Spinal block or general anesthesia? (long)

I just wanted to leave a post here for people who might not be too crazy about being put to sleep for their surgery, and were wondering if there was another option. In some cases, you can have a spinal block done, where you are pretty much awake for the surgery but are totally unfeeling from the ribs down. Before my surgery, I wasn't aware I could have this done, and hate being put under because I wake up barfing regardless of medication put into my IV to stop it, and wasn't too thrilled about how it was going to feel on my stitches or on my sore throat I would get from the tubing they put down there to keep my airway open. On top of having asthma and sleep apnea, my body just does not react well with these drugs. The admitting nurse said to mention this option to my anesthesiologist, and he admitted they can do it, but many women don't like the idea because they're awake, can hear things going on, and are afraid of feeling pain (which is not true). He explained he gives you a relaxant, so although you are awake, the time passes fast and calms your nerves. They sit you up and bend you over a pillow to give the spinal, which is NOT put into the space between the spinal bones (what I thought), but into the fluid outside the spine just under the skin. Felt just like a mosquito bite and then nothing! I chatted through the whole surgery and we swapped jokes, and believe me, that 2 hours went like 15 minutes, I couldn't believe it! And afterwards in the recovery room, while everyone else was laying there waking up, moaning in pain, and barfing, I was reading magazines! The doc said the other plus is that I can start on pain meds before the pain gets too bad, as the spinal (which also contains a long-lasting pain killer) wears off slowly and I am not waking up to severe pain. I didn't have to use the morphine at all (just Tylenol and extra codeine), but although I can't say that is because of the spinal, my roommate (on morphine after 'waking up') couldn't walk farther then the toilet for 3 days, I was taking a shower, touring the halls, etc. the next morning! Remember with the morphine, it has a good chance of keeping you dizzy and nauseous, especially when you are upright (they also don't like to give you a solid diet until you are off morphine because of the choking hazard, unless you can prove you won't throw up). Anyhow, I guess the point of my story is that you should check with your surgeon if you would like an alternative to the 'usual' procedure. It's definitely worth looking into! I'm glad I did!

Vina
TAH, w/ bladder suspension
[Edited by Vina on 11-20-2000]

I did a spinal and was very glad to have done so. The anesthesiologist whom I met a few days pre-op suggested no morphine drip or pca if vomiting was a worry. The worse of the pain - first night - was controlled with injections, subsequent pain with standard otc meds.

I had general anesthesia and will NEVER do it again. I was sick and throwing up after surgery. The morphine was horrible. If I were to suggest a choice, it would be to do the spinal/epidural instead of general.

I had general, but initially wanted a spinal. The reason that I coouldnt have spinal was because they were doing cancer staging. And if they found cancer then they wouldd have to operate on a more severe level and then to go from spinal to general is not considered safe. So, I went with general and hated the fog I was in for the first 24 hours but i am cancer free! and got to have a vaginal hyst! I am home and ok. Glad to be alive and well, and I did get over the grogginess eventually.
Sincerely, tander
11/14/00 TVH

Thanks for that information. I am having a spinal block and was wondering how it worked. The doc wants me awake while he is doing the procedure, because he is using a special tape to support my bladder and needs me to cough at the end of the procedure so that he knows it is in the right place. You have answered lots of my questions.
Thanks
from rainy Australia, a in waiting.
Only 3 more sleeps to go.....
Bee

tander --

Glad they didn't "find anything."

All the best for a speedy recovery!

Hi there
I just wanted to say that I also wanted to avoid all of that nausea and vomiting stuff from general anesthesia and chose to have an epidural for anesthesia for my vag hyst. My epidural did not completely work ie keep me totally numb for the whole procedure so for part of the surgery I was sedated with IV meds. After surgery they used a type of Morphine that could be inserted into the epidural space through the epidural and give long term pain control for 12-15 hrs after surgery. To make a long story short, I reacted to the Epidural Morphine and ended up having 15 hrs of nausea and vomiting after surgery, uggghhhh!!! So I guess the point of my reply here is that the best laid plans do not always go as we would like. Also, a piece of advice, there is medication available to reverse the Epidural Morphine thus decreasing the side effects (I didn't know that and no one offered that to me). The down side is if the Morphine is reversed then you will have pain that will need to be controlled in some other way. If I had it to do over, I think I would still go with the epidural/spinal but would hopefully be better prepared!
Anne
TVH 12/14/99

So glad for this information. I have been debating whether to have the general or the epidural. I think you've firmed up my preference with the info here... at least for now.

I told the doc I wanted an epidural since I remember fondly being able to give birth to my second dauther without feeling like I had a knife raking back and forth accross my pelvis. I don't usually have a problem with the general but, this last time I was in for a lap they must have had a field day with the breathing tube. Almost three weeks later now and the roof of my mouth is still recovering. They did a number on the tip of my tongue as well. You can be sure the anesthesiologist will know about this... just in case!

Thanks for the update... and here's to a continued good recovery!

I always am very sick after general, and given lots of stemitil jags to prevent it. I was offered an epidural when I had endometrium ablation done, but I'm terrified of being awake during the surgery and also they when I had the op done it was fairly new over here - I was the youngest person to ever have it done [25] and the hosp decided to invite all these med students! - I couldn't bear the thought of an audience when my legs were up in the air

I had an epidural when I had my first child, and didn't feel well after it - felt for months as if somebody had hit me in the back with a baseball bat. Apparently there had been complications with the epidural and no-one told me!

So I've opted for the general - apparently it's down to the anethatist {sp?} as to how sick you are after, and also how long you have gone without fluids/food. You should also, if you smoke be honest and admit how many cigs you really smoke (especially pre-op cigs)

Decisions decisions!

Dear Evie:

Scotland? How cool! You must write me. We have relative in Wales, Scotland and N. Yorks.

I'm a bit leary about the morphine pump since my sister said it made her very ill after her hysterectomy. I hate throwing up more then anything, and add to it a belly full of stitches, no thanks. I will talk to the anesthesiologist about both options, but am thinking of leaning toward the epidural. Who knows!

If I do opt for the epidural, I will also be asleep. So, I don't have to worry about the world observing me with my feet straight up in the air. As I tell my girls, "once you've had kids... nothing is sacred any longer and modesty goes out the door". <sigh>