Expert: JM Starkman, MD - 7/29/2009

Question
QUESTION: Each time I have a general anesthetic I vomit for 12 to 24 hours, no matter how much gravol or similar medications I am given.  I may have to have surgery on my hand and am dreading it.  Do you have any advice?  Thank you.

ANSWER: Ask the anesthesiologist to provide a regional, instead of a general anesthetic for your hand operation.  In this case, that would involve a "block" or injection of the nerves near your neck or axilla that would render your hand numb, so that you wouldn't feel anything your hand surgeon is doing (it's called an axillary block or an interscalene block or an infraclavicular block).  Alternately, if the proposed surgery will not take too long a "Bier Block", also known as an intravenous infiltration block, would work well in many cases.

---------- FOLLOW-UP ----------

QUESTION: Yes, they said they could use a block but that sometimes the block doesn't work and they would need to give a general.  So, any further advice, re the type of general, or other meds to prevent the vomiting?  Thank you

Answer
Hopefully, when you expressed your concerns to your anesthesiologist they were able to formulate a plan to minimize your post-operative nausea!

There are many published protocols and suggestions for dealing with the matter.  Good luck and best wishes to you.