Expert: Ronald Levy, M.D. - 7/2/2009

Question
Hi Dr. Levy,

First of all thank you for your help in the past.

I now have an incisional hernia; about the size of my hand that needs taking care of.  It is at the site where they did a laparascopic gall bladder removal in February 2009.  It is right next to my belly button.

I am not a good risk for general anesthesia yet my surgeon is all too willing to put me at risk (I have COPD).  I am wondering if I should get a second opinion from a different surgeon about using an epidural rather than a general anesthesia.  I am not sure if you remember my case but I did code blue when they gave me the sedative to put me to sleep for an ERCP to contain bile.  I stopped breathing right away.

Also how long does an epidural take to wear off where I can walk again?

Thank you so much for your time again

Answer
Actually, a general might not be a bad option for you for the following reason. For them to get a good anesthetic level on you, they would need a level high enough that it might make it difficult for you to breathe well (the level would include the diaphragm so you would be able to use that to help breathing). The person you need to speak to is not the surgeon but the anesthesiologist. They determine the type of anesthetic, not the surgeon. Explain the problem you had before and let them give you their best advise. As for how long the epidural lasts, it depends on what they use but you can figure 2-4 hours after the operation, it will be safe to walk again (although you will feel your legs long before that).

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston