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NA and Anesthesia -- Local or "Twilight Sleep"?
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06/13/2013 22:46
Randy_H 
06/13/2013 22:46
Randy_H 

Re: NA and Anesthesia -- Local or "Twilight Sleep"?

Dr. Gary Press along with Dr. Denkler were some of the first US surgeons to adopt NA after Eaton. There are too many good reports about him (and he has been doing NA from the jump) for me to believe he would risk nerve damage for temporary patient comfort.

My one experience with twilight sleep was for a root canal. As the doc began I was very relaxed but I still wondered when the stuff would actually kick in. Then he suddenly removed the stuff from my mouth and said "All done". That's when I knew that it had, and how well it works. 50 minutest seemed like 10.

I'd go for it.

06/16/2013 17:56
moondanc 
06/16/2013 17:56
moondanc 
Re: NA and Anesthesia -- Local or "Twilight Sleep"?

Maddie:

Dr. Pess said it's really a personal choice; he said he has done larger areas with just a local, and some patients want twilight sleep for even small areas. The downside to twilight sleep is you need to fast before the procedure, you need someone to drive you home afterwards, and it costs more.
I'd love to get input from anyone who's had experience with either option. I'd also love to hear from people who have experience with NA on thick cords. My big one is about 1/4 inch wide (0.6 cm for you metric folks).

Thanks in advance for your feedback!

Maddie

Hi Maddie,
I'm in the same position as you. I'm going to fly across the country and have NA with Dr. Pess probably in early September and I have extensive disease-- it affects all eight fingers but a few aren't very contracted yet. I have too many cords to count and lots and lots of scar tissue after Xiaflex and 7 NA procedures. I'm trying to get a response from Dr. Pess with regard to how "out of it" I will be especially since my experience with this type of anesthesia for dental implants and colonoscopies is that I'm totally out of it--but that may just be because the medications affect memory and I don't remember being awake.

I did talk to Lisa in his office and she said you are "awake" and the anesthesiologist regulates the dosage to make sure. I sent pictures of both hands but I'm also having a problem answering the question on the intake forms, "what hand and what finger will get done?" I don't know what he's going to decide. Did you speak with Dr. Pess directly? If so, did you ask him about the ability to experience the "tingle" when a nerve is approached?

During previous NA procedures the lidocaine injection bothered me more than the needle but I always took lots of Valium. With Xiaflex the injection into the cord hurt way more than the manipulation the next day but that could be because my cord "broke" more easily. I just need to know if some patients just don't stay awake with "twilight sleep"-- or if it's a dosage regulation and a memory problem.

When have you scheduled your procedure? I'm going to send you a PM as I'd like to stay in touch.

Diane

07/15/2013 23:46
bstenman 
07/15/2013 23:46
bstenman 
Re: NA and Anesthesia -- Local or "Twilight Sleep"?

Regardless of the area to get the local anesthetic a good doctor will make a couple of injections with the pain lasting for about 5 seconds for each and then wait and let the numbing spread to adjoining areas and then continue to make additional injections, none of which you will be able to feel.

A general is a high risk procedure and when people die in surgery it is often a result of the anesthetic and not the procedure which is why the cost is dramatically higher than for a similar procedure performed in a doctor's office using a local anesthetic.

07/16/2013 18:02
moondanc 
07/16/2013 18:02
moondanc 
Re: NA and Anesthesia -- Local or "Twilight Sleep"?

bstenman:
Regardless of the area to get the local anesthetic a good doctor will make a couple of injections with the pain lasting for about 5 seconds for each and then wait and let the numbing spread to adjoining areas and then continue to make additional injections, none of which you will be able to feel.

A general is a high risk procedure and when people die in surgery it is often a result of the anesthetic and not the procedure which is why the cost is dramatically higher than for a similar procedure performed in a doctor's office using a local anesthetic.

I've had NA 6 times with two "good" doctors--Drs. Eaton and Denkler. My last several procedures involved both hands and multiple fingers on each; that was 10 or more "initial injections" - each hand-and despite 15 mg of Valium I "jumped" each time I got the injection--they hurt! And when one isf having an hour long procedure, the local wears off and more injections are needed. I trust that Dr. Eaton knows (knew in 2011) how to do this with the least pain possible.

My DD is extensive and because of all the NA procedures I've had- in addition to Xiaflex- I've lots of scar tissue and my cords are thick with multiple cords per finger--both front and sides-- and this time I'm again having both hands and will need at least 10 joints worked on in addition to both palms.

Please re-read the original post and the title. Nothing was said about *general* anesthesia. What is being discussed is "twilight anesthesia" or modern intravenous sedation or "conscious" sedation. This is often used for colonoscopies and serious dental procedures--multiple extractions or implants.

http://www.howstuffworks.com/anesthesia1.htm
"Under procedural sedation, you remain fully awake and can respond to questions and instructions"
http://en.wikipedia.org/wiki/Twilight_sleep

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