ERPC - anyone opted for local anaesthetic?

[getawiggleon]

I'm booked in for an ERPC on Tues and was given the option of general or local anaesthetic - I opted for local. From the scan it appears that the gestational sac has gone but there is still a small amount of tissue left and blood left.

I'm starting to wonder if this is a silly idea though and I should've opted for a general? I just don't like the thought of being out cold if I don't have to. The Dr assured me that there would be no horrible noises and I wouldn't feel anything, I'd just be aware of what was happening.

Has anyone else chosen a local anaesthetic?

I was offered the choice too and chose local, then on the day when I spoke to the anesthetist, I changed my mind and went for general.

I'm quite glad I did, for both physical and psychological reasons.

I had had a medically managed miscarriage (which didn't work in the end, hence the ERPC) I had 7 rounds of pessaries being inserted, each time I was about 20 minutes in the stirrups, and while it didn't hurt I was aware of everything and got more and more anxious every time.

I don't know if you have been through a lot of poking and prodding recently, but I found that I just didn't feel as strong as I did before about those things and didn't really want to "be aware" during another procedure.

After the ERPC my doctor told me that they had found more products than expected and in the end the procedure had been quite complicated. I am really glad I didn't have to hear them say that as they were doing it.

I am sure a local wont be painful, and if your particular case seems uncomplicated, it should be quick. At the end of the day general for me meant "blissful ignorance" but if the idea unnerves you, its not for you.

You will always talk personally to an anesthetist before any procedure though, so you have an opportunity there to go over doubts.

I wish you a speedy recovery,

xxxx

I had a ERPC on Wednesday. I wasn't give the option of a local, but I don't think I could have done it anyway; I would not like the idea of being awake through that, even if I couldn't feel or see anything, to me it would just add to the distress.

I was only out for about a hour but you need to be careful for 24-48 hours afterwards so I guess it depends if you can or not. Luckily my husband has been given time off work to look after me. I wasn't even allowed to boil the kettle in case I burnt myself. Don't forget, you shouldn't eat beforehand if you want the general.

Good luck.

hi there, sorry to hear what you are going through. Many years ago I had a D+C for which i was just "sedated", not fully anaesthetised. it was absolutely horrible. i was fully aware what was going on and i remember it being extremely painful, despite assurances that it would only be "uncomfortable." it's no fun lying on your back with your legs skewed, watching and hearing medics rummage around inside you. sorry to put it so bluntly, but that was what it was like.
i think the whole experience is distressing enough, without adding in awareness+pain. I have had two ERPCs under general anasthaetic, and they were both fine, as far as these things go. indeed, i really like being under anasthaetic - i'm a crap sleeper at the best of times and it's a lovely deep sleep! so my personal advice would be to ask if you can change your mind and have a general instead. HTH

I've had two ERPCs under local. They only offer it if you've had a normal vaginal delivery previously I think. They were both performed in the same hospital and by the same consultant but were quite different in terms of the level of discomfort. Both however were manageable and the pain very short lived. You must have someone with you for the second part of the procedure to take you home.

Below is a description of what they do - don't read if you think it will be upsetting.

I had to go in at 9am and have a balloon thing inserted in my cervix which would dilate it enough to perform the surgery. This is pretty much painless and no anesthetic needed. You then have to go away for a few hours to allow dilation. You may experience some cramping and spotting during that time. Take lots of pain killers before this first bit and then about an hour before you have to go back. You cannot eat anything all day until after the full procedure. Once back in the hospital they will put a canula in a vein in your hand, take you in the room and take blood pressure and pulse etc, then the doctor will remove the dilator and cover you with surgical sheets. They will insert a speculum and give you a couple of injections of anesthetic and test it has worked. The nurse will then perform a scan on your abdomen and this will continue throughout the operation to check that all the tissue has gone. They do apply quite a lot of pressure. The doctor then uses a metal tubed instrument to essentially suck out the pregnancy (don't look at the instrument!). There is a bit of a strange noise when the instrument is used, and it is after each time that it is used that you may get some cramping - it was quite unexpectedly painful the first time but lasts only a matter of seconds, the second time I hardly felt it - must be about where the anesthetic is placed. The doctor may have to use the instrument several times to check that everything is removed. Lasted about 15 minutes. Afterwards they clean you up and you have to lie there while they check your pulse and BP etc. After about 20 minutes you can get dressed and they take you to a recovery room where you are given tea and snacks. They check you again and your bleeding about 30 mins later and then you can go home. They provide you with pads and you shouldn't bleed too much initially.

It is not nice but manageable and a much easier recovery then from GA. I hope it goes well and sorry you're having to go through that.

No. I had a general. Wouldn't have wanted to be awake at all.

I have had 2 ERPCs, both with a general. I wasn't offered local. I wouldn't have taken it had I been offered it.

just one thing to add, in response to what twinkletoes says about local being a much easier recovery than from GA. in my own experience, there was no real recovery from GA. you wake up; you feel a bit woozy for a few minutes, but basically, you're fine. you have something to eat, and you go home. that's it. you might feel a little tired, but unless you're unlucky (some people feel queasy) there's no need to spend the rest of the day in bed or anything like that. and no pain at any stage.
also, i think emotional recovery is at least as important, if not more so, than physical. i'm still horribly haunted by my D+C under sedation, but not haunted by the ones under GA, because i didn't "experience" them as such.
i'm not contradicting *twinkle" - just adding more about my own experience.

Hi Sotough. You may well be right, I'm just going on what the docs said and the leaflet I was given, which says more possible complications because of the anesthetic and feel woozy, which you don't at all with the local - but no personal experience myself and personally I hate the idea of being knocked out! However, I choose local as it was offered to me the next day on both occasions, I would have had to have waited a week for it under GA. It really wasn't that bad though - and I kind of felt like I needed to experience it to get over it, if you see what I mean. Though I appreciate it is not for everyone though.

I'd like to add that I also found the "recovery" from GA really easy. The woozyness wore off really quick, was not unpleasant and was even in a way a welcome relief from all the stress I had been experiencing before hand.

do let us know how you get on getawiggleon

Thank you all so much for taking the time to describe your experiences, and for the kind words. I'm sorry if this has meant you mentally reliving some of those experiences too but all of your comments have been really valuable.

I think if it was any other procedure/ operation then a local would be my choice, if available. I'm not especially squeamish and I like to know what's going on and experience what is happening and I've seen my DH come round from a general and he said it was horrendous (admittedly he was in for much bigger surgery and was therefore under for much longer). But this is different and the emotional rather than the physical side of this mc is what has been the hardest.

After the hormones calmed down, the bump disappeared and I no longer felt pregnant I was surprised by how together I felt. I'm aware that there may be a delayed emotional response and that the grieving may well hit me later on but at the moment I'm doing very well considering.

After reading all of your posts and thinking some more my concerns are that being awake for this procedure could mean lying there and suddenly being hit by the reality of it all, that because that was what was happening that I'd suddenly start dwelling on everything and thinking about the pregnancy and the subsequent loss in the finest detail.

I don't know, I'm worried I could suddenly breakdown whilst a load of medics are just getting on with their job and prodding around with speculums etc. God, come to think of it I'm amazed they even offer a local for such an emotive procedure!

I think I'll skip breakfast (which I'm allowed if I opt for a local) and talk to the anaesthetist on the day. Hopefully he/she will help me overcome my fears of a general and that may be the best option.

I'll let you know what I decide on Tues. Thank you all once again xx

glad you've found all the comments helpful, getawiggle.
the first time i was due to have a general anasthaetic i was really scared about dying (!!!) but the statistics for bad reactions are absolutely TINY - like one in a million or something, literally. the thing is that over the course of a life time it's pretty likely you'll need one or two general anasthaetics for one thing or another, so at some point you'll probably find yourself facing up to your fears, with less choice in the matter. once you've done it once, you know your body is fine with it, and so you're cool about having it again. wishing you all the best with the procedure.x

I have had 3 ERPCs and 2 laparoscopies and I have had GA every time. I have never had a problem with GA. It's a bit like waking up from a nap, only you are somwehat drowsy for the next few hours. Hope it goes ok for you, and the anethestist can calm your fears. I cannot imagine a local for an ERPC is very nice.

Hi all, just to report back...

I ended up going with local anaesthetic in the end (combination of not being able to get hold of nurses beforehand and the fact that I'd have to wait another week to get an appointment for a general)

I was scanned in the morning and told that there was only a small amount of tissue left and it was low down, towards the neck of the cervix anyway so the procedure should be fairly quick and straightforward.

It was thankfully quick although certainly not the most comfortable experience in the world. Had it taken any longer or had there been more tissue etc it would've been quite unpleasant and rather painful, I think.

DH arrived at the hospital mid-procedure and the nurse asked if I'd like him to come in - I looked at her strangely and was half way through telling her that he'd only just recovered from seeing 'more than he bargained for' at the birth of DD1. Too late! He appeared from behind the curtain just in time for a full frontal. Lord knows what he saw down there this time but he seemed more in need of the tea and sandwiches in the recovery suite than I did though!

I hope I never have to go through the experience again. My situation meant that it was a very quick op and so a local anaesthetic was bearable but I think in any other circumstances I would opt for a general.

The nurses were absolutely lovely and they and the consultant told me I had been very mad brave afterwards!

Glad you got through it OK. Brave is the word.

xxxx

I'm glad to hear your experience was not so horrendous. I didn't see your original post last week so didn't reply but I have had 4 erpc's and decided to have my last one under local. I found it so excruciatingly painful and traumatic, as well as very upsetting, that I screamed and cried all the way through and had to ask the gaenacologist to stop because I couldn't take any more. I then had to wait for nature to help me out with the rest which sort of defeated the purpose. Never again for me. I guess it's different for everyone but I wanted to share my own experience because before I had it done I.did a search on here to see what others' experiences of this had been so it may be helpful to someone else to see how it can differ.

Kittens So sorry to hear about your experience and your losses.

I think that if it had gone on for any longer I too would've asked them to stop. I would definitely have needed to ask for more anaesthetic too as it didn't feel anywhere near as numb as I would've expected.

I wanted to post back about my experiences in case, like you and I, anybody else searches for more info. Like I said before, I wouldn't go through the same thing again - the experience is upsetting enough without having to suffer physical as well as emotional pain. I hope you have recovered now x

Thank you getawiggleon. I'm sorry for yours too. Not fair,huh?!

I was only told during the procedure "oh, well, we can't actually numb the uterus itself. Only the neck of the womb and cervix" - so when they say local anesthetic they mean on the way in but then when we actually have to detach anything from your uterus wall there's a good chance it will hurt like f*! Thanks for that!

I have recovered both physically and mentally now though, it was back in June. But I do know that if I am unlucky enough to need one again it will definitely be under general anesthetic again. The procedure takes such a short time that they really don't have to give you too much of the stuff so the recovery isn't too dreadful. I made the mistake of thinking the anesthetic affected me badly because I had terrible stomach pains and bloating for a few days afterward but then realised that was because they gave me painkillers that were notorious for causing stomach problems!