Tubal Reversal Blog ‘outpatient anesthesia’

Submitted by Dr. James Split
Anesthesiologist
Chapel Hill Tubal Reversal Center

At Chapel Hill Tubal Reversal Center, we use general anesthesia for our tubal reversal surgeries. You will be completely asleep through your operation. When under general anesthesia, you will be totally unconscious and will not be able to feel any pain. In addition to the general anesthetic, your tubal reversal surgeon will place local anesthetic into the skin and deeper structures that are operated on to help you be as comfortable as possible when you wake up.

You will have an IV started after you arrive at the surgical center on the morning of your tubal reversal procedure. After you arrive in the operating room, we will give you an intravenous sedative similar to Valium to help you relax prior to going to sleep. We will take a blood pressure reading and then ask you to take several deep breaths of oxygen through a loosely applied face mask. We will put a sedative medication into your IV line that will make you fall asleep very quickly, usually in 10 to 20 seconds. We will keep you asleep during your surgery by having you breathe an anesthetic gas. During your operation, you will be given additional IV medications to prevent post-operative nausea and vomiting, and to minimize pain when you awaken.

We usually place a soft airway in your mouth after you are asleep. This airway is positioned behind your tongue to keep your airway open. This allows us to be sure you always have a safe open passageway for oxygen to enter your lungs. This airway goes into your mouth after you are asleep and is removed when you awaken. Most patients do not remember having a soft airway in their mouth, but some patients will have a scratchy or sore throat for 12 to 24 hours after surgery.

The anesthesiologist or nurse anesthetist will always remain with you while you are asleep. Throughout your tubal reversal procedure, we will monitor your blood pressure, heart rate, temperature and oxygen concentration in your bloodstream. You will awaken quickly after your surgery. Most patients are able to move themselves off the operating room table onto the stretcher to be taken into the recovery room.

Sometimes patients ask if they can have conduction anesthesia such as an epidural. We do not use epidural as outpatient anesthesia because of the risks involved. The method of general anesthesia that we use is safer than conduction anesthesia in the outpatient setting and less likely to cause a complication requiring hospitalization.

Anesthesia for Tubal Ligation Reversal

Submitted by Pam Mills, CRNA

Being part of the anesthesia care team at Chapel Hill Tubal Reversal Center has given me the opportunity to work one on one with tubal reversal patients in an outpatient setting and to assure they receive the best medical care they have ever experienced.

For anesthesia purposes, we record pain scores and the incidence of postoperative nausea for all of our patients. We conduct comprehensive reviews of our data and implement changes to our anesthesia protocol, if necessary. This performance improvement activity is the beauty of working in a small private setting.

All of our patients receive individual attention and care. We have had patients tell us, “This is the first time in my life I have not been sick after anesthesia!” and “This was the easiest anesthesia I have ever had!”

I can’t think of anything more rewarding than to have helped our patients have a safe and pleasant experience while they are here for their tubal ligation reversal procedures.

Personalized Anesthesia Plan

If a patient tells me that she experienced nausea after an anesthetic in the past, I sit down with her and discuss our anesthesia plan and how it is designed to optimize her comfort and well being during her postoperative recovery. I want her to be confident that she will be well taken care of and that we will do everything in our power to make this anesthetic different from what she experienced previously. Our patients receive two medications through their IV to prevent nausea, and for patients with special needs I give what is is fondly referred to as my “special cocktail”. This cocktail has a combination of two additional anti-nausea medications, also given through the IV before the patient wakes up. This covers all the possible trigger centers in the body that can cause nausea.

Power of Positive Thinking

I usually end our discussion of postoperative nausea by telling the patient and family member that this will be the last we will mention of this subject, as I am a firm believer in planting the seed of positive thought. So from then on I want them to focus on positive thinking, knowing that she will be well taken care of and anticipating that she will wake up feeling well and free of pain or nausea.

Patient Care at Chapel Hill Tubal Reversal Center

Our dedication to patient care and outcome is evident in our patient follow up care. Every patient is entered into our computerized database. This database includes information from the day of surgery, their postoperative recovery, follow upcontacts by our nurses, as well as every pregnancy following the tubal reversal procedure through to its outcome. There is no better place for women to have tubal reversal surgery than at Chapel Hill Tubal Reversal Center. Our anesthesia staff goes to extra lengths to ensure the patient’s safety, comfort, and sense of well-being during and after the tubal reversal procedure.