Expert: Ronald Levy, M.D. - 6/17/2007

Question
My husband has been on Nardil for over 25 years.  He has an inguinal hernia.  His anesthesiologist told us there was no safe anesthetic that could be given without risking his life.  She said the same applied to a spinal and that the local shots planned could give him seizures.  She also asked how high his pain tolerance was, since the locals would not block all the pain.  In reading your previous answers to others, you contradict this information.  Could you please be specific in what can be used safely.  My husband has an intense fear of being unconscious, but would a sedative and a pain killer be advisable instead? We are in the need of answers, since the local doctor is not knowledgeable in this area.

Answer
I don't know where this other doctor trained but while your husband is certainly at a higher risk than a healthy person, I wouldn't say that his life is at risk. As for local, I used to be a surgeon and we did inguinal hernias all the time this way and if the local is give properly, it works perfectly. A sedative and pain killer would not be enough. I have never seen or heard of seizures from local in a patient taking Nardil. Is the procedure being performed at a teaching hospital or a ambicare center? I would recommend the former. As I see it, he can have the procedure under local, regional (or even general, if necessary, with appropriate precautions).

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston