Expert: Dr Ian Jackson - please note UK based - 3/9/2009

Question
HI,
I am a 32 year old Female who has an extremely lengthly medical history.  I have been diagnosed with endometriosis, sciatica, and Pseudotumor Cerebri.  For the PTC, I have had 6 failed LP Shunts which has pretty  much ruined my lumbar spine, and most recently I have had a VP Shunt placed for the PTC which has already required 2 revisions.  I also have severe carpal tunnel syndrome and have a semi-confirmed diagnosis of Trigeminal Neuralgia in which further testing is needed to complete that diagnosis.  I am scheduled for surgery for Bilateral Carpal tunnel surgery in 2 weeks and I am extremely anxious about it.  This will be my first surgery in which general anesthesia will not be used.  I have an extreme fear of OR's or any setting like it and it often causes me to have full blown panic attacks.  I have an extremely long list of medicine allergies which consist of:
Amoxicillian, Rocephin, Keflex, Erythromiacin, Thorozine, Millirill, Pseudophedrine, Dextromethorphan, Dilaudid, Morphine, Anzimet, and Zofran.  The dr said he would give me IV sedation and then a local anesthetic.  He plans to do both arms at the same time.  What do they usually give people for that, and will I actually be awake for this or asleep but just not completely under?  I am scared to death and I just know that if Im awake in there I will totally freak out.  What has been your experience with people with my magnitude of fear, allergies, and such for this type of surgery?

Thank you in advance for any input you can offer.  

Answer
Hi Sara
I am truely sorry to hear about your list of problems.
We do large numbers of patients each week for carpal tunnel under local anaesthesia only - we do not give any of them a general anaesthetic and only seldom provide sedation.
Typical agent used for sedation is midazolam - this makes you relax and can make you sleep but is not a pain killer and is not a general anaesthetic so you are not completely under. Hence you will probably feel the local anaesthetic injection being given as a little sting. This is not a problem.
I only occasionally meet someone who sounds as worried as yourself. This is a simple operation (in the UK we have some nurses who do it now) and it only takes a short time for each hand. You must try and deal with your fears and accept the advice given to you by those looking after you.
Kind regards
Dr Ian Jackson