TKR Monday with anesthesia & pain questions

twosit

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Hi, I’m having my second TKA Monday October 22. It a different doc this time. I have always had major nausea after General Anesthesia so I would really like an alternative. The vomiting has always been so severe that I can’t lift my head off the pillow, without vomiting, for days. During the last TKA I had to stay in the hospital an extra day. Every time I bring the subject up with my surgeon, he tells me the alternative is not “enough”.
Their standard procedure is to use an adductor block with GA along with infusing the area with local infiltration analgesic.
My BMI is high so he anticipates this being longer than typical TKA and my risk of infection is also greater than usual. He does not leave any sort of catheter in for pain control because he said it raises the risk of infection. I asked about long acting (several days)LIA, but he said this has been found to not last longer than the regular LIA.
I don’t get to speak with the anesthesiologist until Monday before surgery.What should I be asking for? Is there a GA that doesn’t produce nausea? I’ve read every article on here but haven’t found the answers I need.
Thanks for any help you can give me.
Lynda
 
I don’t get to speak with the anesthesiologist until Monday before surgery.What should I be asking for?
Ask for anti-nausea medication before they even start the procedure. I have major nausea problems with many medications. I always have anti-nausea meds before, during and after any procedure.

Many people are fine with GA. But if you are sensitive to it the only other option is a spinal and sedation. Sounds like your surgeon doesn't want that - and it could just be your particular medical situation. But discuss this option with the anaesthetist.

BTW when did you have your first TKR (date) and which knee? I'll put the information in your signature for you.
 
Thanks, I had my first TKA in 2011.
should I be asking about IV General? Is there such a thing? When I had my Achilles repair they used something called LMA, along with lots of Zofram, and I had no nausea. I thought I had General because she was pretty insistent on it, is that not a form of GA?
 
LMA is used for shorter procedures. If you are sensitive to the drugs used in GA do have a discussion with the anaesthetist. I can't take GA either. If you can have a spinal and sedation it is much easier to recover from. No nausea or groggy feeling.
 
I also get sick from anesthesia. I have had major surgeries in the past and found when they put the antinausea patch behind my ear it has helped tremendously. The anesthesiologist also mixes up a "cocktai" of sorts too I believe that also helps.
Praying your surgery goes well
 

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