I don't have a problem with with Novocaine, I have had 5 laser surgeries using it and it worked well. I also can block a lot of pain, but the Novocane doesn't work unless you inject it, that's where the problem was, as I was wheeled out, one of the Nurses told me she was sorry, and had never seen anything done like that. I had my head covered, and was tied down, my guess is his last patient got away. there was nowhere for me to go, but it lifted me off the table eight times. JimBamalady wrote:Jim....that sounds awful! I don't do well with Novocaine myself, but I let them know in a hurry! And I won't let them continue until I am comfortable. There is another med that can be used if you don't respond well to Novocaine, but I don't remember what it is off hand.
Having Major Surgery...Have Questions
Use data to optimize your xPAP treatment!
"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire
"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire
surgery and sleep apnea
I am the new kid here. I had emergency gall bladder surgery in May 2005. Even though I discussed my Sleep Ap with Anesthesiologist, I didn't think it was a concern. However, I stopped breathing on my own and it was necessary for them to use emergency techniques to start me up again. They put a Bipap on me until the next morning when my cpap could be brought to me. Instead of a normal room, I was in ICU overnight.
Hope this helps.
BTW CalabZ
Hope this helps.
BTW CalabZ
Hi CalabZ. Stick around and you will find lots of good information. I have and folks are so willing to share.
Your experience exemplifies what I have been writing about. While it seems most of us can have surgery without problems, there is always the chance that something could go wrong. I simply do not understand why a hospital would want to take that chance, and I am sure that I would rather have my CPAP than an experience similar to yours.
Your experience exemplifies what I have been writing about. While it seems most of us can have surgery without problems, there is always the chance that something could go wrong. I simply do not understand why a hospital would want to take that chance, and I am sure that I would rather have my CPAP than an experience similar to yours.
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barbyannRN
hospital
You will be OK during surgery/recovery room and monitored (O2 saturation) constantly. It gets tricky when you get back to your hospital room though. Yes, you will need your CPAP equipment, respiratory should come up and check it out, add O2 if required. The problems I see (I am a hospital nurse) is that the patient frequently nods off/on all day and the mask doesnt get used. Unfortunately, most nurses think the mask is for night time only. We all know this is not true and you need it ANY time you are sleeping. The result is that you may spend much of the day and night on the mask. The cat napping is mostly to do with the pain medicine and you might nod off quicker than you can put the mask on. Talk to your nurses and ask them to please monitor your mask usage closely, if they see you sleeping with it not on they should wake you and place the mask on.
Surgery is so very stressful to the body. This is a very important time to make sure your CPAP is used consistently to give your body all its resources to heal quickly.
Surgery is so very stressful to the body. This is a very important time to make sure your CPAP is used consistently to give your body all its resources to heal quickly.
They do a tracheotomy, although I read somewhere that they are not the best people to do that, maybe not as neat as they could be, but after all it is done in emergency conditions. But this must be quite rare, we don't want to worry our patient to be unnessarily.
It is important to get your cpap equipment on A.S.A.P., make sure that the nurses in recovery know how to do it. I have to say that I didn't get the feeling that they took it as seriously as they should, or as I did. The Dr. secretary said it's no big deal I know lots of people with it, but when I said it was important as I could actually die she smartened up. I had to ask for my equipment when I came to the 2nd time, guess I zonked back out too soon the first time. so someone you know there is a good idea, if it is allowed.
It is important to get your cpap equipment on A.S.A.P., make sure that the nurses in recovery know how to do it. I have to say that I didn't get the feeling that they took it as seriously as they should, or as I did. The Dr. secretary said it's no big deal I know lots of people with it, but when I said it was important as I could actually die she smartened up. I had to ask for my equipment when I came to the 2nd time, guess I zonked back out too soon the first time. so someone you know there is a good idea, if it is allowed.
Ms Piggy ..... if I ever wake up with a tracheotomy, the hospital is going to have a very, very irriate person on their hands. The Sleep Apnea is on my records there, and it is discussed before I am admitted. I really don't think they want to go there.
barbyannRN
Can you give us any insight into why XPAPs aren't used in the OR? As I said, it seems such a simple, preventative measure.
barbyannRN
Can you give us any insight into why XPAPs aren't used in the OR? As I said, it seems such a simple, preventative measure.
OR
The patient on the OR table is hooked up to multiple monitoring devices. Blood pressure, temp, HR, respirations and oxygen saturation at all times. If any of these vital signs are abnormal the team knows how to fix them. Anesthesia has everything they need to keep your airway open right there in front of them. If your airway becomes blocked, bells and whistles will sound and it will be addressed. That is their job and they sit right behind your head and watch your airway. If you need to have an artificial airway put in they will, no problem. If you need a face mask, they have one for you, no problem.
In the recovery room you will be asleep and they will be monitoring all your vital signs closely, the airway equipment is nearby and anesthesia is usually in and out frequently. Some people do go on their CPAP in the recovery room if they request, but if you don't you will be on oxygen and your saturation will be monitored and addressed if it dips. Remember they can increase your oxygen percentage so each breath you receive will have more O2 concentration. I usually have the family bring the CPAP up to the room and we set it up at bedside so when the patient arrives to the floor from recovery we can put it right on. In a regular hospital room you will not have continuous monitoring of your vital signs. They will check them every few hours. The CPAP needs to do the job now because your intensive monitoring period is over. Depending on your O2 saturation when you arrive to the floor will determine if you need O2 hooked up to the PAP or not.
If a patient needs BiPAP they do not go to a regular hospital floor, they need to be in a more intensive environment.
Another problem I have seen in the hospital is that some uninformed nurses have put normal saline in the humidifier and not distilled water. Make this clear right from the start. One patient came back and told me his unit got ruined on his last visit. If a patient forgets his unit at home they tell the family to bring it in. The patient stays on O2 through nasal cannula or simple face mask until the family brings it. The hospital does not loan CPAP units.
None of this information is a substitute for talking with the OR team. The more information you give them the better. If your doctors or nurses tell you differently, than by all means do it. Just wanted to tell you how I see things done in my hospital (and its a good one).
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CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, humidifier, CPAP
In the recovery room you will be asleep and they will be monitoring all your vital signs closely, the airway equipment is nearby and anesthesia is usually in and out frequently. Some people do go on their CPAP in the recovery room if they request, but if you don't you will be on oxygen and your saturation will be monitored and addressed if it dips. Remember they can increase your oxygen percentage so each breath you receive will have more O2 concentration. I usually have the family bring the CPAP up to the room and we set it up at bedside so when the patient arrives to the floor from recovery we can put it right on. In a regular hospital room you will not have continuous monitoring of your vital signs. They will check them every few hours. The CPAP needs to do the job now because your intensive monitoring period is over. Depending on your O2 saturation when you arrive to the floor will determine if you need O2 hooked up to the PAP or not.
If a patient needs BiPAP they do not go to a regular hospital floor, they need to be in a more intensive environment.
Another problem I have seen in the hospital is that some uninformed nurses have put normal saline in the humidifier and not distilled water. Make this clear right from the start. One patient came back and told me his unit got ruined on his last visit. If a patient forgets his unit at home they tell the family to bring it in. The patient stays on O2 through nasal cannula or simple face mask until the family brings it. The hospital does not loan CPAP units.
None of this information is a substitute for talking with the OR team. The more information you give them the better. If your doctors or nurses tell you differently, than by all means do it. Just wanted to tell you how I see things done in my hospital (and its a good one).
_________________
CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, humidifier, CPAP
BAMALADY.
sorry, the tracheotomy was in reply to an ealier question by someone which I took to mean an "if all else failed condition", as I think that is what they do then. NOT in your case. fear not, you will be ok, especially if you follow the good advise people have given, it pays to be informed and ask questions.
sorry, the tracheotomy was in reply to an ealier question by someone which I took to mean an "if all else failed condition", as I think that is what they do then. NOT in your case. fear not, you will be ok, especially if you follow the good advise people have given, it pays to be informed and ask questions.
BAMALADY.
sorry, the tracheotomy was in reply to an ealier question by someone which I took to mean an "if all else failed condition", as I think that is what they do then. NOT in your case. fear not, you will be ok, especially if you follow the good advise people have given, it pays to be informed and ask questions, now you will have a good list of questions.
sorry, the tracheotomy was in reply to an ealier question by someone which I took to mean an "if all else failed condition", as I think that is what they do then. NOT in your case. fear not, you will be ok, especially if you follow the good advise people have given, it pays to be informed and ask questions, now you will have a good list of questions.
Barbyann-
Thanks for an 'insiders' perspective. It was interesting reading.
Miss Piggy-
Well, I made it through the last procedure OK. I hope the one coming up will be a repeat.
BUT... this is a part of the information given at the .gov site I left a link to earlier:
Intraoperative Management
Because of their propensity for airway collapse and sleep deprivation, patients at increased perioperative risk from OSA are especially susceptible to the respiratory depressant and airway effects of sedatives, opioids, and inhaled anesthetics; therefore, in selecting intraoperative medications, the potential for postoperative respiratory compromise should be considered. For superficial procedures, one should consider the use of local anesthesia or peripheral nerve blocks, with or without moderate sedation. If moderate sedation is used, ventilation should be continuously monitored by capnography or another automated method if feasible because of the increased risk of undetected airway obstruction in these patients. One should consider administering CPAP or using an oral appliance during sedation to patients previously treated with these modalities. General anesthesia with a secure airway is preferable to deep sedation without a secure airway, particularly for procedures that may mechanically compromise the airway. Major conduction anesthesia (spinal/epidural) should be considered for peripheral procedures. Unless there is a medical or surgical contraindication, patients at increased perioperative risk from OSA should be extubated while awake. Full reversal of neuromuscular block should be verified before extubation. When possible, extubation and recovery should be carried out in the lateral, semiupright, or other nonsupine position.
My bold.
Thanks for an 'insiders' perspective. It was interesting reading.
Miss Piggy-
Well, I made it through the last procedure OK. I hope the one coming up will be a repeat.
BUT... this is a part of the information given at the .gov site I left a link to earlier:
Intraoperative Management
Because of their propensity for airway collapse and sleep deprivation, patients at increased perioperative risk from OSA are especially susceptible to the respiratory depressant and airway effects of sedatives, opioids, and inhaled anesthetics; therefore, in selecting intraoperative medications, the potential for postoperative respiratory compromise should be considered. For superficial procedures, one should consider the use of local anesthesia or peripheral nerve blocks, with or without moderate sedation. If moderate sedation is used, ventilation should be continuously monitored by capnography or another automated method if feasible because of the increased risk of undetected airway obstruction in these patients. One should consider administering CPAP or using an oral appliance during sedation to patients previously treated with these modalities. General anesthesia with a secure airway is preferable to deep sedation without a secure airway, particularly for procedures that may mechanically compromise the airway. Major conduction anesthesia (spinal/epidural) should be considered for peripheral procedures. Unless there is a medical or surgical contraindication, patients at increased perioperative risk from OSA should be extubated while awake. Full reversal of neuromuscular block should be verified before extubation. When possible, extubation and recovery should be carried out in the lateral, semiupright, or other nonsupine position.
My bold.