Getting the Pacemaker Put In, General Anaesthetic??

my experience

by Electric Elise - 2018-10-08 16:35:54

hi there, hope you'll get the surgery that's best for you. let us know how it all goes! as for mine, i have to admit i wasn't a huge fan of it, especially the lead part - but that said, there are SO many other folk who've said it was a walk in the park for them. i also admit that in the very beginning i was so nervous i was shaking like a leaf, i actually apologised to the EP who was doing the surgery! he laughed and said it was perfectly normal. towards the end of the procedure, things had loosened up slightly and at one point we were talking about the FIFA world cup (had my surgery early july this year, haha!) but for me personally it was not as easy breezy as for the majority of folk i've spoken to. so you have high chances of sailing through this! best of luck!

My Experience

by RAS - 2018-10-08 17:34:30

I too did not have a general anesthesia,  but instead I was in a twilight state. I was told I talked to the doctor and pacemaker technician, but I have no memory of the procedure.  I also had an ablation at the same time. I do remember them draping my face which was my least liked part of the entire process because it made me claustrophobic.

the good drugs

by Tracey_E - 2018-10-08 17:44:21

I had general for my first three but that was years ago and not at all how it's done now. General requires a breathing tube and recovery is a lot longer. When I got the one before last (I'm on #5) they said local and I had the same reaction as you. They gave me versed which is conscious sedation. I was conscious but have no memories. You are awake and alert almost instantly when they stop it, no nausea or side effects. Good stuff!

Talk to the anesthesiolologist when you have your pre-op, tell them you are afraid and nervous about being awake. They also offered me sedatives pretty much as soon as the iv was in each time. You can even ask for something to take the night before if you want. 

Sedation was good!

by LondonAndy - 2018-10-08 18:03:39

My pacemaker was inserted about a week after I had a mechanical valve fitted in my heart, and was because of a 'surgical complication' (ie they accidentally damaged my electrics) when doing the op.  So my experience won't be typical.

I was expecting local anaesthetic, but looking at my pacemaker insertion document it says I was also sedated - your posting of the question now is the first time I have realised this!  However, I woke up whilst the operation was still in progress because I could feel the surgeon pushing hard, presumably as he was pushing it to embed it thorougly as the operation finished soon after.  There was no pain, I just drifted awake, hearing the surgeon and anaesthetist (I assume) discussing some sort of business in a very matter-of-fact way, so I immediately knew things were going fine by their relaxed manner, and grunted to let them know I was awake. My head was pointing to one side, and under a semi-rigid cover such that I could see a nurse beside me, and the wall, but not the ceiling or what they were doing.  I then remained awake until time to trolley me off to the ward again and made small talk with the nurse.  

So my advice would be to let them know of your worries, and they will treat you appropriately.  If you Google "Problems with general anaesthetic" you will see that can be problematic for some people, with sickness, damage to teeth and other issues, though serious problems are rare.  It is worth weighing up the pros and cons, in consultation with whoever is going to perform the procedure. 

Tracey-E beat me!

by LondonAndy - 2018-10-08 18:05:33

And she gives great advice, so I'm happy to agree!

No pain, no strain

by Gotrhythm - 2018-10-08 18:48:36

When facing pacemaker surgery, I told the surgeon right up front that I was chicken, a fraidy-cat, lilly-livered, and a total coward. I flat did not want to know anything about it. He chuckled, and told me not to worry. 

You don't have to have a general anesthetic to keep surgery from being emotially traumatic. Today, there's this thing called consious sedation. You can see and hear everything that's going on, follow directions and answer questions. The thing is, you have no pain, and as for how you feel about what is going on--you really, really don't care. Most likely, you won't remember anything. You come out of it very quickly with no hangover.

I had conscious sedation when I got the pacemaker and also earlier this year for cataract surgery. I actually do remember that in bits and snatches, the bright light, the surgeon talking to his assitant. I don't remember feeling anything. I remember, as I was being wheeled out, saying, "That's all?"

Seriously, just ask for all the help you need to get through it.

Don’t worry

by Kiwi - 2018-10-08 20:39:36

Although I was a bit anxious I didn’t want any sedation at all as I hate waking from a general and didn’t want to feel drowsy and out of it with conscious sedation 

once I was in the Cath lab on the table I said hey guys I’m feeling a bit stressed so maybe give me something light so they started with only 10 micrograms of Fentanol which didn’t do much but make me feel like I had a couple of shots of Whiskey and that’s all I had

from my perspective of being 99.9 % awake once you relax it was worse getting a filling at the dentist 

they got me comfortable with a choice of plllows,  covered me with a heated blanket as the O/R is quite cool, stuck on the usual monitors and put a drop sheet in front of my face and over my head so you can’t see what’s going on.

I could still see out each side so it wasn’t claustrophobic at all. Once settled they said ok let’s start with a local around the incision site.Honestly I hardly felt it, kind of like someone giving you a playfull pinch for a quick second. That’s all I felt.  We chatted while he made the pocket, there is a slight tugging kind of like a small child pulling on your hand to get your attention. As far as the lead insertion I did feel a quick sting for a second when he first inserted the guide tube but nothing else.You don’t feel it being fed in.He asked me to cough a few times while he fed the leads in to help position them.once connected up and tested he simply placed it in the pocket put in a few internal sutures and then glued the incision closed and taped it up. I felt the removal of the monitor tabs more than any of the procedure. They then took down the drop sheet from over my head and said your all done. I said I was happy to get up and walk out but they laughed and said it was procedure to be slid over to a gurney and be wheeled out.once I was wheeled out and into recovery I took the bed remote and put myself up about 45 degrees for about 5 minutes then got out of the bed for a bit of a walk

So if you get the usual sedation you will be fine whether it’s general concious or like me nothing at all

i know you’re nervous we’ve all been there 

when it’s over you will have a great story to tell us Wishing you well and a speedy recovery!

Tracey-E beat me!

by AgentX86 - 2018-10-08 21:01:19

Gotrhythm and and that LondonAndy guy gave pretty sound advice, too! ;-)

By the time I got my pacemaker I was a regular in the cath lab (they even forgot to put me out completely for a cardioversion) so I had the minimum of the minimum amount of sedation (and locals in my shoulder and groin).  I remember it clearly and was talking to one of the surgeons through the whole thing.  I also had the tugging and pulling sensation when they were stitching the PM in place but it didn't hurt at all.  There was considerable pain when they made the pocket, though.  I didn't like that much but I've had tooth fillings that were more painful.

I agree with the others.  Don't hesitate to tell your surgeon that you're a big chicken.  He'll reassure you and make sure you're fine.  You aren't the only chicken he's worked on (but perhaps one of the more honest;-). 

Don't worry about this.  It's not a big deal.  You'll be fine but please come back and tell us (and future club members) how it went.

Milk Of Amnesia

by MartyP - 2018-10-09 21:45:27

All 9 yards or squeamishness .... I went out like a light, felt nothing and woke up with no nausia or anything else - just woke up ..

PROPOFAL aka Milk Of Amnesia.

General

by El Gordo - 2018-10-13 13:48:29

They put me right out, same stuff as Marty.

When I woke up I felt better than when I laid down.