Spinal Anesthetic

[mmelny]

I thought I might spin off the topic from Devi's conversation here, to keep this discussion from hijaacking her voice thread:

https://www.susans.org/forums/index.php/topic,69966.msg478791.html#msg478791

As it is very interesting and a big question for me.... and I would guess others.

Renate posted:

I'm a big proponent of spinal anesthesia for SRS.
General anesthesia has been implicated in post-operative depression.

For SRS, you will get an IV and they will sneak in some tranquilizers.
The will shoot a local anesthetic into your back in preparation.
Then they will shoot the actual spinal anesthesia into your spine.
They may squirt you with a cold alcohol spray bottle up and down your side to check where you are insensitive.
You will probably take a nap, maybe waking up a bit. You will not care about anything.
You will be fully conscious afterwards faster than those who had a general.

(A spinal tap is something else.)

Has anybody here actually went this route for anesthesia?  Are there any drawbacks, because wouldn't everyone want to do it his way to avoid the negative affects of general anesthesia?   Anyone know if Dr Suporn offers spinal anesthesia?   


Thanks,
Melan

[sarahb]

I've actually been curious about that too. After reading the info packet from Dr. Brassard, he mentions it as well. He says that he'll do either one, whatever the patient requests. Although, there are some cases where he will only provide the usual anesthesia.

I'm not sure about whether Suporn has that choice though. Good question to bring up though.

~Sarah

[rejennyrated]

As long ago as 1984 my surgeon in the UK did my SRS with an Epidural and only a light general anasthetic.

Ok it wasn't QUITE what you describe - but because of the epidural they used a much lower level of general anasthesia and so I came around almost before I had been wheeled out of the theatre. And of course it meant that I felt pretty good for most of the day as the epidural blocked any discomfort for several hours.

So yes, I would think that this route has got potential.

[Janet_Girl]

If it is anything like my local when I had my Orchie, I would op for the epidural.  My first ex was give an Epi with both our children and was up and walking as soon as it wore off.   I was up and around right after the surgery and I like the fact that I wasn't nitey night.

But I can not lay that still for that long.  When I had my carotid surgery, I got very antsy half way through the surgery.  I get very claustrophobic. when I have to stay still for a long time.


Janet

[Ms.Behavin]

Hum.  well GRS is about 5 hours or so long which is a long time add 2 hours+ for BA.  I had a general anesthetic, so it was nighty night and then no time passed and I was awake again.  But then I have not had problems with Anesthetic. 

Either way you will not be getting up after GRS surgery anyway and will most likely be on a morphine pump for the first day.  Then pills after that.  Really the first 2 days post op, your pretty out of it... Well I was anyway. 

Beni

[Janet_Girl]

That I understand beni, but when I had another surgery I was under general anesthetic and I felt like poop.  The morphine drip was cool, so I am total. I don't remember.

But because of the hours on the table, I think I would go for the general because of my claustrophobia.


Janet

[Renate]

An epidural is where they basically run an IV into your spine so that they can continuously dose you with whatever.
A spinal anesthesia is a one-shot deal of injecting you then removing the needle.
In either case they could stick you with an IV in your arm with tranquilizers and make you doze off.

General anesthesia can cause nausea, post-op depression and send your bowels into lockdown.
The tube they stuff between your vocal cords to breath might cause soreness.
Opiates are also not good for getting the GI tract moving afterwards.

I know somebody who had a general anesthesia and was vomiting the whole evening.
I know somebody who had a spinal and was fine that evening.

Morphine pump? The second person cited above just took a few Tylenol on the 3rd & 4th day.

Semi unrelated: My wacko theory: The less painkillers you take, the more careful you will be moving around and jumping in an out of bed.
You won't be the one with ripped out stitches.

[june bug]

Just got my packet from Dr. Brassard.  This is what he says about options.  Notice that if you have multiple surgeries at once, it says general is required... which is kinda a bummer because I'm getting BA at the same time and was hoping it'd all be spinal.

ANAESTHESIA FOR YOUR SURGERY

Gender reassignment surgery (vaginoplasty) can be done under general anaesthesia or regional spinal  anaesthesia.  Both work equally well but patients like having less side effects with the spinal.  However, there  are some contraindications.  The anaesthesiologist will decide if you are a good candidate for a spinal.   General anaesthesia is always used if you have another surgery at the time of your vaginoplasty.

[Purple Pimp]

I believe that that must be what Chettawut does (or at least did, I had SRS in May 2008).  I got an epidural, which I think was combined with a low level of general anesthesia.  The only complaint I had with that was that Chettawut would leave the epidural port there during your stay in the hospital in case they had to go back into the OR, which made laying on your back extremely uncomfortable (not to mention a potential infection site).

Lia

[Hannah]

Until I was 28 I thought I was an alien abductee, when in fact the memory was of waking up during a surgery on my neck being done with a local and sedation. Personally when it's my turn in thailand I'm gonna ask them to knock me the hell out, then smack me around a bit to be sure.

I've thought about this before, and I can't decide if it would be neat or traumatic. Somewhere out there is a couple videos of the actual procedure. They say you can't feel anything from the injection site down, but having watched those videos countless times I'm not sure I want to hear all the cutting and sucking and digging and the doctor cursing and holding up skin flaps and digging out holes and bloody stuff everywhere. Besides with 5 hours on the table, even if you couldn't feel any pressure or tugging it seems like one would get horribly bored. I guess a sedative inhand with the spinal would be alright, but again it seems like a tramautic thing to wander in and out of consciousness during. Either or I could do, but both sound kinda spooky.

Anyway I believe the only real drawback/side effect is a helluva headache a couple days later, but I guess it's better than 6 months of depression.

[FairyGirl]

I think I'm allergic to morphine, anytime I've ever been given it I get extremely nauseous which to me is worse than dealing with pain. Percodans however, although a synthetic opiate seem to work just fine. I kind of like Renate's wacko theory.

I was also wondering about epidural/spinal but I'm having another minor procedure done at the same time so it may not be an option for me.

[Renate]

Dr. Brassard takes about 2.5 hours for SRS.
He can throw in a tracheal shave even with a spinal, you just need a bit of a local.

[june bug]

Dr. Brassard takes about 2.5 hours for SRS.

Wow!  That's about as long as the FemLar with Dr. Thomas.

It's so amazing learning about all this surgery stuff.

So... do you think BA can be done with a spinal?

[Ms.Behavin]

Nope, BA requires general as your above the diaphram muscles on the spine.

On the second day the pump was removed on I was on pain pills, Though after a week It was just one pill now and then, except for the flight back home...  The pain from the BA was more then for GRS, though the top pain was gone pretty much in four days,  the swelling and tenderness below lasted much longer, but it was not a sharp pain, more just discomfort and not bad really

[katgirl74]

Epidurals are not without side effects, I do know women who had epi's during delivery and have had pain or other discomfort in the injection site even years after giving birth. In the experience of those I know, side effects from epi's seem pretty common. I don't know that I could be in a semi conscious state during such a procedure as GRS, I had general for my rhinoplasy and trach shave, and was just fine with it, looking forward to being under again in 22 days.

Kathryn 

[girl_ashley]

There's no way I am not doing general anesthesia for my surgery.

[JessieMH]

There's no way I am not doing general anesthesia for my surgery.

Agreed, I want to be completely 100% no chance of waking up for hours out.

[Freyas Passion]

Hi all..

I know I'm a few years out of date here but I still think this will be relevant for anyone that comes after me that is curious about the subject.

I am due for surgery in 8 weeks time and I have a disability that makes it impossible to insert the tube down my throat for incubation during anaesthesia, I have now been told to expect to undergo surgery with a spinal sedation !

After having done a little research I found the following details (they may relate to different forms of surgery but the results/findings will still be the same):-

(I shall be back after my surgery to let you all know how it went)....

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3214358/

[SadieBlake]

I would always opt for a spinal or epidural over general anesthesia if it's an option. GA takes a lot out of the body and carries quite a few risks on its own.

I've had surgeries both ways and really hate coming out of anesthesia, it's the worst combination for me of confusion, intense nausea etc.

Happily both work so sometimes we have choices.

[Jenna Marie]

I had an epidural (Brassard strongly prefers it) and appreciated it; I was able to avoid the risks and aftereffects of general anesthesia and still had all the benefits of being solidly under during the surgery.