Guest guest Posted September 22, 2005 Report Share Posted September 22, 2005 I had a total pancreatectomy in 2003. I had a team of pain management doctors on call that visited me frequently (several times a day). I opted for an epidural on advice of the surgeon. Before I went into the OR they placed it. I could tell I didn't have good coverage but the pain doc said " don't worry, if it isn't good enough we got you covered. " And they did. It did not help much and by the time I woke up in the SICU and they got me extubated I screaming and rolling around in severe pain. The pain docs rushed in, hooked up a PCA, left the epidural in, and bolused me both epidural meds and dilaudid. They got it under control, but I had problems for months with severe pain. A perfect epidural should eliminate most of the pain. But I had a less than pefect one. If I had it to do over again (heh I wouldn't have the surgery) I would have started with the PCA. What is important is that you know you got a pain management team that will be there for you. That makes all the difference. Good luck! I second guess myself and wish that I would have tried a whipple first. Happy Autumnal Equinox! Bert > What did you use for pain management, epidural or IV? How did it > work for you? I am nervous about the epidural, because I've heard > they fall out and you can't feel your legs, etc. I want to make > sure I get the best pain management for my upcoming Whipple. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2005 Report Share Posted September 22, 2005 Hi , The surgery that you are undergoing is a major abdominal procedure. The anesthesia that will most likely be used will be the type that there is basically no chance that you will wake or feel pain of any kind They will use a very, very deep general anesthesia....the type when you are basically on life support (for breathing that is, because it paralyzes your muscles). I have had two major abdominal surgeries and half a dozen less drastic procedures and from my experiences, the likelihood of you waking up or even feeling pain is basically not there. Now coming out of GA is another story, as well as the recovery period for the next few days and weeks. Usually what will happen is that they will give you a PCA pump (for patient controlled anesthesia) and it will have morphine or dilaudid or some other powerful pain med. It is a lock-out type machine that allows you, the patient, to directly control when you get a dose of med. It is set so that you can not ovredose yourself....it has a lock-out mechanism so you can only give a dose once every ten minutes. It is an IV system. Then as you get better, they will try to get you to take pain meds by mouth. Usually this is done the day or so before you go home, and can be one indicator of your readiness to be discharged. So basically, in a case of this kind of surgery. you do not have to worry about feeling pain during the procedure itself....it is virtually impossible with the type of anesthesia that is used. Your body's mechanism for feeling pain just isn't functioning at that time. It is in the recovery unit and the ward that your pain, if any, will become apparent. This is the time period when you have to advocate for yourself for proper pain management. But most hospitals are very good at post-surgical pain control Of all the things to be apprehensive about with your surgery, this is the least thing to worry about, in my experience. laurie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2005 Report Share Posted September 22, 2005 Hi there, Of course the surgery itself will put you under as deep as you can go. They will use two different meds to control paralysis and anesthesia. You will be entubated. They will have an aterial line to monitor your vitals up to the second. You will have a central line put in once you go under so they can push heavy volumes if need be. But it does indeed matter what kind of pain management you get when you wake up. Because as soon as you are entubated if you are not adequately covered you will know it. Like I said an epidural alone was not enough for me. PCA helped a lot. They actually also gave me morphine in the central line while being on both the epidural and the pca. My pca had dilaudid I received almost 2 mgs. an hour! So find out about the kind of pain management teams they have and talk to them before hand if possible. Bert > Of all the things to be apprehensive about with your surgery, this > is the least thing to worry about, in my experience. Quote Link to comment Share on other sites More sharing options...
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