Expert: JM Starkman, MD - 11/14/2010

Question
I will be having a second procedure to unblock a tear duct at a prestigious eye clinic in a distant state.  Previous (unsuccessful) surgery in my hometown used local anesthesia only (my own preference.)  When I met with my new surgeon (for about 10 minutes) last month, he initially checked general anesthesia on the form.  When I objected to this type of anesthesia to his assistant, she (amazingly!) changed the form herself to MAC anesthesia.  (I will be having a minimally invasive procedure with an endoscope, which can apparently be done with any of the anesthesia options.)  We had no choice as to the surgery date, and my husband really needs to be back home the day after my surgery.  The assistant did not think that flying home on the same day as surgery would be a problem--she suggested that I request drugs for MAC that leave the system quickly.  I will not be seeing either the surgeon or the anesthesia provider until the day of surgery, and I am very nervous about the current plan.  (What if the anesthesia provider/surgeon refuse to comply with my request?)  I'm 58 years old and healthy.  Advice please.

Answer
Perhaps your surgeon would be willing to have your anesthesia "provider" (I note the word or concept of 'doctor' was not used) call you at home in advance to discuss your various concerns and formulate an anesthetic plan, etc. amenable to the both of you.....that should obviate a last minute "refusal to comply".   For a much longer and more invasive operation/anesthetic a flight home afterward might present a problem---but not a tear duct procedure with local and sedation.