Avoiding General Anesthesia
I had surgery for an inguinal hernia and had a regional anesthetic instead of a general one.
A regional anesthetic has several advantages: You remain conscious, which is much more interesting; you don’t have to overcome the effects of a general anesthetic in addition to the surgery; and you go home sooner.
In the case of an inguinal hernia, a regional anesthetic blocks the nerves to everything below the belly button. It is injected into the nerves that run down the spinal column and is relatively painless. During the surgery, you are not exactly without feeling, but you don’t feel pain.
For this surgery, I think it is much better to have a regional anesthetic. However, it is not always easy to convince a surgeon and an anesthesiologist to go the regional route. One reason is that they have a problem if the patient gets scared, difficult, or confused mid-surgery. Also, administering a regional anesthetic may take more time and require more skill than does a general anesthetic.
MY HERNIA SURGERY
For my hernia surgery I requested a regional rather than a general anesthetic. The surgeon was okay with that but said that the anesthesiologist would need to agree.
In my experience here in the United States, anesthesiologists are not assigned to patients. They work in shifts, so there’s usually no way to know in advance which anesthesiologist you’ll have and therefore no way to negotiate issues before the surgery.
I spoke with my anesthesiologist for the first time just moments before my surgery. I explained that I had requested a regional anesthetic, and he said, “We don’t do this surgery under a regional.” He wasn’t interested in negotiating with me in the few minutes available for getting me ready. I also explained that I’d had two prior surgeries with regionals, but that made no impression on him.
Fortunately, a good friend of mine (who was still with me) said, “You know, he’s had three colonoscopies without sedation.” At that, the anesthesiologist exclaimed, “This should be no problem then! Let’s go ahead with the regional!”
ANOTHER EXPERIENCE
Another experience was negotiating on behalf of my eighty-year-old father in advance of his bladder cancer surgery.
I told the surgeon that my father was struggling with his memory and that I was concerned that general anesthesia might add to his difficulty.
To my surprise, the doctor told me that he himself had recently had surgery and since had struggled to recall things, and he agreed to do my father’s surgery with a regional.
FINAL THOUGHTS
The above stories illustrate the usefulness of offering a perspective that medical personnel might be able to identify with.
Also, I don’t believe we can undergo a medical procedure that we have not agreed to, unless our life is in the balance [unless we are in danger of dying]. We could put in writing that we are approving a surgery only if it is done with a regional anesthetic and ask our physician to put what we’ve written into our medical record. We should also print out a copy of it and carry that with us into the pre-operative area.
Seattle, Washington, USA
Reprinted from the e-mail discussion list for RC Community members
(Present Time 208, July 2022)