Surgery pacemaker

I haven't asked my Dr but is it normal for you all ..everytime I get a pacemaker replacement they doit with out putting Me to sleep I get to hear all the tools and such horrible experience....what's the reason I don't get full anesthesia 


5 Comments

new pacemaker

by enoch - 2022-07-20 06:39:28

My last two have been done without putting me to sleep.Its normal procedure. It is less risky tha putting you totally under.Lets you recover and go home much quicker. Tell the operating room personel of your anxiety and they will give you extra (joy juice). You wont care what they do then!!! 

A General Anaesthetic is not without risk

by Gemita - 2022-07-20 09:34:04

Cadaverock, a replacement device apparently is a relatively straightforward procedure, certainly less traumatic than the original “complete” pacemaker implant, where leads have to be fed through veins and lead tips attached to our hearts.  During a device replacement, the current pocket is opened, the leads are disconnected from the old device which is then removed.  The new device is then reconnected to the leads, carefully checked and placed in the same pocket.  The wound is then closed up.  From what I have read here, it is a simple enough procedure and does not require a general anaesthetic (GA).

As Enoch states, conscious sedation is often adequate for most of us, and you can always ask for extra medication before your procedure if you are really anxious and would prefer not to see or hear what is going on.  With a GA you would need to have an anaesthetist with you during replacement surgery, to make sure your airways stayed open, your blood pressure and heart rate and things like this monitored closely.  This takes time, effort and costs more too.  

After a GA, your recovery will take longer and you may need to spend a night in hospital.  You may wake with a sore throat due to the breathing tube they place in your mouth (I certainly did).  A GA suppresses many of our body’s normal automatic functions like breathing, heartbeat, circulation of blood including blood pressure and movements of the digestive system.  You will have to prepare for a GA and be nil by mouth for hours. As you can see, it requires preparation, a prior health assessment, monitoring during surgery and care following surgery which is why for a straightforward procedure like a replacement device, they will probably not recommend a GA.

anesthesia

by Tracey_E - 2022-07-20 09:51:42

There is an alternative, conscious sedation. We are still awake so none of the problems/risks of general anesthesia, but we remember nothing. Good, good stuff! 

Conscious

by AgentX86 - 2022-07-20 22:05:05

"Hear tools?"  What tools?  I just had locals in my thigh and chest.  There was no noise other than some talking.  I was talking with the EP implanting my PM.  I've had many caths with just locals, including my carotid where I had to be completely lucid to make sure there were no "oopses".

As others have said, the less anesthesia used, the safer and faster the recovery.  With only a local, there really isn't any anesthetic recovery time. With a general, it could be a day or even more for it to completely leave the system.  They only use what's really needed.

room is mostly quiet

by dwelch - 2022-07-26 00:55:09

so five devices.   first two I was awake-ish.  first replacement, device number two the doctor said "oops" my brain said, what do you mean oops, but my face and mouth could not make teh sounds.   Broken lead, now I have an unused one.  I could feel the tugging and all that, first one no tent over my face, so I could see the doc right there over me.  

Second one awake-ish but with a tent over my face, nurse would peek in the top every so often and ask how i was doing.

third one different doc, not general but i was out.

fourth different doc, not general but i was out. so far out that apparently he came to talk to me after the surgery and I had a conversation with him and remember none of it.

number five, not general but I was out.  this one they couldnt get the ekg machine to work had to wait for IT.  so I had to sit through prep, usually right when they put me on the table I am pretty much gone.  You may feel tired.  and right about when you are going to say I dont feel anything this wave comes over and out like a light, then later, you did good we are done.  I fought to stay away this time becauase I didnt want to forget that I talked to the doc.

It may vary by country, insurance, or doc, but just tell them you want to be out, give me something so that I dont have to see/hear what is going on. I would expect they could accomodate that, you certainly do not need general for that.

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