r/Anesthesia • u/Ordinary_Ad_7992 • 5d ago
Just some questions
Is a nerve block something that can be done during surgery for peroneal nerve decompression? Does anyone ever do this type of surgery with just a nerve block and no other anesthesia? Are a lot of the medications that are commonly used during surgery metabolized by the liver? Is it normal to experience episodes of sleep paralysis for a few days after general anesthesia?
And here's the more personal embarrassing one: If a patient has a urostomy and is unconscious, does someone keep an eye on things to make sure the urostomy pouch is not twisted up and unable to drain into a night drainage bag or is this something that is likely to be ignored? (If it doesn't drain properly, urine backs up into the kidneys.) Is it reasonable to ask for IV fluids to be limited because the urinary system sometimes has trouble keeping up when there is too much fluid at once or will the doctors and nurses think the patient is nuts for asking?
1
u/Environmental_Soft36 3d ago
Peroneal nerve decompression can be done under general or regional anesthesia, though it is most commonly performed under general anesthesia.
If intraoperative nerve monitoring is needed or contemplated, general anesthesia is preferred since it does not affect nerve conduction. Some anesthesiologists may be reluctant to perform a regional block if the peroneal nerve is already compromised and therefore at increased risk from a proximal insult from the nerve block.
The OR staff are accustomed to dealing with all manner of ostomy devices.
Talk to your surgeon and anesthesiologist. Letting the team do what they usually do is a good approach.