Epidural vs General A.

I would like to know if you have an epidural for a
TAH ,what pain medicine would you have after
the operation. I always hear about the morphine
pump with the general, but don't know about
the epidural. Im trying to decide which is right
for me, hoping I have that choice. I understand
how the epidural blocks your pain, all I know
about the general is it puts you to sleep,what
do they give you for pain when they operate?
Also has anyone woke up when they were operating
with an epidural & sedation. I hear it can gross you
out.Thanks in advance!



Penny

Hi Penny,
With general anesth. you don't usually get pain meds, you're so deeply asleep, you don't feel any pain at all. I've been under general anesth, 5 times and never woke up during an operation. I have an surgical procedures with just locals and sedation, and some I did wake up, and a few I was wide awake during the whole thing. For minor procedures, it was okay - there's no way, for a longer major surgery, that I would want to be awake to feel the tugging - pain or not. But hey, that's just me.

I'm not sure if they can do just an epidural with a TAH or not, maybe they can. I'm having general anesth, with an epidural for post-op pain control, as I can't take morphine.

Sue,

I am faced with the same decision as you for my surgery this Wednesday, April 9th for a TAH BSO.

Hopefully one of our expert sisters can answer both of our questions. My understanding was that the epidural was for the Post Op pain, but either way, I would be given a general. If the epidural is in for 2 days than I will go right into oral pain meds such as Percocet. If it is only in for 24 hours than they would give me a morphine drip for a day or two.

I must admit, that I am a little confused about what to do and the benefits vs. risk of the epidural. I was told that the epidural is better for the pain, but some people get severe headaches. The Dr. said that some prefer the epidural because you don't get the "dopey" feeling that effects some with the morphine.

I vascilate between the two. Let me know what you decide.

FROM MY EXPERIENCE, AND I HAVE HAD LOTS OF SURGERY... GEN ANESTH IS THE BEST WAY TO GO... THEY GO BY YOUR BODY WEIGHT SO MAKE SURE THEY WEIGH YOU BEFORE SURGERY... I HAD AWFUL SPINAL HEADACHES WHICH HAD ME GO TO THE EMERGENCY ROOM...THEN THEY HAD TO RE INSERT A NEEDLE IN MY SPINE TO TAKE THE HEADACHES AWAY NO THANKS! GOOD LUCK HUGS MY SURGERY IS APRIL 14TH MY PRE OP EXAM APRIL 8

I haven't had my hyst yet but I've had other operations. I LIKE general A.

I'm not a doctor so I don't know that this is true but what I've been told is general A is two drugs: one drug puts you to sleep and the other one is an amnesiac - it makes it so you don't remember. There are other beneficial aspects of general A - the DR can administer drugs that greatly reduce your bleeding (I had surgery on my head which is quite vascular and only lost a few tablespoons of blood) and they can administer a muscle relaxant so there may be less trauma than if you're conscious and "guarding" over what they may do next.

I have a very active imagination so when I had one operation that only required a local A, I had more anxiety than with a general. If I have a choice I'm going to tell the DR I don't want an epidural because I'm terrified of anyone doing anything with my spine.

I've also had DRs do all sorts of different things with nausea. For instance, with my Lap I had horrible nausea and refused to wake up from my "twilight sleep" because I was feeling so bad. BTW, I didn't notice any difference between twilight sleep and general A. On the other hand, in a later operation (the one on my head), I told the DR I was so afraid of nausea he gave me some great drugs and I don't think I could have thrown-up if I tried.

I know nothing about morphine but I'm a big fan of Demerol. Geez, I wish that stuff was approved for OTC use!

Before I ever had general A, I was scared out of my wits. Now, I almost look forward to it. I've never been soooooo relaxed! Since I have terrible insomnia, general A is actually a nice break.

	Quote:
Since I have terrible insomnia, general A is actually a nice break.

I'm with you - give me a nice nap!!!

I've had 2 epidurals with 2 of my pregnancies, and only one gave me troubles. It was the doctors fault (student dr. , actually) and not a normal circumstance. So I don't have a problem having another. I don't like that doped up feeling, and generally have that anyway with gen. a. My docs office assures me they have new and better anti-nausea drugs since my last gen. a surgery in 1997. I get terribly sick from gen. a. I'm hoping the new drugs work better for me.

HONEY PULEEEEEEEEZE STOP WORRYING SO MUCH!! IT WILL BE FINE... AS MY DAUGHTER CALLS IT" MY VACATION" JUST TRY AND THINK THAT THE DOCTORS THAT WE TRUST KNOW WHAT THEY ARE DOING...THE ANESTHESIOLOGIST IS A DOCTOR AND KNOWS WHICH MEDS GO WITH WHAT...WE REALLY DONT HAVE TO KNOW SUCH DETAILS...MY SON IS A DOC BUT HE IS NO HELP TO ME LOL LOVE U

In my case I was afraid of general because I had a previous experience of severe nausea and vommiting for three days after general and I wanted to be sure this time I wouldn't have as great as a chance with a belly full of stitches. I had planed to have an epidural but I ended up having both a spinal and epidural. (one stick only)

With general, they sedate you so you don't experience the sensations when they administer the drug that paralyzes you, which is why you need intubation (tube in throat). If that's not enough to make you sick, often times they need to administer other meds, post-op, to "re-start" the digestive track, antibiotics to combat infection or irritation from the intuabtion tube, and of course, the nausea, and vomiting.... Not what you want with an abdominal incision! Although if general is the only choice allowed such as in laporoscopic procedures due to the gas or dr's choice, there are meds to control that such as zofran. Here's a link about nausea.http://www.hystersisters.com/vb2/sho...ghlight=nausea

The sedation (no tube in throat) used with a regional is different from the sedation used for general. And with a regional, the level of sedation can be varied (light--just relaxed, medium-groggy, heavy--sleep through it all).

I was awake, alert, and not sick when my family came to visit me in my room after I got out of recovery. I felt great and had absolutely NO pain. If I had had general or a pca pump I would have probably had a very foggy brain and maybe an emesis basin in front of me.

If you do opt for an epidural it can be left in for 24 hours post op pain. I wasn't sure if I could tolerate a PCA morophine pump. (nausea, fogginess, etc) I wasn't concerned about morphine in an epidural/spinal because it doesn't have the same circulation--effects are limited to nerve-endings in lower portion of body and drug does not cross brain/blood barrier. You can read my story at the www house link below.
Here are some additional links that can help.

http://www.hystersisters.com/vb2/sho...pidural+or+pca

http://www.hystersisters.com/vb2/sho...light=sedation

http://www.hystersisters.com/vb2/sho...ghlight=spinal

Hi

You need a pain medication for surgery whether you have a general anesthetic, regional or spinal. In fact, you might be surprised to find out how many drugs you get for surgery. Ask your anesthesiologist!!

What I had for surgery, and I really liked it, was an epidural with light general anesthesia for surgery and the epidural left in for pain control. The first time I had a pain pump because I didn't have pain medication in my epidural. More recently I had Dilaudid in the epidural and therefore no pain pump afterward. If I had not had such a high incision in both instances I may have gone for sedation rather than the general.

For my last surgery they were able to get away without the paralytic drug that is usually needed for closing you up, too, but I'm not sure that would be possible for a hysterectomy.

It's important that you discuss all your concerns with the anesthesiologist. Hopefully you will have a chance to do this at pre-op. If not, you will surely see the anesthesiologist before surgery.

Joselle

I also had an epidural with mild sedation for my TAH BSO vertical incision - with the epidural left in for 24 hours for pain control. I highly recommend it! When I woke up in my room, I was alert, had NO pain, was not nauseaus or head achy ( as I'd been after general anes.). I had no problem with "not feeling" my legs, was sitting up that afternoon. They administered another dose of pain medd before they removed the epi next day - which lasted for 24 more hours - so I was up walking, going to the bathroom, etc. Then I went on vicodin for pain in the hospital when I needed it.
Another woman also had a hyster that day, same dr - different anesthesia( I don't know why - whether she asked for it or he recommended it for her surgery) - and she was miserable. In pain, pleading for more demoral after she had emptied her pump, throwing up from the general, headache - just terrible.
Just remember that your Dr will usually recommend the typw of anesthesia that work best for your surgery in your situation. Everyone is different!