Local anesthetic through pelvic catheter? What should I expect?

[Merlin744]

Hey guys... here in a little bit I'm gonna have some fairly serious surgery, they're gonna remove a plate of bone from my pelvis (right) to graft into my upper mouth so there'll be enough support there to mount artificial dental implants. Now of course for oral pain my doc says I'll have a ton of pill-based painkillers... but he says for the pelvis, I'll have a catheter running right into it, into which I'll directly dispense a local anesthetic that'll make the whole area feel good. I always try to make myself look as much *NOT* like the average 19 year old college druggie looking to cash in on his hospital visits, so I abstained from asking for specifics/drug names... does anyone know what sort of stuff I'll end up with to put down the tube? He says it'll be in there for probably around a week, and that it'll be my best friend during that time.. haha.. I'm a bit scared, considering the only local anesthetic I know of is cocaine... if any of you guys know anything about this type of procedure/what sort of medications I'll likely end up with, would love to hear from you, thanks.
[ 04 December 2002: Message edited by: Merlin744 ]
[ 04 December 2002: Message edited by: Merlin744 ]

 

[two wobinas over the cuckoos nest]

wow thats a scary surgery.....good luck

 

[Bonecutter]

MOst likely Novocaine or Lidocaine

 

[DrWild]

Probably Marcaine (R)
Its long acting. It exhibits little cardio- toxicity. And its not as likely to cause a motor block as lidocaine. With appropiate dilutions, you can actually get a differential motor/sensory block with Marcaine. Thats one reason why the anesthesia people love it.
In a nutshell, the area will be numb, but you will be able to move properly and completly because your muscles will still be receiving signals.
Dont expect any sort of a buzz from this stuff though. :-( It doesnt really have any central action except in near-toxic dosages.
Hope that helps.
Happy Trails,
DrWild

 

[gasbo]

I Agree with Dr. Wild that they will likely use one of the longer acting agents like Marcain (bupivacaine), Chirocaine (levobupivacaine) or Naropin (ropivacaine).
However - this is purely on an academic level about cardiotoxicity and motor/sensory selectivity - Marcain is very cardiotoxic (in fact the most cardiotoxic of the commonly used modern local anaesthetics and certainly more so than lignocaine/lidocaine). The CC:CNS ratio for Marcain is 3.7 and for lignocaine is 7.1.
As for the differential motor and sensory block - Marcain isn't all that selective, however Ropivacaine has some selectivity as does levobupivacaine.
Most LA's used via a catheter technique run at low concentrations eg. For Bupivacaine & Ropivacaine 0.125% - 0.25% for peripheral nerve blocks, but down to 0.08% for epidural type blocks. At these conventional doses and infusion rates, toxicity is avoided.
The exact site of the catheter will determine the concentrations chosen as well as the motor/sensory selectivity - ie. If it is sited within a nerve plexus supplying the area or an epidural - then selectivity can be a concern - However if it is embedded in the surgical field away from a nerve plexus - then there is likely to be little if any motor block regardless of the agent / concentration used.
[ 05 December 2002: Message edited by: gasbo ]

 

[Merlin744]

ah dang. I guess if there's not much recreational potential I'll get it taken out asap instead of a little delayed like I had thought. thanks for the help, it will definitely be an interesting experience..

 

[groovee]

Def ask your doc what they are putting in you and do some research. Its your right, esp in that sensitive "area".