Epidurals

[MacBook]

Bah now comes the next question. Feel free to ignore it, once again. Is there such a thing as getting an epidural done while being under some form of sedation or even under general anesthetic as opposed to awake and sitting on the bed?

Another more personal question.Now scheduled in for another PAO vs the originally planned BHR. We had a few complications with it and considering requesting to manage pain control strictly with a PCA to bypass having to get the epidural.

any thoughts or expert opinions thanked ahead of time.

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[huktonfonix]

absolutely. For the majority of procedures (epidurals, peripheral nerve blocks) we offer light sedation. My goal is comfortable but cooperative. What you're probably thinking of is our labor epidurals, for which I dont give sedation. You could get an epidural under general anesthesia as we do for kids, but in a normal consenting adult I would strongly prefer to do it awake/sedated. Epidurals may also be done in a lateral (lying on your side) position as opposed to sitting up.

 

[LongSnow]

For Pain procedure epidurals, I give every one some sedation - some alot, some a little.

For labor and delivery epidurals, I typically do not, however, if I expect the epidural to be difficult or for an obviously apprehensive patient, I will adminster versed and or fentanyl, titrated to effect. The effects of the sedation are long gone by the time dellivery occurs.

Some in private practice will give practically L&D epidural versed.

 

[MacBook]

The first and last time it was done, was for acetabular osteotomy, which is what is happening again next month. Received a general anesthetic shortly there after.
It must be just me whining then. For the lack of actual numbing after the surgery (which was next to none) and the amount of discomfort involved in getting it put in the first place-not sure it's worth going thru it again. If I do recall correctly the epidural was left in for 2-3 days post op?

Got a feeling like the placement wasn't right, tho I know little about them.

 

[Planktonmd]

The first and last time it was done, was for acetabular osteotomy, which is what is happening again next month. Received a general anesthetic shortly there after.
It must be just me whining then. For the lack of actual numbing after the surgery (which was next to none) and the amount of discomfort involved in getting it put in the first place-not sure it's worth going thru it again. If I do recall correctly the epidural was left in for 2-3 days post op?

Got a feeling like the placement wasn't right, tho I know little about them.

You need to start going somewhere else to have surgery as I previously told you.

 

[coprolalia]

For the majority of kids who get caudals or epidurals, it is done while they are already under general anesthesia. You don't need them awake to place it. But, you need them awake to assess it.

-copro

 

[MacBook]

You need to start going somewhere else to have surgery as I previously told you.

I couldn't agree more actually. Just had the other side done and had the chance to work with another anesthetist. Took the advice given here and explained the situation from my last experience.

Fantastic doc! Was sedated prior to having the epidural placed which was fantastic. Have no recollection of it
Thanks again for the replies, very much appreciated

 

[milrisome]

The first and last time it was done, was for acetabular osteotomy, which is what is happening again next month. Received a general anesthetic shortly there after.
It must be just me whining then. For the lack of actual numbing after the surgery (which was next to none) and the amount of discomfort involved in getting it put in the first place-not sure it's worth going thru it again. If I do recall correctly the epidural was left in for 2-3 days post op?

Got a feeling like the placement wasn't right, tho I know little about them.

I'm sure you are right about the placement. A well-placed and managed epidural should take care of most or all of this type of surgical pain. Not that every epidural is placed properly, but I think one of the worst things you can do to someone is to put in an epidural that doesn't work and then keep playing round with the epidural. Either it needs to be replaced or abandoned in favor of an alternative pain regimen.

 

[MacBook]

I'm sure you are right about the placement. A well-placed and managed epidural should take care of most or all of this type of surgical pain. Not that every epidural is placed properly, but I think one of the worst things you can do to someone is to put in an epidural that doesn't work and then keep playing round with the epidural. Either it needs to be replaced or abandoned in favor of an alternative pain regimen.

This second wasn't quite right either once in recovery but all that was done this time which caused it to work, was that it was pulled slightly out. Go figure-the anatomy of my back might be slightly off. Sure makes you consider your future in having your own children thats for sure.