Anesthesia for fistula revision surgery

[AnnieB]

Hello everyone, I just wanted to know what sort of anesthesia people had for fistula revision surgery. I've had several surgeries before, one when the AV fistula was created and a couple of others for other things (outpatient). I never had any problems before, but then I think they might have used iv fluids for the anesthesia. This time when I went in for the revision, they intubated me. That was on Monday (outpatient surgery), and not only do I have to deal with having been infiltrated during surgery, but I had some really painful and annoying responses to the anesthesia. I have had a bugger of a sore throat ever since Monday. The first day after surgery I was coughing nonstop, starting from a throat irritation then going down to a chest cough almost like bronchitis. It is finally starting to get a little better, but I am wondering if other people also had this experience? Is it normal to be intubated for fistula revision? I had never heard of other people talking about it before. And is it normal to have these reactions after surgery if you were intubated?

Thanks for any feedback! 

[smartcookie]

I can't speak to if they use general anesthesia for fistula revision, but the coughing is very normal.  After anesthesia, you should take really deep breaths to fully expand your lungs.  Sometimes you can get a cough and throat irritation from the tube down your throat.  From what I have experienced, the coughing can last a couple days.  It is okay if it is a productive cough (bringing up mucus).  If it is more than a couple days, I might call your doctor and ask if it is still okay.   

[kickingandscreaming]

It wasn't for a fistula, but when I was intubated it took me a week before I could even speak.  I was so raw.

[AnnieB]

So is it unusual to be intubated for fistula surgery? The explanation I was given was that it was to protect my airway. But like I said, I had never heard of anyone being intubated for a fistula revision.

[Simon Dog]

Intubation is used for general anesthesia when the machine needs to take over for your breathing.

My fistula surgery was done using MAC which is the new marketing name (Monitored Anesthesia Care) for what used to be called "Conscious Sedation"*.   This uses a mix of IV drugs like fentanyl, versed and benadryl to keep you in a semi conscious state.    It is not uncommon to go completely under, or to be awake at the beginning or end.  When I had my fistula installed, I remember coming to and asking "How is it going" and the doc told me "Just closing up now".   But it worked well, and I didn't feel a thing.

I also had it when I had a twofer - removal of the PD cath and groin line and a central venous cath inserted.  I remember telling the doc who took out the PD cath  "I want to see that part" (I remember it was this curley thing), and the other doc telling me to turn my head to the left.  Once again, it did a great job of keeping me comfortable.

I had a general twice - once for the PD cath insertion and once for my hip job.   I had the sore throat after the first, but no such problem with the hip job.  Maybe  it was luck, or maybe it was going to the big league medical center instead of the community hospital.

And finally, I had milk of amnesia (Propofol) for my rectal probe.  Absolutely completely out, no tube.   Just a dream of being abducted by aliens.

* - It's funny how the medical community renames stuff.  MRIs were originally NMRs, but they were renamed because "Nuclear Magnetic Resonance" contained that scary nuke word.  Also, how nurses always say "this will feel like a pinch" rather than a more honest "this might sting".   Plus, dialysis staff being told never to use the works "stick" or  "puncture".

[GA_DAWG]

I have a graft. If it is just for routine maintenance, they use Versed. Very clean and easy to wake up from. If it is a declot, it is full anesthesia because it is a more violent procedure. Lots more swelling from a declot.