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Home > Archive > Chronic pain Support > February 2006 > Why General Anaesthesia For Partial Meniscectomy?
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Why General Anaesthesia For Partial Meniscectomy?
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| It was surprising to learn that general is the preferred choice,
although local or regional are used also for this arthroscopic
procedure, which entails the shaving of loose cartilage from the knee
joint.
Asking the surgeon is like talking to the wall. He mumbled something
about having to use a tourniquet.
Anyway, does anyone know why general anaesthesia is preferred?
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| Mxsmanic 2006-02-13, 11:28 am |
| Jack writes:
> It was surprising to learn that general is the preferred choice,
> although local or regional are used also for this arthroscopic
> procedure, which entails the shaving of loose cartilage from the knee
> joint.
>
> Asking the surgeon is like talking to the wall. He mumbled something
> about having to use a tourniquet.
Ask the anesthesiologist instead.
> Anyway, does anyone know why general anaesthesia is preferred?
I don't know that any type of anesthesia is mandated for most
procedures. It's a choice of the anesthesiologist in cooperation with
the surgeon or surgical team and (sometimes) the patient.
--
Transpose mxsmanic and gmail to reach me by e-mail.
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| Puddin' Man 2006-02-13, 11:28 am |
| On Mon, 13 Feb 2006 13:07:06 GMT, windswept@home.net (Jack) wrote:
>It was surprising to learn that general is the preferred choice,
>although local or regional are used also for this arthroscopic
>procedure, which entails the shaving of loose cartilage from the knee
>joint.
>
>Asking the surgeon is like talking to the wall. He mumbled something
>about having to use a tourniquet.
>
>Anyway, does anyone know why general anaesthesia is preferred?
Why general anaesthesia is preferred by any particular
practitioner? Couldn't say.
Just a somewhat educated guess: many/most docs assume that some
patients nerves are not up to remaining still whilst the doc
is excavating in his/her knee (or wherever). Simpler/safer
to just put 'em all under.
Think what could happen if the patient suffered an attack of
anxiety and did a knee-jerk while the little scalpels were
engaged. Or if a local was insufficient or wore off sooner
than expected.
I'd rather be 100% under for such procedure.
Prost,
Puddin'
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| because it hurts??
had one last year...excellent anesthesia guy...was under for less than an
hour..and woke up instantly once the med was stopped...best general
anesthesia experience I have ever had..and have had many
no post op nausea...they filled the joint with lidocaine,,so post op pain
was minimal for the first 12 hours as well...
having seen arthroscopies on the health channel...ain't no way anyone would
stick that scope into my knee if I was awake...
"Jack" <windswept@home.net> wrote in message
news:43f08475.6967062@news-60.giganews.com...
> It was surprising to learn that general is the preferred choice,
> although local or regional are used also for this arthroscopic
> procedure, which entails the shaving of loose cartilage from the knee
> joint.
>
> Asking the surgeon is like talking to the wall. He mumbled something
> about having to use a tourniquet.
>
> Anyway, does anyone know why general anaesthesia is preferred?
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| Howard McCollister 2006-02-16, 11:27 am |
|
"Jack" <windswept@home.net> wrote in message
news:43f08475.6967062@news-60.giganews.com...
> It was surprising to learn that general is the preferred choice,
> although local or regional are used also for this arthroscopic
> procedure, which entails the shaving of loose cartilage from the knee
> joint.
>
> Asking the surgeon is like talking to the wall. He mumbled something
> about having to use a tourniquet.
>
> Anyway, does anyone know why general anaesthesia is preferred?
A simple arthroscopic meniscectomy is a short case, and having good
relaxation is important. Spinal or epidural can be used, but really, that's
more complicated and the PACU recovery is much slower. A femoral-sciatic
block can be used, but is a little tricky, and if it doesn't work then you
end up with general anesthesia anyway. Local anesthetic can also be used,
but the same thing applies. Anything that doesn't uniformly allow complete
patient cooperation and muscle relaxation makes the operation more difficult
and take longer. Bottom line, that operation under local or regional
anesthesia is no safer, no cheaper, and recovery is not uniformly quicker.
With general anesthesia, the hassles to the patient and to the surgeon are
less and patient acceptance is better.
HMc
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| Adelle 2006-02-16, 11:27 am |
|
"Howard McCollister" <nospam@nospam.net> wrote in message
news:43f0c193$0$69616$bb4e3ad8@newscene.com...
>
> "Jack" <windswept@home.net> wrote in message
> news:43f08475.6967062@news-60.giganews.com...
>
> A simple arthroscopic meniscectomy is a short case, and having good
> relaxation is important. Spinal or epidural can be used, but really,
> that's more complicated and the PACU recovery is much slower. A
> femoral-sciatic block can be used, but is a little tricky, and if it
> doesn't work then you end up with general anesthesia anyway. Local
> anesthetic can also be used, but the same thing applies. Anything that
> doesn't uniformly allow complete patient cooperation and muscle relaxation
> makes the operation more difficult and take longer. Bottom line, that
> operation under local or regional anesthesia is no safer, no cheaper, and
> recovery is not uniformly quicker. With general anesthesia, the hassles to
> the patient and to the surgeon are less and patient acceptance is better.
>
> HMc
And according to two knee specialists I've seen - the outcome is better. To
maneuver around the joint with the scopes and miniaturized instruments is
pretty tricky. I've been told it's easier to reach things when the joint is
fully relaxed. Spinal anesthesia will do the same thing. But most others
still allow for the patient's resistance and anticipation to maintain some
level of tension in the joint.
Adelle
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| Zombywoof 2006-02-16, 11:27 am |
| On Mon, 13 Feb 2006 13:07:06 GMT, windswept@home.net (Jack) wrote:
>It was surprising to learn that general is the preferred choice,
>although local or regional are used also for this arthroscopic
>procedure, which entails the shaving of loose cartilage from the knee
>joint.
>
>Asking the surgeon is like talking to the wall. He mumbled something
>about having to use a tourniquet.
>
>Anyway, does anyone know why general anaesthesia is preferred?
>
Because you are limp as a biscuit. You will not voluntarily move
causing a possible slip of the knife. Modern general anesthesia is
very safe & effective. Most patients are awake & fully alert very
shortly after the medication used to sedate them is removed.
Now that being said, it is usually a joint decision reached by the
patient, the Dr and the anesthesiologist. If for some reason you
don't want to go down, or have medical issues that would preclude you
being put down, you should bring the issues up with your medical team.
Everything is your choice. However, they may not agree to proceed
given your choice.
--
December 9, 2005 (CNN) While interviewing an anonymous
US Special Forces soldier, a Reuters News agent asked
the soldier what he felt when sniping members of Al Quaeda
in Afghanistan.
The soldier shrugged and replied, "Recoil." (Possible Urban Legend)
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| LooseCannon 2006-02-16, 11:27 am |
| Hawki63@sbcglobal.net wrote:
> because it hurts??
>
> had one last year...excellent anesthesia guy...was under for less than an
> hour..and woke up instantly once the med was stopped...best general
> anesthesia experience I have ever had..and have had many
>
> no post op nausea...they filled the joint with lidocaine,,so post op pain
> was minimal for the first 12 hours as well...
>
> having seen arthroscopies on the health channel...ain't no way anyone would
> stick that scope into my knee if I was awake...
It sure LOOKS like it hurts, and I cant imagine too many more sensitive
areas on the body than the knees (yeah, theres a few, but not too many!)
I am grateful every day that I have neither knee nor back problems!
>
>
> "Jack" <windswept@home.net> wrote in message
> news:43f08475.6967062@news-60.giganews.com...
>
>
>
>
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| Nann Bell 2006-02-16, 11:27 am |
| > Anyway, does anyone know why general anaesthesia is preferred?
i second the idea of asking the anesthesiologist.
i know there can be underlying reasons. they did general for my thumb
synovectomy, rather to my surprise. surgeon said the thumb is really hard to
numb up via other methods for some reason. bummer though, i hate that
anesthesia hangover that follows general. (ya know, i never planned to be
comparing my experiences under anesthesia this way before i even hit 50!)
--
Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare
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| Carol 2006-02-16, 11:27 am |
| I recently had this procedure on my left knee. The surgeon wanted general
anesthesia, but I didn't want it! I told him that about a year earlier I had
experienced trauma surgery with nerve blocks because the doctors had a lot
of trouble intubating me.
The day of my knee surgery, my surgeon and my anesthesiologist came and
talked to me about my history and did a physical exam. The consulted and
agreed to not intubate me. They did the surgery with iv drugs - versed and
some other stuff - with no problem. The surgeon said he preferred general
because of the total relaxation - it made it easier for him to move my leg
around as needed.
--
"Jack" <windswept@home.net> wrote in message
news:43f08475.6967062@news-60.giganews.com...
> It was surprising to learn that general is the preferred choice,
> although local or regional are used also for this arthroscopic
> procedure, which entails the shaving of loose cartilage from the knee
> joint.
>
> Asking the surgeon is like talking to the wall. He mumbled something
> about having to use a tourniquet.
>
> Anyway, does anyone know why general anaesthesia is preferred?
| |
| Howard McCollister 2006-02-16, 11:27 am |
|
"Carol" <cat13@houston.rr.com> wrote in message
news:f7uIf.8364$Ob5.7802@tornado.texas.rr.com...
>I recently had this procedure on my left knee. The surgeon wanted general
>anesthesia, but I didn't want it! I told him that about a year earlier I
>had experienced trauma surgery with nerve blocks because the doctors had a
>lot of trouble intubating me.
>
> The day of my knee surgery, my surgeon and my anesthesiologist came and
> talked to me about my history and did a physical exam. The consulted and
> agreed to not intubate me. They did the surgery with iv drugs - versed and
> some other stuff - with no problem. The surgeon said he preferred general
> because of the total relaxation - it made it easier for him to move my leg
> around as needed.
>
It sounds like you HAD general anesthesia, no doubt done with some
auxilliary method of airway protection, probably an LMA.
HMc
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| sheila voss 2006-02-16, 11:27 am |
|
Jack wrote:
> It was surprising to learn that general is the preferred choice,
> although local or regional are used also for this arthroscopic
> procedure, which entails the shaving of loose cartilage from the knee
> joint.
>
> Asking the surgeon is like talking to the wall. He mumbled something
> about having to use a tourniquet.
>
> Anyway, does anyone know why general anaesthesia is preferred?
i've had three arthocopic surgeries on both knees and all were done via
local with mild iv sedation. i was awake throught all three surgeries.
my surgen much prefers to use a local, as he feels it is much safer.
i live in nothern califorina, by the way.
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| Puddin' Man 2006-02-16, 11:27 am |
| On 14 Feb 2006 19:12:47 -0800, "sheila voss" <sheila56voss@yahoo.com>
wrote:
>
>Jack wrote:
>
>i've had three arthocopic surgeries on both knees and all were done via
>local with mild iv sedation. i was awake throught all three surgeries.
> my surgen much prefers to use a local, as he feels it is much safer.
>
> i live in nothern califorina, by the way.
But the iv was started. If the surgeon gave the nod, the
anesthesiologist would've put you into deep, deep, sleepy-
times. No? Methinks that the key is that the docs have total
control.
I once had an ortho do surgery on a finger joint with local
only (it's hard to start an iv in po' me). He knew what
he was doing, it worked OK. But it wasn't ideal for the
doc or for the patient.
When they start pumping me full of dope and cutting and
probing, I no longer trust the behavior of my body. Much
rather be under.
For some folks with certain med conditions (i.e. weak
respiratory), general anesthesia might be risky. AFAIK, for
everyone else, general is safest (for the doc and the
patient).
Cheers,
Puddin
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| Carol 2006-02-16, 11:28 am |
| Nope - nothing in my mouth or throat. Just IV sedation. I've had similar
sedation for oral surgery.
--
"Howard McCollister" <nospam@nospam.net> wrote in message
news:43f27330$0$41519$bb4e3ad8@newscene.com...
>
> "Carol" <cat13@houston.rr.com> wrote in message
> news:f7uIf.8364$Ob5.7802@tornado.texas.rr.com...
>
> It sounds like you HAD general anesthesia, no doubt done with some
> auxilliary method of airway protection, probably an LMA.
>
> HMc
>
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