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Anaesthetic - Transurethral Resection - High Risk Patient


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#1 Guest_Martin_*

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Posted 22 December 2018 - 05:54 AM

Urgent Assistance Required

 

Look for direction in finding alternative options for surgery on patient deemed too high risk for general anaesthesia. 

 

62-year-old woman with advanced secondary progressive multiple sclerosis and dementia. She has been identified as having a 7cm mass in her bladder (currently unidentified due to doctors refusing to perform biopsy because it requires general anaesthesia). At the moment the mass is contained within her bladder (non-muscle invasive) but this could obviously change.

 

Her physicians have refused Transurethral Resection Surgery to remove the mass based on the risks of General Anaesthesia and the possibility of jerking during the surgery. There is of course the risk of conversion to an open procedure and the increased length of time there-in that she would need to be under.

 

Seeking medical practitioners guidance on potential alternative treatment, particularly with regards to Anaesthesia and M.S, I am seeking any and all anaesthetic options that you may be able to recommend as an alternative to general anaesthesia which would be suitable for the purpose of seriously mitigating the risks and being able to conduct the surgery. 

 



#2 Guest_Vicky_*

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Posted 27 December 2018 - 01:23 PM

While safer overall than general anesthesia, regional techniques do have some risks…The primary forms of regional anesthesia are…

• Nerve block. A local anesthetic medication is injected near nerves that affect specific body parts. Anesthesiologists use ultrasound to guide the needle to exactly where it will reach the right nerves.

• Spinal anesthesia. Anesthetic medicine is injected into spinal fluid inside the lower back, quickly numbing the lower half of the body.

• Epidural. Anesthetic medicine is injected outside the spinal fluid sac. It takes longer to work, but a tube can be left in place to give you pain relief after the operation.

• Sedative. Since the regional anesthetics will not affect the central nervous system—meaning you’ll stay awake—you’ll be offered a sedative drug to relax you and ease anxiety.



#3 Guest_Martin_*

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Posted 13 January 2019 - 02:19 AM

Hi There Vicki,

 

Thanks for the response. Can you advise on what the risks are?

 

 

 

While safer overall than general anesthesia, regional techniques do have some risks…The primary forms of regional anesthesia are…

• Nerve block. A local anesthetic medication is injected near nerves that affect specific body parts. Anesthesiologists use ultrasound to guide the needle to exactly where it will reach the right nerves.

• Spinal anesthesia. Anesthetic medicine is injected into spinal fluid inside the lower back, quickly numbing the lower half of the body.

• Epidural. Anesthetic medicine is injected outside the spinal fluid sac. It takes longer to work, but a tube can be left in place to give you pain relief after the operation.

• Sedative. Since the regional anesthetics will not affect the central nervous system—meaning you’ll stay awake—you’ll be offered a sedative drug to relax you and ease anxiety.

 

 

 



#4 Guest_Martin_*

Guest_Martin_*
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Posted 13 January 2019 - 02:20 AM

Hi There Vicki,

 

Thanks for the response. Can you advise on what the risks are?

 

 

 

While safer overall than general anesthesia, regional techniques do have some risks…The primary forms of regional anesthesia are…

• Nerve block. A local anesthetic medication is injected near nerves that affect specific body parts. Anesthesiologists use ultrasound to guide the needle to exactly where it will reach the right nerves.

• Spinal anesthesia. Anesthetic medicine is injected into spinal fluid inside the lower back, quickly numbing the lower half of the body.

• Epidural. Anesthetic medicine is injected outside the spinal fluid sac. It takes longer to work, but a tube can be left in place to give you pain relief after the operation.

• Sedative. Since the regional anesthetics will not affect the central nervous system—meaning you’ll stay awake—you’ll be offered a sedative drug to relax you and ease anxiety.

 

 

 





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