I’m having my total hip replacement next month. With the first hip replacement, I had general anesthesia and felt like crap for a good 5 days, even with deep breathing to get rid of the anesthesia. I want to have an epidural with IV sedation
this time. Other than the possibility of a spinal headache and perhaps waking up a few times during the procedure, I can’t come up with any negatives. There is a slight chance of serious complications if the epidural sac is ruptured, but many more possible chances of complications with a general. I should also mention that I am bipolar and take multiple meds, and that last time I had 2 psychotic episodes after the general anesthesia.
Has anyone had an epidural for major (longer than 2 hours, not just childbirth although that is pretty major) surgery? If there are any anesthesiologist dopers out there (baby jesus help me if my doc is on dope), what are your feelings on the subject? Any and all opinions, pro or con, will be greatly appreciated.
My husband had an epidural with sedation when he had his knees worked on. Other than the panic of not being able to feel his penis for a while, no complications.
I had an epidural 3x, once when they removed an external fixator from my leg, and twice when they surgically lengthened my Achilles tendon. The Achilles surgery took about 2 hours each time. They didn’t give me a choice, really, about the epidurals - anasthesiologists apparently don’t like giving generals to asthmatics if they can help it, though they did give me a general when repairing my leg bones and installing the external fixator (along with a metal plate on the fibula). Apparently epidurals have their limits, and they were expecting the first surgery to run quite a while (I think it ran 4 - 5 hours all told, but that whole month of my life is a bit of a blur).
I much preferred the epidural - no hangover, and no vomiting afterward.
Just a note about the spinal headache. If you’ve never had one, let me tell you that it HURTS. So if you do go for a spinal anesthetic, LAY FLAT for as long as they tell you to afterwards. The headache is bad, and the cure, while it works instantly, sure ain’t a walk in the park.
The cure I refer to is a “blood patch.” They take blood from your arm (about 30cc in my case) and inject it into the epidural area. The pain was intense, shooting across my hip and down my leg. But the headache was gone instantly! Of course, the nurse whose arms I was holding onto may have needed ice packs for the bruises I’m sure I left!
I don’t think headaches are common with a true epidural as opposed to spinal (there are differences in how/where the medication is injected but I can’t remember what they are).
My own experiences with epidurals consist of two childbirths - one vaginal, and one caesarian. I’d recommend you find out IN ADVANCE how they will confirm that it’s working, and what the backup plan is if they begin the surgery and find out the epidural isn’t working quite well enough. With one of mine (the vaginal), it took hours for them to a) believe me, and b) do anything effective about it. With the other (the caesarian), they’d already cut things open when they found out that it didn’t numb everything it was supposed to (skin/muscles: fine. Bladder which was getting jabbed and shoved around: NOT fine).
During the 20 minutes of pain relief I had with the first delivery, I thought the epidural was dandy.
Mine didn’t work, and once you’re on the delivery (operating) table, your options are down to gas (for me, anyway…30 years ago). I worked with a guy whose wife had a bad experience with it…the headache nearly killed her and she was leaking spinal fluid. I’d go with general anesthesia if it were my sitch.
My grandfather’s guts have been taken out yard by yard. He lost the first piece when he had ruptured peritonitis circa '58, the rest in two chunks in '96 and '01. The last surgery was done with epidural. He has to go every few months to burn the polyps that come up in what little intestine he’s got left: if it’s been only two months it takes about 45 min and they do it with epidural; if it’s been three or four months it takes longer and they put him down completely (he swears they don’t). He comes off the epidural in about one hour and can walk home (less than one mile from the hospital); when he’s gone down completely he’s disoriented for several hours and sometimes his legs just fail to support him, so they have to take a taxi.
My husband had one hip done in 2002, and the other one done in 2004. The first time they planned on an epidural, but once he got in the OR, he got agitated and they decided to use the general. So the second time he just went with the general again. Both surgeries went very well and he didn’t experience too many side effects of the anesthesia.
I don’t have any advice on your original question - just wanted to wish you well. I’m sure you know from your past experience that you will feel so much better in a few weeks! Are you getting titanium? You’ll be bionic. We can rebuild him…
My wife has had almost 30 abdominal surgeries over the past 4 years and most times they have done epidurals. She prefers the peace of mind she gets from not having to worry about general anesthesia. Also, she recovers from it very quickly and is on her feet within a couple hours. She knows she is ready to leave when she can pass the “ass test” – sitting on a toilet and not feeling like she is hovering.
On the few occasions where she had to have general, it was because the surgery was going to take longer. Fortunately, she tolerated it OK.
Well, I have only ever had an epidural for childbirth, but I had it for about 4 hours. Other than the pain of the needle going in, it was fine. Very quick recovery after, I was on my feet in minutes. Having gone under general a few times, I would choose the epidural if I ever have a choice about it. I also have a hard time with the after effects of general, and I hate the awful feeling I have after. So I sympathize with you there and I understand not wanting general if you don’t need it.
If your Dr. is giving you the choice and you just don’t like general I would say go ahead and pick the epidural. There are risks either way but it sounds like you have a very hard time with general and I can’t imagine that an epidural would be worse than that.
