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I may have an upcoming procedure in which I am requesting a…

I may have an upcoming...
I may have an upcoming procedure in which I am requesting a spinal block instead of general anesthesia. I am reading that now a days they use Versed in combination with spinal block to relax you. When I had my children and they didn't use this only spinal. What happens if you throw up from versed or have some other reaction? How do you even sit up to throw up when I won't be able to feel my legs? This is very scary thought.
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Answered in 2 minutes by:
3/18/2018
Connie Pennington
Category: Medical
Satisfied Customers: 569
Experience: Colorectal Surgeon at Colon & Rectal Surgery Consutants, PC
Verified

Hello, I am Dr. Pennington. I am a surgeon. I would like to help.

What type of procedure are you having?

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Customer reply replied 4 months ago
I am having a uterine polyp removed. My dr. says it is only a 45 minute procedure. I really don't want to go under general anesthesia with intubation, so I am requesting a spinal block. I am on a calcium channel blocker and my concern with spinal and versed combo that my bp may go too low. Also I have never been under any anesthesia, but am sensitive to sedatives. My brothers and sister throw up when they do versed. I am concerned I will too. I just talked to a friend of mine who had a meniscus repair and they told him his procedure was so short that he could only do general anesthesia. They told him that the spinal would take long to wear off with such a short procedure and he would be better off with anesthesia. Hopefully this will not be my case. I have a small throat and tmj. I was also told by an ENT dr. that I may have difficult intubation due to a short distance from chin to neck and just the way my mouth is structured. When I go to the dentist I have trouble keeping my mouth opened and mouth doesn't open very wide because of the tmj. The dentist has to use pediatric xrays and I even gag on those. I know a lot going on. I really would just want a spinal but no versed.

Good morning.

Honestly the easiest thing for you to do is propofol with an LMA. Propofol (diprovan) is the "***** ***** drug" and can be used as general or as MAC. For short procedures, it is ideal because it wears off so quickly that there is no hangover effect and we do not have to intubate your airway. A LMA (Laryngeal Mask Airway) slips in your mouth/throat to hold your airway open. It is considered a general when we do this, but it is extremely light. Also propofol does not cause nausea, if fact it is given for nausea. I have done hundreds of cases this way. We use propofol for colonoscopies with no LMA, and with an LMA for short surgeries. I think this would be the best option for a short case. You could do a spinal block if you like, but it may take a while to wear off. When we turn propofol off, it is off, people are awake, no nausea, no hangover effect.

Does that help?

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Customer reply replied 4 months ago
That does help. I was reading that propofol is really tricky because if too much is given or person isn't monitored correctly, there can be issues with breathing? Is it safe in your opinion? What different from this than general anesthesia? How come they don't use this for all surgeries?

Propofol is titrated to dose. It is given by an anesthesiologist or CRNA and is given by hand under direct observation (***** ***** drug) and only administered with enough to keep you slightly under. It is extremely safe because you have someone hand titrating it and you are in control of your own airway. I personally (as a surgeon) think it is perfect. You will be monitored as if under general anesthesia. It is totally safe, in safe hands (like our anesthesiologist). You breathe on your own, via an open airway or LMA. Surgery length dictates whether we use it or not. Short surgeries are perfect. Longer ones, not so ideal, but you can titrate for up to 12 hours ( we do that for trauma patients) but it is time consuming and requires ventilation and pumps. When someone is there hand administering it for short periods, it is perfect. I would ask for it! You will be fine. I trust it and use it every day.

Ask your anesthesiologist about propofol and a LMA. They will be impressed! Good luck!

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Customer reply replied 4 months ago
can you use propofol for surgeries such as gall bladder removal or is it only used more for procedural type of surgeries?

Quite useful for low pelvic work. Not gallbladder work. I am a colorectal surgeon, and its the only thing I use for colonoscopies (short) and hemorrhoidectomies (little longer). GYN's are the same, they love it. It is a "general" with an LMA and "local" without an LMA. For you it would be best used as a general with an LMA. It is that versatile. And no hangover. When it is off, it is off. Ask them NOT to give you versed. Perfect.

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Customer reply replied 4 months ago
Will the LMA open my mouth very wide? With TMJ that is a little challenging. I am wandering why my gyno didn't mention propofol to me.? She said I would require anesthesia with intubation. On another note, I was reading that in Europe they don't use sedation at all for colonoscopy, because it is so short. Is it possible to do a colonoscopy with nothing?

No an LMA will not open your mouth very wide. Yes, I have done colonoscopies with "nothing" but is is long, slow, and tedious with a pediatric scope. It is better and faster with propofol. Propofol can be a general with an LMA or intubation. Ask the anesthesiologist for an LMA. It's their choice. Intubation is not a bad thing. They are highly trained and use video scopes if needed to visualize everything. Try to trust them. They really know what they are doing, and are safe. The easiest way to get your case cancelled is to argue with your surgeon and anesthesiologist. W really know how to do this best. Try not to worry. I know it is hard. I want you to have a perfect surgery with excellent results. Try not to worry, and trust the process. Do not be afraid. You will be ok. We are highly trained professionals who do this every day.

I hope that helps.

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Customer reply replied 4 months ago
ok. Thx. I will try to trust. I read horror stories on the internet such as what happened with Joan Rivers and then I start to over think.

Oh my gosh, I know. I know. I agree with your concern. Just politely ask the anesthesiologist if propofol and an LMA is an option. It is safe. Intubation is safe. I have witnessed it for over 25 years.

You need the polyp out. It will be over in less than an hour.

You will be home safe. Really.

I wish you the very best!

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Customer reply replied 4 months ago
I think my biggest concern is I have chronic Epstein barr and have goofy symptoms and reactions that drs can't explain. I also have very strange sleep disorders so I have been really scared of going under since I have never done this before, not sure how I will react.

I understand. It is common to feel this way. I can say that I believe propofol is one of the safest drugs out there. Each individual is given only what they need. I really think you will be fine. I personally think a spinal block is undesirable but I guess people ask for them so they can "be awake" as if that affords some kind of control. I personally would not want to be awake for a procedure and I believe it creates anxiety for the patient because the OR environment is a lot to take in. I wish you the very best of luck. If you have EBV, read Medical Medium's work. It's pretty interesting. A food based diet to rid the body of heavy metals and viruses is awesome. Good luck to you!

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Customer reply replied 4 months ago
Thanks for all the information. It has been very helpful. Does Propofol paralyze the muscles like general anesthesia does?
Customer reply replied 4 months ago
I was reading on Web MD that Propofol has a little room for error on the part of the person doing the administering and monitoring. It said that blood pressure can drop and breathing can stop and that heart has to be monitored minute by minute and beat by beat. Sounds scary.

Propofol can use used in low doses as MAC or high does as general. Its that versatile. We monitor everyone! Carefully.

Perhaps a pre- anesthesia appointment would help ease your mind. Sit down and talk to them.

I hope that helps. We work only for stars, so please rate this question if it was helpful. Thank you.

Connie Pennington
Category: Medical
Satisfied Customers: 569
Experience: Colorectal Surgeon at Colon & Rectal Surgery Consutants, PC
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