Concerned re Anaesthetic

[Michele]

Hello everyone, I have started a new thread as for some reason my original one is closed - I am the 46 year old whose consultant has finally agreed to a TKR or if possible a repplacement knee cap. I went for my pre op assesment yesterday and was informed that depending on which Anaesthetist is on the day of surgery, I may have the TKR under epidural and sedation, to say I am freaked out over this is the understatement of the year. I had heard of this and have seen it mentioned on this forum but can anyone please let me know of their experience if they had their operation with this. To be quite honest I don't think its the feeling of anything that I am concerned about but just the thought of knowing whats going on / hearing everything etc that is making me feel really stressed and I am not having the op until February.

The nurse tried to reassure me that this was more and more common and in lots of ways a safer and easier to recover way of surgery but I remain unconvinced. The nurse said I could voice my opinion but the Anaesthetist has the final say on the day.

Please can anyone out there reassure me in any way.

Many thanks

Michele

 

[edk]

It works just fine. I had a spinal, epidural, and femoral nerve block (the latter was mostly for post surgery pain). The spinal gets you through surgery, the epidural was a think catheter which took care of pain for 24 hrs then it was removed when they want you to think about standing and need your leg to move under your control.

If your worried about freaking about what your seeing during surgery you won't see a thing. From the patients point of view the deep sedation drugs they give you during surgery put you just as out as a general, but recovery, danger, and side effects are lessened.

 

[schoust]

I was totally nervouse about the same thing! In fact it worried me so much that I insisted that there be NO chance of me waking up and if I did I would be so upset!! I never woke up and things went fine.. Try to relax and except that these people will do the right things,honestly I don't think it would be in there interest to have there patients waking up on the table while involved in a big procedure! You will be fine....

 

[beachcomber]

I have had major bone surgery with a general anesthetic and with the spinal/epidural/sedation combination and REALLY prefer the SES. I had much less pain when I woke up and the epidural allowed for great pain control post-op. My docs left the epidural in for an additional 12 hours ( I was able to get up and walk with it in) and it was great pain control. I will definitely request that combo for my next KR. I was "asleep" before I even got to the operating room (from the IV sedation) and knew NOTHING until I "woke up" hours later in my hospital room. IMO you are really fortunate if your docs choose this anesthetic option for you. Relax--- let them do what they think is best for you. They are "pros" and know what they are doing!

 

[edk]

Just a couple of other notes. They usually give you a calmative (Ativan) as soon as they put in the IV so you're pretty calm going into surgery. Then when you've been transfered to the operating table generally prepped, they give you a combination of somthing like Demerol (opiate for pain) and Versed (hypnotic/amnesia drug) continuously and you immediately won't remember a thing.

Also, they leave in the epidural drip for pain for 24 hours, they have to take it out then so they can start giving you anticoagulants. If you have the epidural in with anticoagulants you run the risk of getting a bleeding problem into your spinal cord.

 

[JudyS]

Like everyone else has said, just relax.
I had a hip replaced and refused the calming meds as I knew it would knock me out and I wanted to see everything in the OR. I then had the epidural, the anesthesiologist said I am giving you something to relax you, then put in the epidural. Apparantly there was a kink in my IV line, so I was fully awake at that point. I heard one of the nurses say, OH there is the problem, then I was asleep. I don't remember the recovery room at all. My first memory is in my room at nite!!! No pain at all as the epidural was still working.
You will be fine
Judy

 

[Linda2]

I also had the spinal/epidural with sedation and it was the best! I don't even remember the trip to the OR (which is a good thing for me!). When I woke up after surgery I was really awake--not groggy and nauseous. I would definitely take that route. Plus that, you don't have to have the breathing tube. I've had a really sore throat from that in the past.

 

[Sandy R]

I also had an epidural with sedation... worked very well. The epidural allows you to wake up without that horrible rush of pain. Mine wore off about 2 1/2 hours after surgery. I was already in my room and the floor nurse had given me something for the eventual pain I was going to have. I think the sedation they're talking about is "conscious sedation", used for out-patient arthoscopic knee surgeries. You don't remember a thing but the OS can actually rouse you if they need to talk to you. My OS told me that he and I had a short conversation before I was wheeled into recover... I have no recollection of it.

Freaking out before surgery is absolutely normal. It certainly was normal for me! Good luck.
Sandy

 

[Gretchendz]

Here's another reassurance. I had this on both my TKRs and it's great.

I understand it is much safer overall than general.


The sedation was still working when I was in my room and I was giggly and happy (until it wore off...)

 

[Josephine]

All been said - nothing for this 'expert' to add as you can't beat the words of those who have "been there, done that"!

You feeling better about it now, Michelle?



(btw - I close threads that haven't been posted in for over one month to stop new members posting in them and thinking they are taking part in a 'live' conversation!)

 

[Michele]

Thank you all very much for your words of reassurance , I do feel slightly more at ease. As I said I will not know until the day of the operation what method they will use but it appears to be out of my hands.
Your experiences have made me realise that the sedation appears in most cases to almost knock you out anyway and I do accept that it is a safer method and aids a quicker post op recovery.
Thanks again to you all - this forum has really given me alot of information not just from replies to my postings but by reading other peoples experiences / questions. THANK YOU

 

[Josephine]

That's what we do, Michelle. And, even if I do say so myself, we're pretty darned good at it!

 

[szarak2000]

Yep. Agreed. The freaking-out-understatement-of-the-year was my case too. Had surgery 6 weeks ago. I did not take any calming drugs all the way till the OR (my stupid choice). In front of the OR door I was pretty much in tears I was so scared. Then my nurse and doc showed up. They said they'd give me something now to relax. I barely remember them moving me around on the table, i remember the big lights and someone told me there was a camera in there too. They had to give me epidural twice, because it didn't work first time. Don't remember any of it. Then they ended up putting me out completely, because surgery took longer than expected. Everything worked out fine. I'd do this again if I had to (the spinal/amnesia meds) - and I would not be so nervous.

 

[belldawg]

I just had mine (left TKR) done this week with an epidural and like everyone else said, I remember them opening the door in the pre-op room to take me to the operating room and the next think I remember is waking up in the recovery room. I hgihly recommend it. Relax and Im sure everything will be fine.

 

[SportHog]

Belldawg, you just reminded me of my experience with the epidural. Towards the end of my RTKR surgery, I woke up in the operating room feeling great. They were not finished yet. I saw the curtain in front of me and said I wanted to see what they were doing. They quickly said I couldn't do that and put me to sleep again. Darn, I wanted to see the surgery!!! Anyway, after the surgery I woke up in the recovery room and felt really good. No after affects, just hungry. I asked where the pizza was and they gave me a glass of ice water. O well, I tried!! Michele, you will love the epidural if you have one.
Cheers, Ross

 

[Josephine]

I always gave my patients a drink of chilled water as soon as they woke. Having had several anaesthetics myself, I know that "bottom of the birdcage" taste you wake up with!

 

[Coppernob]

Hi Michele. I had a spinal block for all 3 of my replacement ops and it was no problem. Each time I was asked if I also wanted to be sedated and I said yes, and I don't remember much about any of them. This latest time was the only time I can actually remember going into the OR. When I did come round a bit during each operation I was given more sedation and it was all fine. The biggest problem for me afterwards, before the spinal wore off, was knowing when I needed to wee (no catheter fitted), but the nurses seemed to have an in-built radar system so all was well! The only time I've had a GA was for my very first arthroscopy and the after effects of that were far worse than the spinal. Good luck. Linda

 

[Gretchendz]

For some reason, this thread reminded me of a couple years ago when hubby had to have gall bladder surgery. As we waited in pre-op, my tough guy began falling apart (so much so that the surgeon took one look at him and said "we're putting him under now" which was way early so he wouldn't go into full blown panic attack.)

The part I remember best though was the great surgical nurse. He looked hubby in the eye and in a very calm reassuring voice said "I understand that this is a once-in-a-lifetime event for you & you are stressed about it, but also know that we do these many times a day with great results. Trust in that."

Not sure if it made hubby feel better, but it sure helped me. Something for those of you with great fear to think about, maybe it helps