Any experience of surgery under local/regional anaesthetic only?

[beebeebeeb]

I need surgery on my hip but am terrified of the side effects of general anaesthesia (nausea/vomiting specifically, and general grogginess/disorientation/very unpleasant feelings). I am very emetophobic so this part of the surgery really scares me- more than pain or being unconscious or the squeamishness of surgery.

I haven't met with the surgeon or anaesthetist yet so I'm not sure if the option of local/regional anaesthetic will be offered to me, but would like to be prepared with any questions I might have so was wondering if anyone had any experience!

I've read that pain control is often better with regional anaesthesia, so less opioids with grim side effects (including N/V) and recovery is faster. I have read about people having full hip replacements under local/regional and coping fine!

The surgery will involve drilling some screws through hip bone. I think I would like some sedation too so I'm sleepy during the surgery and not too anxious.

Any experiences welcome!

I've had many GAs (I think at least twelve - I've lost count!).
I've never suffered with nausea or vomiting afterwards - the GAs are very good these days.
If you are anxious about it, make sure you speak to the anaesthetist when they come to see you.
I believe an anti-nausea medication is part of the usual 'package' of drugs they give you to bring you round, anyway.
I hope that helps.

I am also phobic. If it helps I had a 5hr op, no nausea or grogginess. I did ask them to load me with as much anti sickness as they could as I'm petrified of being sick so they did!
Woke up on a ward at 4pm, wide awake and eating a full meal at 6pm

I had nausea / vomiting after C sections under spinal.

The only people I've heard of having that kind of op under regional had health conditions that made a GA very dangerous for them.

I asked about local anaesthetic for a surgery that I was having but I was told that they don’t offer local when the incisions need to go fairly deep. Mine was a gynae procedure (marsupialisation of a Bartholin’s abscess) and I didn’t actually think it would have been too deep into my skin yet it was so I can’t imagine that a local would be possible for a hip operation. You can always ask but I would just say to prepare yourself for them not allowing it under a local.

I get very nauseous after general anaesthetics and now that I know this I ask for anti-sickness meds after the surgery and these have worked very well for me. I’ve also recovered from most general anaesthetics with just paracetamol for the pain, a couple of times I’ve had cocodamol but nothing any stronger than that so I’ve had no issues needing strong pain relief.

Have you had GA before? Some people are not at all groggy after. I've had some for 3 hour+ ops and have never been groggy upon waking, on the contrary.

GA is amazing don't worry about feeling crap after,most people are fine.

Thanks all! I'm slightly reassured by the positive GA experiences. However even the thought of waking up from a GA makes me feel anxious and a bit queasy. So I worry I'd end up making myself sick with anxiety! It's the lack of control I can't deal with I think.

@poxypixie I would definitely want a GA for abdominal surgery!!
They can do regional anaesthesia alone for a hip replacement, and my surgery is less major than that (some screws through a fairly small incision).

@indeoestmeafiducia I haven't had a GA before which is why I'm so worried. You're right- I could be fine (or pleasantly delirious) after with no grogginess or nausea.

Mine wasn’t abdominal. It was just surgery on an abscess on the glands at the opening of my vagina. I wouldn’t have asked for a local for abdominal surgery either! I just assumed hip surgery would be cutting through more layers than what mine was. Though saying that I had a spinal for a c-section and that is abdominal surgery so maybe it varies depending on procedure. If yours can be done under local and you’re happy with that then just make sure you make it clear beforehand but if it can’t be done then I hope you can feel reassured by the posts here.

I live in Spain and its normal for hip and knee replacements to get done with a block and sedation. I had to have both my knees with a GA as my spine is very crumbly and bent. To get honest it really wasn't too bad. Its a lot better than it used to be. Make your anesthetist aware of your fears and they'll sort it out .

I really don't think you can just have a local anaesthetic for hip surgery. I've had GA for various operations and was fine after. Had tonsils removed under GA was back at work after a week. Good luck.

They can definitely give you anti-emetics with the GA.

anything with bones/joints/tendons is really painful and no surgeon will agree unless there are very good reasons.
speak to the consultant. there are meds to make you comfortable.

Anaesthetist here. You can absolutely have a spinal anaesthetic for hip surgery. In my hospital we perform approx 80-90% of hip and knee replacements with spinal anaesthesia and if it were me I'd always choose this technique over a GA if possible. Incidence of post op nausea/ vomiting is less with a spinal compared to GA.

I had a spinal block for my back surgery because I am very frightened of having a general anaesthetic. It was perfectly fine. I felt no pain only a little pressure. I'm due more surgery and I will be having another spinal.

I've had multiple operations on my leg under spinal anaesthesia. It isn't just for people with contraindications to general anaesthesia and has some advantages. It might be an issue if you are a day case as it can be a while before you are fit to go home - GA is often quicker and you may be ready for home faster, especially if its a short procedure, but I have been discharged on the same day after a spinal. Talk to the anaesthetist or ask at your pre op assessment appointment.

I had knee surgery with an epidural, and I was very very sick afterwards - sorry to tell you - to the point that I refused it when giving birth as I was scared I’d be sick again during/after birth.

Then last year I had 2 surgeries, both GA. After the first one I was sick, then I told the anaesthetist of the second one what had happened and he said he would up the anti sickness meds and I was fine afterwards. So I think you should just have an honest conversation with the anaesthetist and possibly ask him to up the anti sickness dosage?

On a side note, I woke up much much better from the GA, bright and in a good mood.

DMiL had a full knee replacement under spinal aneasthetic many years ago. No problems as I remember.

I have had 3 CS with spinal aneasthetic. Never any problems with nausea though my blood pressure did drop through the floor. Apparently fairly common reaction.

I've had both.

Post op pain relief with an epi is amazing but I prefer full anaesthetic for the op. My sister had hip replacement with an epi and she said it was fine.

I had a nerve block for my hand surgery as didn't want GA.

I had a broken metacarpal and needed a screw putting in to fix it. They gave me several injections under my arm and around my collarbone and my whole arm from shoulder down went completely numb.

I did have to have an IV for antibiotics and just in case they needed to convert to a GA mid surgery.

I had screens up so couldn't see them doing anything though the surgeon did let me have a peek once the screw was in at it holding the bones together which was interesting.

Immediately after surgery I was taken back to a room to get dressed which was a bit difficult as my arm was completely numb and unresponsive, just like a heavy, floppy useless bit of meat attached to my shoulder. Then they put a sling on and I walked out to the taxi rank and went home. I was on my sofa within 45 minutes of surgery finishing, started to regain feeling and movement in my arm about 3 hours later, which is when the pain set in and I started on alternating paracetamol and ibuprofen every 2 hours.

The surgeon was very matter of fact and 'get on with it' about everything. I remember asking mid surgery when I should be good to work again, bearing in mind this was my dominant hand, which had been cut open, screwed, put in a cast and eventually a massive foam sling. Her response was 'why can't you go in tomorrow?'.

I was really happy I chose a nerve block as did not want a GA and did not want to be in hospital even a second longer than necessary. You do have to really think about how you would react to it though, you can hear them using power tools, cutting, describing your innards and discussing the best approach. If you would find that distressing then you need to consider a GA.

I had previously had eye surgery which was fairly long and done while awake, that involved key hole surgery on my eye and laser, I was given a sedative which was just the standard approach. I really loved the sedative, I have honestly never felt so calm and at peace as I did during that surgery, and again afterwards I stayed half an hour for the sedative to wear off then got dressed and got a taxi home. A bit more difficult that time as I'd had a vitrectomy which required me to keep my nose parallel to the ground for 3 days solid so had to walk to the taxi rank bent at the waist 90 degrees and looking at the floor. Must have looked like a right weirdo!

I have had two ankle surgeries, two operations on my wrist and two knee operations (one a total knee replacement) all without a general anaesthetic or sedation. I had spinal blocks for the ankle and knee ops and a shoulder block for the arm surgery.

I found it a much better experience than when I have had general anaesthetic.

You can feel that something is happening but it doesn't hurt at all. It can get a bit boring as you can't see what is going on but I could hear the sounds of the drill etc.
The best one was when the lovely anaesthetist gave me a running commentary throughout my knee replacement. Another time I think the surgeon forgot I was awake as he kept slagging off his boss to his colleagues!

I've had horrible sickness after two surgeries (knee and abdominal) and since then told the anesthesiologist before hand and been perfectly fine Crazy how they can now dose you so perfectly that you are under just the right amount and no after effects.

@PoxyPixie sorry, I completely misread your post! Thanks, lots to consider, very helpful to have an idea so I know what to ask the anaesthetist.

@strawberryshortcake2 good to hear from an anaesthetist in advance! If hip replacements are usually not under GA, can I assume (in your experience) that hip pinning is the same?

@TorysSuckRevokeArticle50 wow 45 mins is a crazy time to be back home after surgery! I think (could be wrong) that I will need to be in hospital at least for a couple of days after my surgery for physio and rehab. The sedative sounds lovely. And thank you for giving me my first laugh in a week with the image of you walking down the street doubled over after your eye op!

@msbevvy you sound very brave. I think I've read there's an option to take music or an iPad into theatre with you for distraction/drowning out the drills- so I will ask about that.

@2018SoFarSoGreat I'm a pharmacist so I know exactly what drugs I would like if possible....will see if they take requests

@beebeebeeb glad to have given you a laugh! It really was the most ridiculous surgery, had to stay face down for 3 days so I had a sun lounger that had a face hole for people who like to read while tanning set up in the front room. Had an under bed storage box full of snacks, magazines and my kindle which I ate and read through my little window to the floor. I had a 2 yr old at the time and she'd lay on my back and have a nap to cuddle up

@TorysSuckRevokeArticle50 oh no. That sounds like fun for the first hour but would get old quite quickly!