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Re: Analgesia for Vag HystsFrom: Gerald P. Rodríguez (geraldpr@cybermesa.com)Fri Sep 5 15:39:18 2003
MessageNever hoid of it, Lynn. I use(d) Marcain 1/4% with epinephrine 1:200K and I injected ~10 cc. into the subepithelium of the portio vaginalis of the cervix just before starting, but that was to keep a drier field and to help develop the planes. Gerald P. Rodríguez, M.D., FACOG Santa Fe ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ "His mother should have thrown him away and kept the stork."-Mae West ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
> ----- Original Message ----- Heh y'all, Another new one on me today. I was just about to begin a vag hyst when the anesthesiologist asked me if I was going to use the "new" technique of injecting the pedicles, as I did my hyst, with local anesthetic. I said "say what". He then told me that because of difficultly encountered in controlling postoperative pain following a vaginal hysterectomy "several" gynecologists were using this technique. When I asked for references, he simply told me that it came from the University of Washington. I responded with the following points: 1. I have done hundreds of vag hysts and pain typically isn't a problem 2. Injecting into what are primarily vascular pedicles would seem risky to me 3. If there is concern about post-op pain management, then why not do a combined anesthesia with regional/duramorph followed by general or even a epidural PCA. He simply responded by telling me that he was only telling me what was the "newest" technique for a vag. hyst. Any comments? Lynn Lynn D. Montgomery, M.D. Rocky Mountain Women's Health 2835 Fort Missoula Rd., Suite 303 Missoula, Montana, 59804 406-549-0978 fax 406-549-0987 e-mail: apgar10@montanadsl.net
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