Expert: Ronald Levy, M.D. - 6/24/2011

Question
Hi Dr. Levy,

I am scheduled to have a D&C, Hysteroscopy, and Novasure on this coming Tuesday (the 28th).  I am having this done at a hospital in Virginia.  My doctor seems to be very evasive in answering my questions regarding anesthesia.  When I first called the office to discuss the surgery, the receptionist informed me that I would just be getting a "local" to my cervix.  When I threatened to back out of the procedure (from total paranoia that I'd feel pain), she put me on hold and came back a few minutes later and said "the doctor said you'll be on MAC anesthesia, so don't worry, you won't feel a thing".  I asked what Mac anesthesia was and she said "I really don't know".  She really doesn't know???  I am already feeling apprehensive/terrified about undergoing this, and the last thing I need to worry about is if I might feel something.  Could you please enlighten me about what I can expect?  What kinds of drugs might they use on me?  Am I going to be awake?  I'm really scared, and I don't feel like I'm getting the answers I want from the doctor!

Thanks for your help!

-Tanya

Answer
MAC anesthesia means they will give you sedation (potentially heavy if needed) plus the local. While you will technically be awake, you should feel anything and furthermore, the medicine they give you for sedation is likely to cause amnesia so you won't remember the procedure. The more important question is who will provide the MAC. If it is their regular nursing staff, they will likely be less inclined to give you heavy sedation while an anesthesiologist or CRNA is more likely to do that because they alway have the option of converting to a general anesthetic. The drugs they will likely use include Midazolam, Fentanyl and perhaps Propofol.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston