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Offline JenSinclair

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Anaesthetic questions...
« on: May 21, 2005, 01:33:53 PM »
Hey, everyone.  I'm a little less than 4 weeks from my op date, and I'm getting all OCD about anaesthesia (surprise, surprise!).  Just wondering what all of you have had...from what I understand, the options are:

General
GA with epidural/spinal
GA with peripheral nerve blocks
Twilight with epidural/spinal
Twilight with peripheral nerve blocks

I'm thinking either twilight with peripheral blocks or general with peripheral blocks (femoral and sciatic).  My OS said that it's basically my decision (to be made in consultation with the anaesthesiologist), and that he doesn't have a particular preference other than my comfort level with the type of anaesthesia.  So...

Opinions?  Experiences?

Thanks in advance, and
Peace,
Jen
LR/TTT 3 August 2006, RK
LR/TTT 16 June 2005, LK
CPMs are evil.

Offline Beauzer

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Re: Anaesthetic questions...
« Reply #1 on: May 21, 2005, 03:04:34 PM »
Lots of experience (unfortunately).  Shoot, I can even rate the different induction agents...

It's actually unusual to have a spinal/epidural and a true GA.  Here's my thoughts.

general - common, safe, works well - makes me puke and shiver upon waking up, which sucks - finally found a good combo of drugs (working extensively with the anesthetist) on this last one

GA with peripheral block - what I had for my OATS - I don't even remember getting the block (or even being in holding for that matter - gotta love versed and dilaudid!) and was pretty comfortable postop - didn't have bad pain until the block wore off (at home the next day)

Sedation and Epidural/spinal - works well for a lot of people  - find out how comfortable your anesthetist is with doing them - personally I had such a bad experience with one (which didn't work and a jacka** anesthesiologist who didn't believe me) when I had my ACL done that I can't even watch somebody else get one 8 years later without nearly passing out

sedation and block - not good for long or very painful procedures - although, the new agents they use tend to have a very fine line between twilight and GA (meaning a lot of patients undergoing "twilight" are actually out enough it should be called GA)

~D
32 - R knee gone to hell
lat. meniscus 94
ACL, chondroplasty 98
Chondroplasty 99
Screw fell out into joint, med. meniscus, microfracture 99
MCL/med. capsule recon, med. meniscus 00
Chondroplasty 04
Chrondroplasty 1/05
OATS 4/05 for OCD lesion
AVN, MFC fracture 10/05

Offline JenSinclair

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Re: Anaesthetic questions...
« Reply #2 on: May 21, 2005, 04:31:44 PM »
I think that kind of solidifies it -- GA and peripheral block...and they'll have to sedate me to do the blocks.  I'm more afraid of actually GETTING the blocks than anything else.  I don't want a spinal/epidural because I'm a little freaked out about the idea of being numb bilaterally.  So, basically...when I start to feel my foot, I should start taking pain meds?

Peace and thanks,
Jen
LR/TTT 3 August 2006, RK
LR/TTT 16 June 2005, LK
CPMs are evil.

Offline Beauzer

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Re: Anaesthetic questions...
« Reply #3 on: May 21, 2005, 05:02:50 PM »
Well, the blocks (I've had 2 now) wear off instantaneously.  I went from absolutely no pain to screaming in about 3 seconds.  Make sure to ask your anesthesiologist exactly how long the block should last and then plan accordingly.

Danielle
32 - R knee gone to hell
lat. meniscus 94
ACL, chondroplasty 98
Chondroplasty 99
Screw fell out into joint, med. meniscus, microfracture 99
MCL/med. capsule recon, med. meniscus 00
Chondroplasty 04
Chrondroplasty 1/05
OATS 4/05 for OCD lesion
AVN, MFC fracture 10/05

Offline JenSinclair

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Re: Anaesthetic questions...
« Reply #4 on: May 21, 2005, 06:24:55 PM »
Hmmm...any thoughts about a unilateral spinal?  A friend of mine who had the same op by the same OS at the same hospital had a spinal and twilight...the spinal lasted about 12 hours, but she was numb from the waist down so she didn't know whether she had to pee or not.  I don't think I could handle that, but I've read about unilateral spinals.  Of course, some of the research seems to indicate that if a sufficient volume of the anaesthetic agents are used the peripheral blocks should last about that long as well.

Is it worth a phone call to the anaesthesiology department at the hospital beforehand, or should I just write it all down and ask them the morning of the surgery???

Peace,
Jen
LR/TTT 3 August 2006, RK
LR/TTT 16 June 2005, LK
CPMs are evil.

Offline cat

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Re: Anaesthetic questions...
« Reply #5 on: May 22, 2005, 12:27:44 AM »
I had a spinal with something to make me sleep. Just the one leg was numb. I liked it. I would like to have a spinal, without the sleepy stuff, when I have my screws removed.
cat
"Miserable malalignment"
 Lateral release, medial reefing, VMO advancement, and TTT-  3/2/04
Screw removal- 5/24/05
Cortisone injection to pes anserine- 7/27/05
Femoral derotation osteotomy, TTT revision- 10/18/07

Offline Mandy

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Re: Anaesthetic questions...
« Reply #6 on: May 22, 2005, 01:36:22 AM »
i just have had spinals for both of my sugeries and am planning on having another spinal with my left TTT on June 2nd.  i was given the spinal first off and then during my TTT i asked for more sedative because i could kinda feel what was going on with my leg and didnt like that feeling! ::) :P  im assuming thats what i'll be doing for my upcoming TTT.

good luck with everything!!!
~Mandy
21 yrs old
12/04: plica removal (RK)
2/05: debridement, LR/TTT (RK)
6/05: debridement, LR/TTT (LK)
10/05: scar tissue removal/debridement (LK)
3/06: screw removal (both knees), debridement on TTT site (LK)
5/08: debridement, HTO, Maquet procedure (LK)

Offline JenSinclair

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Re: Anaesthetic questions...
« Reply #7 on: May 22, 2005, 02:08:39 AM »
See...that's the thing.  I don't want to be aware AT ALL of what's going on.  Not hearing, not smelling, and DEFINTELY not FEELING.  I'm thinking GA and either unilateral spinal (though I have read they fail quite often) or with peripheral blocks (sciatic and a three-in-one femoral seems to work the best, according to the research I've read).  Apparently, if they give you an adequate amount, the blocks can last for up to 14 hours.

Time, methinks, to put the leg up.  I spent the late afternoon and early evening gardening.  This is a highly suspect activity for me -- I tend to kill everything green...but it was a handy excuse not to write my final exams today (which MUST be done tomorrow!).  Now, of course, my knee is REALLY swollen and even more unstable than usual.  I think this means that it's time for TV and maybe some Advil.

Peace,
Jen
LR/TTT 3 August 2006, RK
LR/TTT 16 June 2005, LK
CPMs are evil.

Offline sweetheart0517

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Re: Anaesthetic questions...
« Reply #8 on: May 22, 2005, 03:15:29 AM »
Hi I dont know if this helps at all but I had general anestesia for my surgery because I was so afraid I was going to hear something or feel something is I was to stay awake. But I also did hear that if you opt to have the spinal you can also receive a seditive to calm you down and people have actually told me they dont remember anything from just the mild seditive. If you are worried about going completely under then I would say take the spinal but honestly in my opinion the general was the best thing because I dont remember a darn thing one second they were telling me to take a deep breath the next minute they were telling me to wake up it really is easy. Well I wish you all the best with your surgery and if you have any questions about the general anestesia please feel free to ask I can let ya know anything. Good Luck!!!!

~Laura~
Lateral release 1-12-2005
Pt for what feels like forever...

Offline sharon_g

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Re: Anaesthetic questions...
« Reply #9 on: May 22, 2005, 03:21:39 AM »
I had the general with a block for my ACL reconstruction.  No issues other than I didn't feel like leaving the hospital and felt a bit like throwing up in the car ride home.  I had no issues with the block wearing off, because they gave me percoset before I left, and I was able to have a nice overlap.  I had something, maybe the twilight for my scope - I was supposed to be aware, but I don't remember anything.  I wanted to watch what they found on the monitor.

I had an epidural while having kids and I felt pressure well, which really sucked, but no pain.  I also thought hearing the drill would be too much.

Like all anethesia, there are pros and cons to all, and one will probably be best for you, but maybe not for someone else.

R TPFX-Type I/II-No Surgery,stress fracture - 01/04
Scope 05/04- meniscus cleanup,femur,tibia and patella cartilage shaving, femoral cartilage degeneration
MCL Strain (Healed Long)
ACL hamstring reconstruction (healed long) - 4/21/05

Offline JenSinclair

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Re: Anaesthetic questions...
« Reply #10 on: May 22, 2005, 01:23:40 PM »
Thanks to all for your replies.  I think I am fairly sure on the GA + peripheral blocks.  I'm going to make darned good and certain, though, that they use bispectral index monitoring (BIM) because my sister had anaesthetic awareness once -- albeit nigh on 40 years ago, and my brother always required twice the normal dosage of GA agents to put him under.  They are half-siblings, so I don't know whether that comes from our mother's or their father's side, and mum has been gone a long time...so I can't ask. (My parents were married to different people, both had two kids, then were widowed, married each other and had me...then when my mum died my dad married a woman with two kids...so I'm either an only child or one of seven...depending how you look at it)

I had twilight once, and while I don't remember anything...it was minor surgery that didn't involve saws, chisels, drills, or screwdrivers.  I recall being a nervous wreck when they asked me to move onto the table, and I know that I woke up from it faster and more lucid than average (they told me so).  This all combines to tell me that I need GA and blocks -- the blocks for post-op pain more than anything else.

The dog is asking to go out, so I'd better take him before he pees on the new oriental rug (which would result in his immediate death).

Peace,
Jen
LR/TTT 3 August 2006, RK
LR/TTT 16 June 2005, LK
CPMs are evil.

Offline casey2291

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Re: Anaesthetic questions...
« Reply #11 on: May 22, 2005, 11:49:02 PM »
Hey,

I just thought that I would throw in my two cents worth.  The day of my surgery, I thought that I was going to go with general anesthesia.  I voiced my concerns about vomiting after anesthesia because I get motion sickness very easily.  The anestheologist said that I had a moderate chance of that happening since I was a young woman.  She and the doctor talked me into a spinal (which I was nervous about), but it was great.  I was numb from the waist down.  It took about about 4 hours for it to wear off.  I spent about three hours in the recovery room.  Not being able to move from the waist down was a little bizzare, but for me it was well worth it to know that I was not going to wake up vomiting.  I choose to watch my surgery (I know not what you want).  I wasn't able to feel anything until they started to drill the holes into my bone.  Then I felt some pressure, but no pain.  Other than than, I would have had no idea that they were doing anything to me.  They did give me some sedative before I went into the OR.  That stuff calmed my nerves immediately.  They were going to give me some more as soon as I was in the OR, but I turned them down.  I was also told that if at any point I wanted to be put under to just let them know.  Good luck with your decision. 

Casey  :)
LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline Beauzer

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Re: Anaesthetic questions...
« Reply #12 on: May 23, 2005, 02:21:35 AM »
If you have trouble with nausea and vomiting postop with general anesthesia (like I do, big time), let the anesthesiologist know.  They can give you stuff to prevent it.  I had a scopolamine patch (the stuff you use for air sickness), and a whole bunch of other stuff (not sure what it all was) the past two times and I haven't had any problems at all.  The time before I didn't get anything for it and after the pain medicine in the recovery room I threw up for 5 hours.  Bleah!

Danielle
32 - R knee gone to hell
lat. meniscus 94
ACL, chondroplasty 98
Chondroplasty 99
Screw fell out into joint, med. meniscus, microfracture 99
MCL/med. capsule recon, med. meniscus 00
Chondroplasty 04
Chrondroplasty 1/05
OATS 4/05 for OCD lesion
AVN, MFC fracture 10/05

Offline JenSinclair

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Re: Anaesthetic questions...
« Reply #13 on: May 23, 2005, 02:37:59 AM »
Since I've never had a GA, should I ask for the stuff to prevent nausea off the bat?  I mean...an ounce of prevention and all...

I had an ulcer years ago and recall with agonizing detail the IV compazine...it made me pass out cold.

Peace,
Jen
LR/TTT 3 August 2006, RK
LR/TTT 16 June 2005, LK
CPMs are evil.

Offline stgiles16

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Re: Anaesthetic questions...
« Reply #14 on: May 23, 2005, 03:52:12 AM »
I have had 9 surgeries so far,,,,,,,,, all genearals except one and it was an epidural (which didnt work, followed by a spinal),,, NEVER AGAIN.I had a terrible experience with it. I have gotten sick post general anth. but now the drs have figured out a combination of meds that prevents the puking LOL :P I also had a block with one of my knee surgeries and it was wonderful. My knee didnt hurt for 24 hrs. I hated when it wore off. I wish that I had had one for every surgery. I had no ill effects from the block or even a bruise. They did it after I was asleep.

I would definately ask the ansth. DR to give me something for nausea ,,,, just in case.

goodluck
missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline sweetheart0517

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Re: Anaesthetic questions...
« Reply #15 on: May 23, 2005, 04:15:05 AM »
Everyone is so right DEFINATELY ask for something post op for nausea. That was one of my big concerns with having general but when I told the anestesiologist my fear he said he would take care of it and he did I did not throw up or even feel nauseas at all. The only time I felt a little sick was when I had to eat and drink something for the first time but that was barely anything and I got right out of that. So definately make sure u ask for something it really does help! :)

~Laura~
Lateral release 1-12-2005
Pt for what feels like forever...

Offline blackbeltgirl

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Re: Anaesthetic questions...
« Reply #16 on: May 23, 2005, 07:19:09 PM »
Not that you need any more feedback -

Part of your decision should be based on if you are planning on in-patient or out-patient treatment.  If your surgery is planned as out-patient, you should not be allowed to leave until you can walk with your crutches, or whatever (as appropriate), go to the bathroom without help, and drink.  I had an epidural with my first knee surgery, and found it very frustrating to wait around for hours until it wore off enough to meet these requirements.  I was sedated for the surgery (at 17, I told them that if they didn't sedate me I would crawl off the table, with oir without feeling in my legs) and woke up briefly at the end while they were bandaging the knee.  I remember looking at my leg in the air (a nurse was holding it while the doctor wrapped it), looking at the nurse, telling her in a very drugged up voice that "that's my knee" and woke up again about 15 minutes later in recovery.

When I had my last surgery in December, I planned on an epidural and wanted to stay awake.  I was told I wouldn't be able to see the screen based on what they were doing, and would be stuck at the surgical center anywhere from 2-4 hours longer with the epidural than with the general.  I have also had bad reactions to general, so they gave me an anti-nausea medication in the IV before administering the GA.  I was home, on my couch, about an hour - 90 minutes after they finished with me in the OR.  Half an hour in recovery, 10 minutes to figure out how to get dressed when I was still a bit groggy, paperwork, and the drive.

If you've never had GA, and have bad reactions to different pain killers, tell the anesthesiologist.  They are rarely opposed to giving patients the anti-nausea medication.  If you don't normally have problems with drugs, you may not need it.  Lots of people are fine.  The best decision will be made the day of surgery - you will get to talk to YOUR anesthesiologist, who will know what procedure is planned, and will be able to discuss the options and preferences of your surgical center.

Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline cat

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Re: Anaesthetic questions...
« Reply #17 on: May 26, 2005, 11:17:37 PM »
OOPS! I was wrong. When I had my TTT both legs were numb. Guess I was so out of it I didn't realize it! I was also given something to make me sleep. So, FYI, you dont' have to be awake with a spinal. ;D Now, with my screw removal, I had a general with something for nausea. Worked great.
cat
"Miserable malalignment"
 Lateral release, medial reefing, VMO advancement, and TTT-  3/2/04
Screw removal- 5/24/05
Cortisone injection to pes anserine- 7/27/05
Femoral derotation osteotomy, TTT revision- 10/18/07

Offline Shoomers

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Re: Anaesthetic questions...
« Reply #18 on: July 08, 2005, 12:52:29 AM »
Jen,
Was wondering what you finally decided to use for anesthesia?  How was it?  I am having LR/TTT on August 2, and am getting scared.  My big fear, which I always have, is not waking up, OR, waking up during the surgery.  Do you think this is normal, or am I weird?  Also, I always get very sick with generals, but am very afraid of an epidural, becasue of the whole something in the spine/paralyzed thing.  What to do?
Anyway,  I hope your recovery is coming along very well and you are glad of your surgery! 
Happy day,
Lisa C.
1985-arthroscopy RK plicae removal
1986-arthroscopy LK plicae removal
2001-full dislocation RK
March, 2005 - had to stop running races due to PFS
August 2 L/R and TTT RK

shadehawk

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Re: Anaesthetic questions...
« Reply #19 on: July 08, 2005, 01:15:04 AM »
Lisa C,

I have had some surgeries also and have some really weird dreams.  Think it is just anxiety before surgery....NORMAL!!

About general anesthesia - I remember Heather M. mentioning Zofran (anti-nausea) medication to work with a general and it takes that nausea feeling away.  Maybe ask the doctor for one of the anti-nausea medications next time - I sure plan on asking...I hate that nausea feeling.....

Popsicles right when you wake up also help you alot - I love the lime flavoured ones.

Good luck to you,

Shade[/color]

Offline Shoomers

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Re: Anaesthetic questions...
« Reply #20 on: July 08, 2005, 01:31:56 AM »
Shade,
I will definitely remember that, and ask for something.  I get terrible motion sickness too, and have read it has something to do with it? 
Popsickles are the best after surgery!  (except when I start puking-red for me as I like cherry! Yuck!!)
Good luck to you, too!  You are in surgery right before me, I think?  BTW, how do you write all that stuff down there, below your post, about your knees/surgeries?
Thanks and have a great day!
Lisa C.
1985-arthroscopy RK plicae removal
1986-arthroscopy LK plicae removal
2001-full dislocation RK
March, 2005 - had to stop running races due to PFS
August 2 L/R and TTT RK

Offline JenSinclair

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Re: Anaesthetic questions...
« Reply #21 on: July 08, 2005, 01:21:23 PM »
Lisa:
I ended up opting for an IV general with a bunch of anti-nausea stuff in the "cocktail" and femoral/scitic nerve blocks.  They did the lumbar-plexus approach for the blocks (as opposed to -- ew! -- through the groin).  Evidently, that lasts longer...and mine were complete for more than 24 hours post-op.  When I woke up, I was somewhat nauseated, but the anaesthesiologist gave me more IV anti-nausea stuff in recovery and I was fine.  No puking at all.

Good luck!
Jen
LR/TTT 3 August 2006, RK
LR/TTT 16 June 2005, LK
CPMs are evil.

shadehawk

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Re: Anaesthetic questions...
« Reply #22 on: July 08, 2005, 02:54:27 PM »
Lisa,

Yes, my surgery is on the 28th July.  The day that you have surgery, I have my post-op visit & am hoping we'll be cleared to come back home.  My surgery is a 12-hr drive away....which is a good thing.  So, I should be leaving for home during your surgery.....[/color]

To put stuff at the bottom you click on the Profile button on the top of the KNEEguru page - where the chat, calendar logout etc are.....A screen will come up and you go to the left hand column and look for Modify Profile - click on Forum Profile Info & when screen comes up look for Signature:  Add your stuff and click 'change profile' at the bottom of the page.  Next time you check you should have the stuff added to the bottom of your posts.

I like this idea of the anti-nausea IV stuff that Jen talks about - maybe we'll be lucky enough to get this also.  I certainly will be asking for it.  Makes me wonder why my hospital has never offered something like this to me before......

Good luck,

Shade

Offline stgiles16

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Re: Anaesthetic questions...
« Reply #23 on: July 08, 2005, 08:12:36 PM »
Hey Shade, the anth., dr also put a little patch behind my right ear that contained anti nauseous medicine. It looks like a small round bandaid and works for a couple of days. That tiny bandaid is miraculous. I am sorry that I dont remember the name of the med but I do know that they use it for cancer patients.
good luck to both of you.

missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

shadehawk

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Re: Anaesthetic questions...
« Reply #24 on: July 09, 2005, 12:46:39 AM »
Missy,   ;D

Hi, that is very interesting.  I looked for anti-inflammatory patches and kept getting the name Scopolamine Patch – anti-nausea medication - it is also used for cancer patients - maybe this is what you had....

It is just so amazing all the info you can get off this site.

Thanks, ;)

Shade

Offline mhsflute07

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Re: Anaesthetic questions...
« Reply #25 on: July 10, 2005, 01:25:49 AM »
Hey,

Well...I had a nerve block and sedation, so I didn't have to worry about the nausea from general. However, I was on Vicodin, and that did make me nauseous, so I was prescribed Phenergan as an anti-nausea med. It worked great, but made me very drowsy. I'm with you, though, Shade.....I absolutely can't stand being nauseous. I would much rather have any sinus or respiratory illness over nausea any day.

Oh, it's interesting you should mention anti-inflammatory patches. I have an ulcer and can't take any anti-inflammatories by mouth....just trade knee pain/swelling for stomach pain.....so I always wondered if there was a patch. Did you find anything?

~Erin~
« Last Edit: July 10, 2005, 01:27:55 AM by mhsflute07 »
June 2, 2005 TTT/LR  R.
July 26, 2005 TTT/LR  L.
June 6, 2006 Microfracture R.
June 5, 2007 Microfracture & Screw Removal R.
March 12, 2009 Scope and ACI Biopsy R.
May 12, 2009 TTT, Trochleoplasty R.
December 15, 2009 ACI (patella) & bilateral hardware removal
December 21, 2010 LOA and LR

shadehawk

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Re: Anaesthetic questions...
« Reply #26 on: July 10, 2005, 02:43:37 AM »
~Erin~

Apparently, there are some that are being tested, buit do not have FDA approval yet.  You can get the Scopolamine Patch for nausea - it goes behind the ear.  The anti-inflammatories seem to be still in the pipeline though...It sure would be a good idea.  Think I read that Meloxicam is being used in some European countries in a patch form.....Fentanyl Patches are being used for 3-day pain relief from surgeries.

http://www.medicomm.net/Consumer%20Site/dh/dh_f3.htm

Shade
« Last Edit: July 10, 2005, 02:57:47 AM by Shade »

Offline mhsflute07

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Re: Anaesthetic questions...
« Reply #27 on: July 10, 2005, 03:24:04 AM »
Thanks Shade! Gosh, you'd think with all the patches they have for smoking, birth cotrol, nausea....they would certainly have and Advil or Motrin or Aleve....or something like that.....patch!!

Hmm...I could invent it, patent it, and get rich simply by marketing it to people on this site....hehe.

I did find this article about NSAID patches....it talks about their use in rheumatic patients, but thought it might be of interest.  http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9132322&dopt=Abstract

~Erin~
« Last Edit: July 10, 2005, 03:32:20 AM by mhsflute07 »
June 2, 2005 TTT/LR  R.
July 26, 2005 TTT/LR  L.
June 6, 2006 Microfracture R.
June 5, 2007 Microfracture & Screw Removal R.
March 12, 2009 Scope and ACI Biopsy R.
May 12, 2009 TTT, Trochleoplasty R.
December 15, 2009 ACI (patella) & bilateral hardware removal
December 21, 2010 LOA and LR

shadehawk

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Re: Anaesthetic questions...
« Reply #28 on: July 10, 2005, 03:34:09 AM »
~Erin~


Hmm...I could invent it, patent it, and get rich simply by marketing it to people on this site....hehe.
- Hey, that would be a great idea, but I bet it is already in the pipeline somewhere.

I did not find any, but that does not mean they are not out there.  Sometimes the simple things are very hard to find.....Maybe someone else has seen anti-inflammatory patches.....

Shade
« Last Edit: July 10, 2005, 03:36:06 AM by Shade »















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