Epidural Vs: Pump During O.r., Choice To Be Made

Hi all, Having my surgery Apr 9th, had mtg with anaesthetist Fri am. He presented me with the choice of 1) general anesth. with IV narcotic pump following , or 2) spinal anesth, with a lighter general anesth. and a pain pump afterwards if I need it. He seemed to recommend the 2nd choice as a) leaves you less stoned post op, so can get up more quickly, and you are less dizzy, nauseated b) you're numb from the chest down so you definitely don't feel pain while spinal is in effect . Said it is the way they do all the hip/joint replacements these days and said it great for the elderly( I'm 52, I didn't ask if he meant me!) Draw back of spinal is headaches, apparently if you are prone to migraines (which I am) , you are at more risk of getting headache after this. Anyone have any feed back for me? I have read a couple of women's posts and found them helpful. Many thanks in advance for any help. I can make the decision the morning of surgery. Susan

Due to some mix up I didn't get to meet with the anesthetist, just had a nurse call and ask a bunch of questions. I hadn't found this site yet, so when she asked if I had any questions I totally blanked. It didn't help that I had to keep asking her to slow down, she was talking so fast I could hardly keep up. I have no idea what my choices will even be, but if given the choices you have I would probably go with the spinal. I don't have a history of migraines, but that's no guarantee either.
Hope someone who has had one or the other can give us both some feedback. Good luck. I'll be a day ahead of you. We can recuperate together ; )

This is a really tough question and I think it is just a matter of what you would rather do. I had the regular anesthesia, not the spinal and everything worked out fine. I only had the pain pump for two days (once they take out your IV) no more pain pump but then they put you on pills for the pain. Sorry I don't know if this was much help. Wishing you both a speedy recovery.

Hi there - hope I can help some. I work at a hospital and talked to all the docs about the best way to go with pain management. I did not want to get sick and/or feel fuzzy headed - I hate that feeling! We discussed the pain pump but it is morphine. It has been known to make people feel really queasy and it does give you the fuzzy head.

A "spinal" is a block that is done to numb you during surgery instead of general anesthesia. I believe what you are describing is an epidural for pain control for AFTER surgery vs having a morphine pump which dispenses pain meds via an IV into your arm. You would have general anesthesia during the saurgery with either one.

They recommended (and I went with) an epidural for pain management after surgery. They put the epidural in, then gave me general anesthesia for my surgery (but they could give a lower dose because the epidural was in). I kept the epidural in for the first 24 hours. It provided a continuous flow of pain meds (into my back via the epidural) and they also had a button I could push for more meds if I got uncomfortable. They can regulate how much or how little you get, too. I started out at the lowest dose and had them raise it a little bit as my general anesthesia wore off. I loved it - no fuzzy head; no nausea. I walked the halls the day after surgery with no problems.

The other thing I want to tell you about is Toradol. It is not a narcotic - it is like super Motrin. It's anti-inflamatory and also manages pain. It is the best drug - the down side is that you can only take it for up to 5 days because it can cause bleeding. (my doctor only let me have it the day of surgery and the next day) It is injected into your IV - about every 6 hours. It is really helpful.

I loved the epidural! Remember, the amount (or rate) of meds can be controlled with an epidural. After they removed the epidural the day after surgery, I took percocet (pills) and the toradol. I then walked the halls 3 times that day - no numbness, no headache. I hope this will help you out - and best of luck to you!

An epidural and a spinal are very similar, but not the same.

A spinal is more likely to give you headaches afterwards, due to some loss of spinal fluid. One remedy is to drink as much as you can after you are allowed too.. this will help your body replace the spinal fluid and prevent the headache.

I've had epidurals twice and a spinal once. No headache at all with the epi's.. had a headache with the spinal.

I had epidural with general for my hyst.. and it was left in till about noon the day after surgery for pain control. I don't tolerate morphine well (nauseates me) so they gave me Fentanyl in the epi.

So, if they're offering an epidural.. I think I'd go for it. But since you have a history of migraines, discuss how that would be addressed if you should get one post-op. I think the likelihood of you having one would be low, but if there's a plan ahead of time, that's all to the better.

Good luck.

I had a spinal during surgery. They also put some Versed in it, just enough to make me a bit loopy but awake. Prior to the spinal they put a lot of anti-nausea meds in my IV.

As soon as the spinal was done and I was prone on the OR table I threw up all over the place.

I will never, ever, ever have another spinal if I can help it. Ugh...And yes, I had a whicked headache afterwards which is still lingering a bit.

Many thanks for this info. The doc actually gave me 3 choices, but I was so stressed I didn't remember the 3rd, except it had something to do with an epidural. I was a bit confused about the differences. What he was recommending as a 2nd choice was the spinal, with a general anesthetic. I am worried about the headache bit. I just got my period yesterday, it should be peaking nicely by Wed and I have the usual bad headache as we speak! So not thrilled about that side effect. I am leaning towards this option for all the other good reasons though. The epidural sounds great too. Anyhow thanks for clearing up some confusion. Will keep mulling it over! It's so helpful to hear everyone's personal experiences with these things, I am glad I happened upon this site! Thanks, Susan

[quote=99percentsure]Hi there - hope I can help some. I work at a hospital and talked to all the docs about the best way to go with pain management. I did not want to get sick and/or feel fuzzy headed - I hate that feeling! We discussed the pain pump but it is morphine. It has been known to make people feel really queasy and it does give you the fuzzy head.

A "spinal" is a block that is done to numb you during surgery instead of general anesthesia. I believe what you are describing is an epidural for pain control for AFTER surgery vs having a morphine pump which dispenses pain meds via an IV into your arm. You would have general anesthesia during the saurgery with either one.

They recommended (and I went with) an epidural for pain management after surgery. They put the epidural in, then gave me general anesthesia for my surgery (but they could give a lower dose because the epidural was in). I kept the epidural in for the first 24 hours. It provided a continuous flow of pain meds (into my back via the epidural) and they also had a button I could push for more meds if I got uncomfortable. They can regulate how much or how little you get, too. I started out at the lowest dose and had them raise it a little bit as my general anesthesia wore off. I loved it - no fuzzy head; no nausea. I walked the halls the day after surgery with no problems.

The other thing I want to tell you about is Toradol. It is not a narcotic - it is like super Motrin. It's anti-inflamatory and also manages pain. It is the best drug - the down side is that you can only take it for up to 5 days because it can cause bleeding. (my doctor only let me have it the day of surgery and the next day) It is injected into your IV - about every 6 hours. It is really helpful.

I loved the epidural! Remember, the amount (or rate) of meds can be controlled with an epidural. After they removed the epidural the day after surgery, I took percocet (pills) and the toradol. I then walked the halls 3 times that day - no numbness, no headache. I hope this will help you out - and best of luck to you![/Quopte)

Many thanks for your info Lisa, I will mull things over. I just tried to reply, but did it wrong, so will repeat my thanks here. Doc did actually give me 3 options,but I was so stressed thinking about having to choose, I forgot the 3rd choice, though I know he mentioned epidural. Choice he was recommending was definitely spinal just before a general anesthetic. I am worried about headache side effect, otherwise it sounds all good. I will continue to mull this over. Many thanks for your help. ( and everyone else who replied!!) Susan

	Quote:
Originally Posted by goingthroughit Hi all, Having my surgery Apr 9th, had mtg with anaesthetist Fri am. He presented me with the choice of 1) general anesth. with IV narcotic pump following , or 2) spinal anesth, with a lighter general anesth. and a pain pump afterwards if I need it. He seemed to recommend the 2nd choice as a) leaves you less stoned post op, so can get up more quickly, and you are less dizzy, nauseated b) you're numb from the chest down so you definitely don't feel pain while spinal is in effect . Said it is the way they do all the hip/joint replacements these days and said it great for the elderly( I'm 52, I didn't ask if he meant me!) Draw back of spinal is headaches, apparently if you are prone to migraines (which I am) , you are at more risk of getting headache after this. Anyone have any feed back for me? I have read a couple of women's posts and found them helpful. Many thanks in advance for any help. I can make the decision the morning of surgery. Susan

Many thanks to all of you who replied, the info you have shared has really helped me! Info from a doc or a book is one thing, personal experience is another. I am still mulling, but tending towards spinal. Thanks again. Susan

	Quote:
Originally Posted by 99percentsure Hi there - hope I can help some. I work at a hospital and talked to all the docs about the best way to go with pain management. I did not want to get sick and/or feel fuzzy headed - I hate that feeling! We discussed the pain pump but it is morphine. It has been known to make people feel really queasy and it does give you the fuzzy head. A "spinal" is a block that is done to numb you during surgery instead of general anesthesia. I believe what you are describing is an epidural for pain control for AFTER surgery vs having a morphine pump which dispenses pain meds via an IV into your arm. You would have general anesthesia during the saurgery with either one. They recommended (and I went with) an epidural for pain management after surgery. They put the epidural in, then gave me general anesthesia for my surgery (but they could give a lower dose because the epidural was in). I kept the epidural in for the first 24 hours. It provided a continuous flow of pain meds (into my back via the epidural) and they also had a button I could push for more meds if I got uncomfortable. They can regulate how much or how little you get, too. I started out at the lowest dose and had them raise it a little bit as my general anesthesia wore off. I loved it - no fuzzy head; no nausea. I walked the halls the day after surgery with no problems. The other thing I want to tell you about is Toradol. It is not a narcotic - it is like super Motrin. It's anti-inflamatory and also manages pain. It is the best drug - the down side is that you can only take it for up to 5 days because it can cause bleeding. (my doctor only let me have it the day of surgery and the next day) It is injected into your IV - about every 6 hours. It is really helpful. I loved the epidural! Remember, the amount (or rate) of meds can be controlled with an epidural. After they removed the epidural the day after surgery, I took percocet (pills) and the toradol. I then walked the halls 3 times that day - no numbness, no headache. I hope this will help you out - and best of luck to you!

Hi, many thanks for all the info and help, I am really appreciating hearing everyone's personal experiences. Right now I am leaning towards the spinal. I replied to you, but it is somewhere along this thread ! I am not very good at doing this yet, it's new to me, so I hope you get this and I wrote a longer note somewhere nearby!! Many thanks, Susan