Dr. Levy, I have developed a hernia through the pfannienstial incision from my c section eighteen years ago and will need surgery I also have a inguinal hernia on the right side. I am supposed to talk to a surgeon shortly about repair. I would like to have this repaired with spinal anesthesia and I am wondering if this would be a viable option for this type of repair. Also I do not want to receive ANY type of drug that has amnesia as a side effect. I want to be able to remember everything that occurs.The reason being that several years ago during my csection I received Versed and afterwards became angry,depressed,I had high anxiety and these effects lasted for a few months. I felt so betrayed that they erased the memory of the birth of my only child. No one warned me that I would not remember anything and the fact that I did not know what they did to me during this time and the loss of the block of time really disturbed me. I managed to get through it but it took several months. Four years ago my husband had surgery and did not want to receive Versed and we were met with hostile responses from everyone of the medical staff. They said it is a good drug and everyone gets it. They just stood around the bed and stared at us until he relented. He wound up not remembering the whole day which the hospital said was rare. After his surgery I wound up experiencing the same anger,anxiety, and depression after his surgery and I didn't even have the surgery. It again lasted several months and was even harder to get over this time. Should I explain this to my surgeon? Will they even care or take this into consideration. Can I successfully refuse the drugs that wipe your memory and can surgery be safely performed without them? Is there something they can give you to relax that doesn't affect memory? I understand that in an emergency situation it may have to be converted to general and the amnesia could not be avoided and I get that and would deal with it the best I could if that would happen but I would like to at least try to have it done without them. Any suggestions would be appreciated and I thank you in advance for your time.
The surgery can be done under a spinal anesthetic and it can be done without any amnestic drugs (although I, like most anesthesiologists, would not recommend it because some of the sights, sounds and smells of the OR may be more unpleasant than the amnesia). What you need to do is to talk to the anesthesiologist before the procedure (preferably the day before) and explain the issues to him/her and have them assign an anesthesiologist who is willing to carry out your wishes. In the end, you are in charge of your body and unless your wishes would pose a harm to you or others, most anesthesiologists will agree to them. To be fair to the anesthesiologist, they also have a right not to do an anesthetic that you want (and they are uncomfortable with), but they should refer you to one of their partners who is willing rather than convince you to try a different method. While I agree that amnesia for your childbirth was probably unfair, there are good reasons for amnesia in other procedures. Don't dismiss it out of hand but take each on a case-by-case basis.
Ronald Levy, MD
Professor of Anesthesiology