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General Anaesthetic ?

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User
Posted 05 Jan 2020 at 20:55

Hello, I'm not as brave as some of the chaps here !  I just cannot face Gold Marker Insertion under Transperineal Local Anaesthetic.  How can I find a Consultant who would do this - AND "SpaceOAR" insertion under GENERAL Anaesthetic ? Hope someone can help!

Russell

User
Posted 06 Jan 2020 at 09:52

Another option would be to have a sedative. You won't remember the procedure afterwards, and it doesn't come with all the additional baggage of a GA (theatre time, anethestist, etc), but you will need someone with you to take you home.

At the time I had my procedures, SpaceOAR was mainly inserted under GA. That's becoming less the case now, but there probably are places that would still do that. (I couldn't have SpaceOAR, but it was considered a couple of times.)

If is was just gold marker insertion, treatment can be done without that, but then you need a CT scan (or more strictly, a CBCT scan) at the start of each treatment, which takes 5 mins longer (increasing treatment cost), and the CBCT scans themselves slightly raise the X-ray dose to OaR (Organs at Risk - nearby organs which you are trying to avoid treating such as bladder and bowel).

User
Posted 06 Jan 2020 at 15:01
Regulars will l know that I am Captain Panic.

I dreaded the GA. Took two attempts to insert the canula and spinal. I was in a right state.

I simply gritted my teeth and went for it. Going down and up was fine. A nice rest.

The only shock was waking up to balls the size of coconuts.

Sometimes you have to press on and stomp over your fears. When you do, you get a hell of a buzz.

User
Posted 06 Jan 2020 at 15:21

Russell, I've had three procedures (kidney and bladder stone removal, plus a HoLEP) all carried out with a spinal block anaesthesia and on all occasions my recovery was quick and free from complication.

I know that sometime down the PCa road I'm on I will be undergoing a template guided biopsy and will be most certainly be requesting a spinal block anaesthesia.

GA and I just don't get on at all and I'm pleased to say that when I have made the request, the surgeons and anaesthetists have readily agreed.

Perhaps a request for a spinal block to your consultant may be met favourably.

Edited by member 06 Jan 2020 at 15:24  | Reason: Not specified

Roger
User
Posted 02 Feb 2020 at 20:09

Russell

im the same with needles. Epidural is now my reference for this but wasn’t as bad as I thought. For your procedure I’d just hunt around. If NHS you can have the consultant you choose via NHS choices or go private if you can. Only places I know are around London is UCLH or London Bridge. Marsden might be worth investigating.

Good luck and hope you can get a GA and the procedure isn’t uncomfortable.

TG

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User
Posted 06 Jan 2020 at 00:13
Is there an underlying medical condition that is making your oncologist reluctant to give you a general anaesthetic? If not, have you just told them that you don’t really want a local? You may have to wait longer due to theatre bookings but SpaceOar, which is very new anyway, is only an injection so they may feel that the risks of GA outweigh the benefits and suggest you manage without the SpaceOar.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 06 Jan 2020 at 06:43

Russell

On one of my visits to theatre there was a guy who was having a general anesthetic for a Trus biopsy. He was terrified of having the procedure done and his surgeon agreed to do it under GA. So worth asking. 

Thanks Chris

User
Posted 06 Jan 2020 at 09:52

Another option would be to have a sedative. You won't remember the procedure afterwards, and it doesn't come with all the additional baggage of a GA (theatre time, anethestist, etc), but you will need someone with you to take you home.

At the time I had my procedures, SpaceOAR was mainly inserted under GA. That's becoming less the case now, but there probably are places that would still do that. (I couldn't have SpaceOAR, but it was considered a couple of times.)

If is was just gold marker insertion, treatment can be done without that, but then you need a CT scan (or more strictly, a CBCT scan) at the start of each treatment, which takes 5 mins longer (increasing treatment cost), and the CBCT scans themselves slightly raise the X-ray dose to OaR (Organs at Risk - nearby organs which you are trying to avoid treating such as bladder and bowel).

User
Posted 06 Jan 2020 at 12:08
I had a cardioversion a few months back (heart related) and that was done under sedation, I simply went out like a light and woke up sometime later, I don't know how long but It was a while. My point is there was no GA, no pain and once the canular was in no more injections. Maybe it's worth asking about the sedation route?

John

Gleason 6 = 3+3 PSA 8.8 P. volume 48 cc Left Cores 3/3, Volume = 20% PSA 10.8 Feb '19 PSA 1.2

Jan '20 PSA 0.3 July '20 0.1 Jan. 21 < 0.1 Dec 21 <0.01 June '22 <0.01 April '23  <0.01

User
Posted 06 Jan 2020 at 15:01
Regulars will l know that I am Captain Panic.

I dreaded the GA. Took two attempts to insert the canula and spinal. I was in a right state.

I simply gritted my teeth and went for it. Going down and up was fine. A nice rest.

The only shock was waking up to balls the size of coconuts.

Sometimes you have to press on and stomp over your fears. When you do, you get a hell of a buzz.

User
Posted 06 Jan 2020 at 15:21

Russell, I've had three procedures (kidney and bladder stone removal, plus a HoLEP) all carried out with a spinal block anaesthesia and on all occasions my recovery was quick and free from complication.

I know that sometime down the PCa road I'm on I will be undergoing a template guided biopsy and will be most certainly be requesting a spinal block anaesthesia.

GA and I just don't get on at all and I'm pleased to say that when I have made the request, the surgeons and anaesthetists have readily agreed.

Perhaps a request for a spinal block to your consultant may be met favourably.

Edited by member 06 Jan 2020 at 15:24  | Reason: Not specified

Roger
User
Posted 02 Feb 2020 at 18:29

Thank you ALL for your replies - I'm due to have my first meeting with my oncologist in around 10 days and will discuss possibilities with her. All the best to all of you. Russell A. 

User
Posted 02 Feb 2020 at 20:09

Russell

im the same with needles. Epidural is now my reference for this but wasn’t as bad as I thought. For your procedure I’d just hunt around. If NHS you can have the consultant you choose via NHS choices or go private if you can. Only places I know are around London is UCLH or London Bridge. Marsden might be worth investigating.

Good luck and hope you can get a GA and the procedure isn’t uncomfortable.

TG

 
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