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Biopsy, hysteroscopy and D and C to be done. Which kind of anesthesia should be used?

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HAVING A HYSTEROSCOPIE.D&C BIOPSY.REMOVE ANYTHIG THAT IS NEEDED. CERVIX WON'T OPEN .WHAT KIND OF ANETHESIA SHOULD I HAVE.HEARD WHEN CERVIX WON' VERY PAINFUL IAM 66 YEARS OLD.I WOULD LIKE THE ANSWER FRON DR. XXXXXXX RAICHI THANK YOU
Posted Wed, 10 Oct 2012 in Medicines and Side Effects
 
 
Answered by Dr. Timothy Raichle 3 hours later
Hello, I would be happy to help you with your question. Thank you for requesting me, it is an honor!

I am assuming that you are having this hysteroscopy and D&C related to post-menopausal bleeding AND/OR thickening of the endometrial lining on ultrasound. And I am also assuming, that they were pretty much unable to do a biopsy in the office setting because of "stenosis" or narrowing of the cervix. So this is likely why you are facing this procedure in an operating room setting.

In your case, and assuming that you are relatively healthy otherwise, here is how the procedure would go:

1. You would be taken to the OR
2. You would be placed on the OR table in about the same position as a pap smear
3. The Anesthesiologist would administer sedation through an IV (in most cases, you do not need to be asleep for this procedure. The Anesthesia is called "moderate conscious sedation")
4. The cervix would be visualized with a speculum
5. The cervix would be injected with an anesthetic (paracervical block)
6. The cervix would be gently dilated enough to get a camera into the uterus
7. Abnormalities can be directly biopsied
8. The camera would be remove and a "curretting" performed to obtain a good biopsy of the lining
9. If there was still significant difficulty getting through the cervix, then an ultrasound can be brought into the OR to help guide the "dilators"
10. You would then recover and go home.

So the answer to your question is, "moderate conscious sedation with a paracervical block". I hope this helps. Please let me know if you have more questions!
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Follow-up: Biopsy, hysteroscopy and D and C to be done. Which kind of anesthesia should be used? 2 days later
Thank You for your information about the moderate conscious sedation.I also heard that a drug called versed causes amnesia that is given with conscious sedation. Could you give me some information on this .Do you think that is what i will get. Sounds a little scary. Thank You so much for your help.
 
 
Answered by Dr. Timothy Raichle 1 hour later
Hello and thank you for the followup question!

Versed is often used as part of the conscious sedation medications. The medications that are commonly used might include Propofol, Versed, and Fentanyl. Versed is used to help relax you and does in fact cause some amnesia with regard to the procedure. It is given in relatively small doses and certainly is useful in these settings. I have never seen someone have a bad reaction to this medication in the operating room setting. It is safe and very commonly used. This is best to address with the Anesthesiologist before the procedure. I am assuming that you are having this procedure in the operating room and not in the clinic setting.

I hope this helps. Try not to worry too much - this is a common type of procedure that carries virtually no risk in competent hands!

Please remember to leave feedback at some point - DR XXXXXXX
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