To worry about this procedure after doctor’s comment about birth? (Polyp)

If anyone can remember where it is/find the keys to the cupboard... May just be my hospital though!

You'd think gynae would remember spinals from their obs days though lol. Prilocaine spinal would be best, walking within 2h then home

It's most likely this reasoning. If you deliver naturally you tend to have a remaining small gap which makes it easier to get through the cervix

Doesn't mean you can't try though. I was told the same when I wanted a coil - I told then to try it and I'd let them know and it was fine

Theres no reason why you couldn't just have it under spinal anaesthetic like you had your csection if you wanted, if you don't want a GA. We have a drug called prilocaine which is used for day surgery spinal Anaesthetics as it only lasts an hour then you can go home. Much better recovery as none of the woozy nausea of GA and you can eat immediately

Why wouldn't you want to have a general? I had two myself just in the past year - one for a surgery, one for a colonoscopy. I can't think of anything easier.

x-posted with @SockQueen !

You won't be able to drive same day after either a GA (or sedation) or spinal.

Generally, it's a procedure that can be done with local but some women do find it painful and may not be able to proceed/finish with just local (in which case the alternatives are GA/spinal). If you've passed a baby through your cervix in the past it's often easier to pass the small scope back up through the cervix and that's perhaps why the gynaecologist made the comment about having had a c-section rather than vaginal delivery.

Re. the anaesthetist-delivered options, it can be done with either spinal (or saddle) block or GA. For most fit and healthy patients there's not much in it in terms of safety (there are risks as well as benefits to every medical procedure) but you're probably more likely to go home same day after a GA. The gynaecologist won't have mentioned spinal because it's not their specialty and they probably won't have thought about it...doesn't mean it's not an option though. The anaesthetist would be able to go through the relative risks and benefits. For some patients where we believe there is an increased risk we may be more persuasive for either GA or spinal, for for most people either is reasonable (and either would be an option in the NHS).

Kosenrufugirl's experience of working on labour ward will be very different to providing anaesthesia for other things where the risks/benefits are often very different.

I really believe it depends on the person, my dil has had it done 3 times, not had any children and she had no pain with it. My sister has had 5 children, vaginally and each of the 4 times she has had it done she needed a GA and she has a very high pain threshold. I've had it done 3 times, no pain, but have given birth vaginally. We are all shaped differently.

The risks are different for either option, but if you are otherwise healthy, both are very safe. In obstetrics, GA is less safe, hence the preference for more spinal anaesthetics, but in other surgical specialties the difference is small to minimal.

You should not drive for 24 hours after either a spinal or a GA, so whichever you have, I'm afraid you will need to make other arrangements for your daughter that day.

I'm an anaesthetist. It's totally possible to do this with a spinal, and if you're otherwise well there's not much difference in overall risks between that and a GA. (@Kosenrufugirl this is a bit different from labour ward where we would have a preference for spinal. )

It would need to be booked on a proper theatre list with an anaesthetist though, same as if you were having a GA. The two main reasons I expect it hasn't been mentioned are:

1. Whoever you were talking to just didn't think of it - they're not an anaesthetist so don't know as much about the different options as we do!
2. For a quick day case procedure, you can usually go home sooner after a short GA, whereas a standard spinal lasts for 4-6 hours so you'd be in for longer (which might have logistical implications if you're e.g. in a day surgery unit which closes at 7pm or something). There are other, shorter acting spinal drugs but they aren't available everywhere.

It's a very reasonable thing to ask though, so @Summer20024 it's worth asking them. I'd be surprised if you need to go private just for that reason.

If NHS isn't covering a spinal it's probably because the proposed procedure isn't thought to be painful/distressing enough to warrant a spinal. A spinal is guaranteed to remove all sensation however it does have some small risks of which you should be aware of. Royal College of Anaesthetists have information for patients leaflet Your Spinal Anaesthetic

I think both private and NHS is fine, I can't comment on the individual practioner/setting. If I had to choose between GA and local anaesthetic, I would personally choose local. I have never been under GA and I am not familiar with all their downsides. However, I have seen women waking after GA and I would hate to be in the same state of grogginess. My denstist told me some of her patients listen to hypnotherapy recordings to help with the nerves and it helps them. Maybe this is something for your to epxlore?

Spinal is definitely the answer unless there are contraindications for example a rare situation when the woman's blood doesn't clot easily. You need to speak to the doctor and maybe get a 2nd opinion.

Hi there I work with anaesthetists on a daily basis as a labour ward midwife. No anaesthetist in sound mind would give GA when a spinal would do. You need to go back to the doctor and ask wh a spinal is contraindicated for you and if there is any leeway about it

I had a hysteroscopy and I haven't had any babies or pregnancies.
It was very uncomfortable, like very very bad period pain.
But I didn't have a general anesthesia so I was able to drive myself back to work afterwards . I think with a general my recovery would have taken longer

…you’ll have a pre-op appointment, ask there .. if they say “no” (which I doubt), you can change your mind.

I gathered, from my anaesthetist, the they prefer to give the spinal .. so hopefully you’ll be fine.

You are not the only person they will have seen, with a fear of a general.

I had one a couple of weeks back. I opted for a general, as I had friends who had had it done “in clinic” and had found it very painful.

…as it was, I had a “saddle block”, a targeted spinal block, and didn’t feel a thing. Anaesthetist only made the decision on the day, ask if you can have one during your pre-op

There is one thing about locals - they have to stick a needle in you to administer the local.

I've had local anaesthetic injections in my cervix and didn't even feel them.

And I don't have a particularly high pain threshold. I had local anaesthetic into my vagina when I needed stitches after giving birth and they really hurt! The cervix ones I was terrified about based on the previous ones, but I literally felt nothing.