Sedation for Tympanoplasty

Started by yogenbhatt1, March 14, 2008, 03:30:36 PM

Previous topic - Next topic

0 Members and 1 Guest are viewing this topic.

yogenbhatt1

    What is the choice sedation for a t plasty? I have tried a range, but still looking for an ideal one. It is very difficult for an anaesthesiologist, not to give anaesthesia, and just be an onlooker when a patient disturbs the surgeon and is not quiet. He must be having discomfort, but difficult for us to manage.
There is a place where the surgeon takes about 3 to 4 hours for a T- Plasty, and the patient is not comfortable in supine for that long, and to add to our pleasures, his bladder fills up.
Let me have a range of combinations.
I have tried, Pentazocine, Meparidine, buprenorphin, Butorphenol, Fentanyl ,Medazolam, Clonidine, and so on. But still far from happy.

Please do use the site. It is really very good. I miss you all guys!!!!!!!!!!!!! 

Dr.Madhav

Dear Yogen,Our ENT colleagues still prefer to do Tympanoplasty under local and sedation.Are these patients fasting pre-operatively?As you have mentioned there is no standard combination which will keep the patient well sedated.Each patient is different and u can never predict how he will behave during surgery.As you have mentioned we do have some of our younger surgical colleagues do take hours and hours to do a tympanoplasty.These are the cases where all the problem starts.Basically a full bladder does make the patient extremely restless.If the surgeon is slow,can the surgery not be done under General Anaesthesia?How long and how much will you keep on topping up the sedation?

mchoo

Just did one the other day. Surgeon didn't take an hour. If you have a slow surgeon, I strongly suggest GA. Otherwise I just use midazolam plus tuts of alfentamil for the stimulating bits -- i.e. local infiltration and pressure in the ear.