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Monday, September 1, 2014
40 seconds of anesthesia
I`m having two screws removed from a bunionectomy done several years ago. I don`t want to be `under`, but I don`t want the initial pain of the needle numbing my foot. What drug would you suggest I request that would put me out for a few minutes? Thank you.
Thanks for your question. There are two misconceptions within it. Firstly, there is no surgical procedure that takes 40 seconds other than the clipping of toenails! If you check with your surgeon I think you will find that even something that sounds as simple as "removing two screws" inevitably takes longer than this. If it didn't, then your surgeon would do the procedure in his office.
Second is the idea of being "out" but not "under" with the use of a single drug. Either you need an anesthetic for this procedure or you don't. If you do, the options are local, regional or general anesthesia. General anesthesia is unfortunately more complicated than simply selecting and administering a particular drug. If it weren't, we would all be doing this ourselves in the comfort and privacy of our living rooms.
Please browse other responses on this site for more explanation of the three options listed above. For foot surgery, local and regional anesthesia are both feasible, popular options. Local anesthesia,without sedation, does, as you've realized, mean that you get an initial injection that hurts. Nerve blocks can be done (that is one of the regional anesthesia choices). Spinal anesthesia is another option - the legs and feet will become totally numb. The discomfort of a needle can be reduced or eliminated through the administration of intravenous sedation, but you still need a needle (the IV) to get the benefit of that approach.
A discussion with your anesthesiologist will reveal the options available to you in the particular facility where you will have the procedure, taking into account the exact nature of the operation and any medical conditions that might also influence the decision.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University