GA vs. Epidural for tear revision

[Bubblette]

What would you do?

I'm 5 months pp and just found out today that while the outside healed (and actually has excess scar tissue) the inside of my second degree tear is completely open. I have to have a revision and get this fixed. I am so frustrated and upset, with myself, the back up midwife that stitched me, and the GP that did my pp pap. I thought I was just still sore.... longer than most.

Anyhow, if you had a choice of epidural or GA for a tear revision which would you chose and why? I'm leaning toward epidural since it won't effect breast feeding and won't affect my cognition. I have finals in a few weeks and need to be studying, so brain fog is a major concern of mine....

Thanks for your help ladies.

[tireesix]

I would go for a GA, I just cannot stand epidurals, it really affects my back and I suffer chronic back pain anyway and also, last time I had an epi it not only didn't work well, it had to be redone a couple of times, plus, I am prone to UTIs so really don't like the catheter and I hate not being able to move my legs.

I would alway opt for a GA over an epi because I know for me, a GA works, epis seem to be more hit and miss.

[katelove]

Hi,

We were in the same DDC. Sorry to hear about your tear. I would go epidural personally. They are safer and have fewer side effects than GA.

You can still BF after a GA though, as soon as you're awake.

Hope the revision goes well.

Regards
Kate

[Joyster]

I'd probably do the GA, largely because my back from my first birth and epidural was not a happy camper. With GA, I've only had it once, but only suffered from maybe an hour's worth of fogginess and was back to normal.

[tireesix]

Forgot to add, I generally recover faster from a GA than from an Epi anyway, I can be out of hospital within a couple of hours from a GA but with an Epi they always make me hang on because I have to pee so much and that sort of stuff.

[turnquia]

I'd do a GA. Most GA can is fine while breastfeeding. The most common is out of your system within a few minutes of stopping the medicine drip.

while snuggling a new baby and what not having an epidural for a repair would be fine. But having one 5 months pp would be awkward IMO in the OR. You'll be there in stir ups chatting away? Also they may prefer some GA over epidural because depdning on how they fix the repair they may need the operating table in some goofy position that wouldn't be so comfy when awake.

Good luck with your repair I hope your healed up quickly!

[MegBoz]

I've had GA twice now - once for wisdom teeth removal & once for tonsilectomy. I THINK the after-effects of GA are worse when you are under longer (like 10+ hours long) & I would imagine your tear repair won't require anywhere near that amount of time. So something to bear in mind.

I've heard tons & tons of stories about epidural failures - or things like "windows" where you can feel sensation in some areas or totally feel everything on one side. Not sure on this stat, but I've heard the failure rate can be around 15%! Whereas GA doesn't seem so prone to failure.

Then there's the whole risk of long term back pain thing from epidurals. I never had lingering negative effects from my GA -no nasuea upon waking- and I'm someone who gets nauseous easily. So personally, I vote GA.

[liberal_chick]

I had a tear repaired at 9 weeks PP and I went for the GA. It was really no big deal, I was only out for about 45 minutes (2nd degree repair) and was totally aware as soon as I woke up. And I nursed ds while I was in recovery.

[AlexisT]

Does it have to be epidural specifically, or can they do a spinal? Spinals are simpler and have a lower failure rate. The downside is the time limit.

GA is statistically much more risky than epidural or spinal. The failure rate may be lower, but the rate of serious complications is higher.

[AutumnAir]

Okay, possibly a silly question, but since this is something I may need to look into as well, I'm wondering why they can't just use local anesthetic? If it's good enough to use when sewing you up in the first place why not just use it for tear revision/repair as well. I'm asking because I'm *terrified* of both GA and epidural/spinal and would probably choose not to have my unhealed tear repaired at all if those were my only options.

[MCatLvrMom2A&X]

That is a really hard choice. Both come with very real risks rare but possible.

I think I would look into the local but if the tear is large it might be that to much local would be needed to be safe since you can be overdosed with it as well.

[Bubblette]

Thanks Ladies,

I've spoken to the doctor who is doing the repair and the anesthetist at this point. The open section is quite far up into the vaginal wall, she is not comfortable using local. Honestly, I don't want to feel her hands that deep in even if I can't feel the stitching.....

I tend to have funny reactions to drugs.... which is a concern what ever way I decide to go as I've never had any of these techniques done before. After talking to the anesthetist and discussing this he said that everyone reacts differently, and that some people can feel out of it for a few days. And there are more risks with the GA, so I'm going with a regional technique.

I can go with a spinal or an epidural. I don't know at this point which way I'm leaning. Spinal has less/basically no chance of windows and area failure but a higher risk of spinal headache. I figure I'll bring a book and my Ipod and *try* to zone out.

I'm freaking out more than a bit right now. The procedure has an 80% success rate and I just need this to be fixed - the thought of this failing is enough to keep me up at night. I've never been away from my baby overnight or for this long..... Even though my husband will be coming in both days I'm just depressed about it. I don't know how I'm going to be able to take it easy in the 2-3 weeks post op but I NEED to. I've got finals coming up and a trip home to see our family for the first time in 18 months. I just need this to work out well.

Any tips for healing? I'm planning on frozen pads, sitz baths with comfrey, keeping my legs together and taking it easy.

[tireesix]

Apparently frozen pads are fine for the odd bit of discomfort and swelling but not good for healing, you want warmth for healing (encourages blood flow).......... Thats what i was told anyway.....