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Posted 12/9/2011 5:11 PM (GMT 0)
Just had my preop yesterday and one of the doctors discussed a spinal being given before surgery for postop pain. Anyone out there who has had the surgery what do you think about a spinal? I am 54 and in excellent health except for having prostate cancer. I do not like the idea. I am worried about infection and nerve damage.
Posted 12/9/2011 5:23 PM (GMT 0)
That's how my surgery was done..It negates the need for opiate pain killers after the surgery and gets you out of the hospital sooner.. It also allows the anesthesiologist to lighten up a little on the general anesthesia, always a good thing...It's a very low-risk procedure..
Posted 12/9/2011 5:30 PM (GMT 0)
i didn't and pain was really very manageable and went away quickly. I only used Tylenol 12 hours out of surgery and have heard many others who did the same. How much do they charge for the spinal?
Posted 12/9/2011 6:11 PM (GMT 0)

Hmmm

Will this be an open surgery or DaVinci?

Posted 12/9/2011 7:26 PM (GMT 0)
I would never agree to a spinal for a major operation, things can go wrong, surgeries can take much longer than anticipate, etc. Just get knocked out, in the blink of an eye, you wake up, and it's all over with.

Even if you need some prescription pain meds for a few days, so what, that is what they are for. Not going to make you a drug addict.

I had a spinal tap done wrong a few years back, and will never, ever forget the pain I felt at the time, and for days after.

david in sc
Posted 12/9/2011 7:30 PM (GMT 0)
I am in Canada so I am covered totally. Insurance is only necessary for semi-private room.
Thanks for the advice. I would prefer to do without the spinal.
Posted 12/9/2011 7:37 PM (GMT 0)

Epidural / spinal anesthesia (both are examples of Regional Anesthesia) are very effective and safe.  Thousands of people have this type of approach each day in the United States.  Unfortunately it is not an option at this time for Robotic Prostate approach.  At least to my knowledge it isn’t.  It is also very reasonable to say that over the years general anesthesia has become much safer.  Anesthesia like all of medicine has benefited from new developments and more comprehensive physiologic understandings.  I would be the first to jump at the regional approach if offered but would feel equally safe for a general anesthesia in the hands of experienced anesthesia provider (Physicians or CRNA’s). 

Hero

Post Edited (Herophilus) : 12/9/2011 12:43:21 PM (GMT-7)

Posted 12/9/2011 8:51 PM (GMT 0)
I had the robotic, and very little post op pain. All was manageable with extra strength tylenol (no codiene, although I took the script just in case, but never needed it..
Posted 12/9/2011 10:20 PM (GMT 0)
If you are going to do robotic, I don't think it is really necessary. None of the robotic surgeons I interviewed asked for it. There was minimal pain post op. I did take a few Tylenol mainly to sooth the sore throat due to the anesthesia tube rubbing my throat during surgery. No pain anywhere else.

Of course I am not a physician, so it is just my lay person opinion.

Post Edited (Newporter) : 12/9/2011 3:23:53 PM (GMT-7)

Posted 12/10/2011 12:31 AM (GMT 0)
I had minimal pain after my RP, like the idea of getting knocked out and waking up when it is all over, I would not have a spinal.

Mal.
Posted 12/10/2011 1:48 AM (GMT 0)
I had the open RRP. They gave me the spinal just before they kocked me out. Never felt a thing. Not a big deal. I guess they give it to ease the pain after waking up.
Mag
Posted 12/10/2011 1:51 AM (GMT 0)
I had an epidural with open surgery, and I recommend it.

I ended up sleeping through the whole thing anyway (they give you a "twilight" drug), and they used the epidural through the rest of the day for pain control. I woke up after surgery feeling fabulous. No pain; no anesthetic to shake off.

After surgery I was sitting up in a chair and chatting with family like nothing happened. The only thing missing was the martini. wink
Posted 12/10/2011 2:47 AM (GMT 0)
For prostate surgery, the epidural is used as a supplement to the general anesthesia..You can ask your anesthesiologist the REASON they do it...
Posted 12/10/2011 3:47 AM (GMT 0)
The surgery will not be robotic and it is a spinal injection not an epidural sorry if I was not clear.
Posted 12/10/2011 7:31 PM (GMT 0)
With a robotic surgery you are positioned at an acutely head down position with the abdomen pressurize, this necessarily causes respiratory inefficiency. However with some nifty general anesthesia, oxygenation can be maintained. With an open approach these conditions above are not a concern and spinal anesthesia would be a great choice. You'll receive some wonderful meds to keep you very comfortable / sleep.  There's a reason that a particular anesthesia plan is developed for the individual patient, once explained it is universally agreed to by an overwhelmimg majority.  After a procedure medication can be injected via the "spinal cath" to provide several hours of pain control without causing your brain to be foggy. You'll be very satisfied.

Hero

Posted 12/10/2011 8:33 PM (GMT 0)
i had open surgery at the cleveland clinic and had epidural as well. the reasons i was given; less side effects than general, not as dangerous, i.e. you are breathing on your own vs the anesthesiologist pumping your lungs for you, and easy to self medicate. i had a pump which i could trigger when i felt pain. piece of cake.
Posted 12/21/2011 7:13 AM (GMT 0)
I do anesthesia for a living and did not choose it for my robotic procedure as it would've added little benefit IMHO. If I were having an open procedure...different story. I would have had a spinal or epidural. Your concerns with the risks are valid, but just so remote that I wouldn't let it decide.
Bottom line is if my patient doesn't want a spinal I won't push it on them, unless there are extreme health conditions which make it superior to general anesthesia e.g. pregnant patient, extreme elderly, or cases with extreme debilitating pain(thoracotomy)
Posted 12/22/2011 8:53 AM (GMT 0)

prop70 said...
I do anesthesia for a living and did not choose it for my robotic procedure as it would've added little benefit IMHO. If I were having an open procedure...different story. I would have had a spinal or epidural. Your concerns with the risks are valid, but just so remote that I wouldn't let it decide.
Bottom line is if my patient doesn't want a spinal I won't push it on them, unless there are extreme health conditions which make it superior to general anesthesia e.g. pregnant patient, extreme elderly, or cases with extreme debilitating pain(thoracotomy)



I'm looking at radical prostatectomy probably sometime in late March, though it's not decided for sure. Had a concern for you, if you're willing. I've had 7-8 generals for other procedures, the most recent in 2006. I've never had a problem until this one in 2006, which was for a protracted eye surgery surrounding a retinal detachment. In recovery, I took a long time to come out. That part was not uncomfortable, but they apparently gave me some sort of agonist to the drugs, eventually. I say this because it was proceding gently until I rocketed from groggy to hyper-awake in what felt like an instant. It was like instantly blasting-off. My heart felt like it was beating out of my chest into my throat, like about 12 cups of coffee were suddenly on board, and that I couldn't get air. I thought I was dying and was saying this to the recovery nurses, but it passed after a few minutes. Very disturbing.

Have you ever seen anything like this? I was thinking of attempting to get the anesthesiologist's procedure report for my urologist to review prior to this surgery. Certainly don't want a repeat but, as noted, never had a problem during several previous generals. Something seemed very different, subjectively, but maybe this is a common occurrence and is nothing to bother with?
Posted 12/22/2011 4:54 PM (GMT 0)
We are verging on professional medical advice in this exchange. Please remember that we are not to be doing that in the forum. If you want to exchange private emails  about specific questions, please put your emails in your profiles.

Thanks in advance.

Posted 12/22/2011 6:48 PM (GMT 0)
Noted 142. New here, so maybe overstepped by asking if it's a good idea to request a copy of a procedure report. Apologies, if so.
Posted 12/22/2011 7:21 PM (GMT 0)
Crackpipe The time to talk about this issue is during the pre-surgical anesthesia visit.   I would make the effort to obtain a copy of the anesthesia record and the PAR (post anesthesia recover room) record prior to this appointment.    I would also take a copy of both of these documents with me the day of surgery.   On the day of surgery y ou should have an adequate unrushed period of time to relate your concerns to the actual anesthesia team that draws your surgery. Best of Luck Hero
Posted 12/22/2011 9:04 PM (GMT 0)
Crackpipe,

No issue at all with asking about getting copies of reports. That is pretty much a given around here. Always get reports on your procedures, and always share history with your surgeon. Amazing some of the things we think are not significant that really are.

I was reading your

"I thought I was dying and was saying this to the recovery nurses, but it passed after a few minutes. Very disturbing.
Have you ever seen anything like this?"

as a question to prop70. He has mentioned that he is a medical professional, so that's what takes us to the edge of the rules. If he answered directly, we would be there.

 

Posted 1/1/2012 5:51 PM (GMT 0)
I had open RP and had the epideral on 11-17-11 When I woke up and was wheeled to me room I felt like a million bucks. It took probably 5-6 hours for the epidural to where off. I recommend it also. As far as post op pain I had some and hit the button many times but it wasn't too bad. I also took the vicodine that was perscribed to me when I got home. I took it more though to help me sleep. I would have to say that my Doc was right when he said generally speaking it is not a painful procedure. When I left to hospital after 3 days I was relatively pain free. But ya know what if the pain meds are available why not take them? I have not turned into a drug adict and now 6 weeks alter I am not taking anything.
Posted 1/2/2012 12:38 AM (GMT 0)
I had both General and Spinal for RP.

Worked very good for pain and little discomfort.

Only caveat where ever you go make certain that they have a good sterilization and cleanliness practices.

I and 6 others with similar urological procedures all contacted staph.

It set me back 4 more days in the hospital than I should have been.

Good Luck, prayers and thoughts with you.

Tom of West Central Ohio

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