeper FORUM ADVISOR Forum Advisor

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    ^That was my experience in the hospital.
     
  15. Eeek

    Eeek senior

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    When I went for my pre op, I told the os and anesthesiologist I was really anxious. Then I asked whether or not people freaked out when they awoke after surgery but couldn’t move their leg because of the nerve block. Both docs suggested a general. It was great. Going to do that for my next one in July.
     
  16. Marguette

    Marguette senior

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    spinal and nerve block was the best. I also had sedation that kept me mostly under. I didn't care if I came out of it or not as long as I didn't feel pain. Anesthesiologist was surprise and said most people don't want to wake up. I did come out of it a few times and could tell you exactly what was being done but no sooner awake that I went back under. Honestly, it is nothing to be afraid of. I was awake before I even left the OR and recovered so much more easily than other surgeries where I had a full anesthetic.
     
  17. Jajakio

    Jajakio senior

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    Another vote for spinal plus sedation. I had c section many years ago and that epidural was horrible. It hurt a lot and I vomited for 12 hours straight afterwards. I was afraid the spinal would be similar. It was not. Absolutely no pain. For my TKR I remember them asking me to sit up on the gurney and lean forward so they could do the spinal. That's the last thing I remember. I have no memory of the needle going in, pain, or anything else until I woke up in recovery feeling clear headed fairly quickly.

    Now I'm one of those people who would have been willing to be awake for surgery as long as I was numb. I found my c section very interesting. Nobody implied in any way that it was an option for TKR. I was mildly disappointed I didnt remember a thing. If you've had any trouble with anesthetics and nausea previously, speak up. I did and i got preop anti nausea meds, more in the IV bag and still other anti nausea pills to take home. I wasnt even mildly queasy once. Way better than my c section experience.
     

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