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Having surgery when you have sleep apnoea
#21
RE: Having surgery when you have sleep apnoea
I basically had a roto-rooter done on L4 and L5 (both sides) where the nerves had become impinged. Had me up and walking shortly thereafter. I asked the nurse how far I needed to go and she told me as far as you feel like, but you also have to walk back. Spent one night, and the worst part of the surgery was taking off the go home bandage 4 days later.
Homer

Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies. Monitors are also Advisory Members, just with Extra Work assigned.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#22
RE: Having surgery when you have sleep apnoea
Thanks much appreciated. My surgery is being performed at the Nuffield i uK. Not to impressed so far with they're communication skills.

(03-07-2022, 09:54 AM)LindanHotAir Wrote: I had inguinal hernia repair on one side. They used open surgery so they didn’t disturb both sides with laparoscopic surgery. The anesthesiologist was concerned about my breathing, so they used Versed which I have also heard called Twilight. I didn’t feel any pain and was about half asleep, but I could hear voices and feel movement.

Not sure if this is used in the UK. How long did it take you to recover i.e. back to normal walking etc.? Thanks.
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#23
RE: Having surgery when you have sleep apnoea
(03-08-2022, 11:52 AM)dlong0609 Wrote: As a surgeon, I performed thousands of inguinal hernia repairs."Keyhole", or more accurately laparoscopic repair, requires inflation of the abdominal cavity with carbon dioxide gas. This almost always requires the use of general anesthesia and tracheal intubation. 

There are so called "open" techniques that can be performed under local anesthesia quite comfortably, especially if augmented with administration of an intravenous sedative, with an anesthesiologist or anesthetist monitoring vital signs and oxygen saturation. This is sometimes referred to as monitored anesthesia care. Regional anesthesia, more accurately referred to as epidural or spinal anesthesia, will temporarily suspend all sensation roughly below the naval. Again, the services of an anesthesia professional is required.

For my own hernia surgery, I chose local anesthesia with monitored anesthesia care. For a recent knee replacement, I chose epidural. On each occasion, I received an intravenous sedative immediately before the needle insertion, and have little or no recollection of any discomfort related to the procedure. I used my CPAP machine only during the first postop night, in the surgery center.

Sleep apnea is only one of many health related issues to be considered in planning surgery, and in my opinion, often of lesser importance.

Hi and thanks. The Professor surgeon I am seeing says keyhole inguinal surgery is inferior to open which is what he does. Also he favors general anesthetic but so far has not explained this. I have requested they consider spinal or local anesthetic but so far they have avoided answering. What is your opinion please? Thanks
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#24
RE: Having surgery when you have sleep apnoea
I have had inguinal hernia repair (twice) and open heart surgery, along with various tests that required some level of anesthesia since going on xPap. The tests were done using twilight drugs, but the major surgeries were under general anesthesia. Obviously with the heart surgery, my breathing was not an issue since they put me on a heart and lung machine for most of it, but prep time and recovery time were still an issue.

At no time did I have any problems - the anesthesiologist discussed the risks with me, and was very reassuring about their ability to monitor and deal with any breathing issues. I did need my machine for the hospital stay after the big surgery, but that’s it.

BTW, I had one hernia repair done with the keyhole procedure and one done with the full cut. While recovery was a little faster from the first type, my surgeon also preferred the old style full cut when I needed the second one done - he felt the experiences from years of doing these showed better results. Honestly, I have no preference, and the recovery time was not that different - just a couple weeks faster with the keyhole.
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#25
RE: Having surgery when you have sleep apnoea
When I broke my tib/fib they insisted that my machine and mask be brought to the hospital.
Next day, after the operation, I fell asleep without it on. I also have restless leg syndrome. I kicked and it hurt like ....

So I work my mask and used my brick-machine when I was lying in the hospital bed.

Amazing. nurses and others didn't know why.
DaveL
compliant for 35 years /// Still learning!

ResMed N20; ResMed P30i modified headgear; F&P Evora Full FFM



I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

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#26
RE: Having surgery when you have sleep apnoea
 I had lung cancer and had a lobectomy of the upper left lobe; I was attached to a device call Davinci. The surgeon remotely robotically performed the surgery. At times they purposely stopped me from breathing, the anesthesiologist performs those procedures. I was there for 6 days, I had my CPAP with me but couldn’t use it, they allowed me to tape my mouth and use a chin strap. When I got home it was another week before I could use the CPAP and gradually increase the pressure. I never had a problem.
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#27
RE: Having surgery when you have sleep apnoea
I thought this would be an interesting read for those of you having surgery under general anesthesia.  
I underwent a surgical procedure on Monday.  I have always been more concerned over general anesthesia, and have wondered how our brain functions while coming back out of the anesthesia.

Here's How The Human Brain Reboots Itself After The Deep Sleep of Anesthesia

You may well have spent hours wondering what your laptop is up to as it takes its time to boot up. Scientists have asked the same question of the human brain: How exactly does it restart after being anesthetized, in a coma, or in a deep sleep?

Using a group of 30 healthy adults who were anesthetized for three hours, and a group of 30 healthy adults who weren't as a control measure, a 2021 study reveals some insights into how the brain drags itself back into consciousness.

It turns out that the brain switches back on one section at a time, rather than all at once – and abstract problem-solving capabilities, as handled by the prefrontal cortex, are the functions that come back online the quickest. Other brain areas, including those managing reaction time and attention, take longer.

"Although initially surprising, it makes sense in evolutionary terms that higher cognition needs to recover early," said anesthesiologist Max Kelz, from the University of Pennsylvania.

"If, for example, someone was waking up to a threat, structures like the prefrontal cortex would be important for categorizing the situation and generating an action plan."

A variety of methods were used to measure what was happening in the brain, including electroencephalography (EEG) scans and cognitive tests before and after going under. These tests measured reaction speed, memory recall, and other skills.

Analyzing the EEG readings, the researchers noted that the frontal regions of the brain – where functions including problem-solving, memory, and motor control are located – became particularly active as the brain began to recover.

A comparison with the control group showed that it took about three hours for those who had been anesthetized to recover fully.

The team also followed up with the group participants about their sleep schedules in the days after the experiment. The experience didn't appear to negatively affect sleeping patterns in those who had been anesthetized.

"This suggests that the healthy human brain is resilient, even with a prolonged exposure to deep anesthesia," said anesthesiologist Michael Avidan, from Washington University.

"Clinically, this implies that some of the disorders of cognition that we often see for days or even weeks during recovery from anesthesia and surgery – such as delirium – might be attributable to factors other than lingering effects of anesthetic drugs on the brain."

A lot of surgical procedures simply wouldn't be possible without anesthesia, an effective and controlled way of turning off consciousness in the brain – something that can happen involuntarily in the case of a coma.

Despite their widespread use, we don't really understand how anesthetics work in precise detail, even if we have figured out how to use them safely. There are plenty of ideas about how the brain deals with these drugs, but no concrete evidence as yet.

The recent findings can not only help with treatments and patient care – after major operations involving anesthesia, for example – but also in giving scientists a better understanding of the brain and how it responds to disruption.

"How the brain recovers from states of unconsciousness is important clinically but also gives us insight into the neural basis of consciousness itself," said anesthesiologist George Mashour, from the University of Michigan.



https://www.sciencealert.com/here-s-how-...anesthesia
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#28
RE: Having surgery when you have sleep apnoea
(03-09-2022, 10:36 PM)Homerec130 Wrote: I basically had a roto-rooter done on L4 and L5 (both sides) where the nerves had become impinged. Had me up and walking shortly thereafter. I asked the nurse how far I needed to go and she told me as far as you feel like, but you also have to walk back. Spent one night, and the worst part of the surgery was taking off the go home bandage 4 days later.

Just been told by my sleep service that having central S>A> restricts the type of pain relief after surgery. Any insight into this?!
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#29
RE: Having surgery when you have sleep apnoea
Opiods as an example can cause respiratory depression. I wouldn't say that having central apnea means you can't use these medications but it is worth knowing they could make central apnea worse so care has to be taken.

The nice thing about OSCAR is you can see your data and know if the medication is causing/worsening central apnea.
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#30
RE: Having surgery when you have sleep apnoea
Opiods will contribute to Central Apneas. I speak from experience as my wife is a chronic pain sufferer and has a lot of Centrals. Her sleep doc is well aware of it and my wife has had some good luck with her therapy (when she uses the machine). There are some nights where her pain is so bad, she can't sleep and loves into the other room so I can.
Homer

Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies. Monitors are also Advisory Members, just with Extra Work assigned.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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