Posted by cubbybear on March 20, 2005, at 4:59:43
In reply to Re: Sedation and general anesthesia » cubbybear, posted by ed_uk on March 19, 2005, at 14:24:13
>> Standard practice in the UK is to give an IV sedative, usually midazolam (Hypnovel, Versed) and an opioid, often pethidine (meperidine, Demerol). You must *not* let them give you any pethidine/meperidine!!!
Not to worry; I've long known about the dangers of meperidine.
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> What is your BP at the moment? Do you get dizzy when you stand up?It's fine 95% of the time--stays at around 120/80.
I get a little dizziness only when I stand up after crouching low on the floor (of the bookshop) for a few minutes. I think it's called orthostatic hypotension and it goes away in less than a minute.>
>> >Are you serious? Opioids might not be effective in my case? So what alternatives could there possibly be, that would also be compatible with Parnate?
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> A higher dose of Voltaren or another NSAID might be more effective than an opioid. Have you tried taking aspirin 900mg four times a day?No--that sounds wildly excessive and a bit risky, even if it is aspirin.
> *Do not combine aspirin with diclofenac*
> Aspirin and diclofenac are both capable of causing peptic ulcers, if they are combined the risk is dramatically increased.I'm very glad you told me. I think I tried it on one occasion to see if it offered pain relief. But it didn't anyway.
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> Where are you from? Paracetamol is called acetaminophen (Tylenol etc) in some countries.OH, now I get it! I'm from the U.S., and there, the big name is Tylenol, with generic name acetaminophen. And, all this time, I thought that Paracetamol is something completely different. Live and learn.
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> > Combining aspirin with diclofenac is dangerous, it is toxic to the stomach! Taking a higher dose of diclofenac on its own would be safer. Diclofenac can be combined with acetominophen, but not aspirin or other NSAIDs.Very glad you told me.
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> >>A combination product such as Percocet might be prescribed if paracetamol, diclofenac and muscle relaxants weren't helpful. Percocet is often very constipating, prepare to purchase some laxatives!This could be a welcome side effect, since I ordinarily have a mild case of irritable bowel syndrome (IBS) which is manifest in occasional, unpredictable, nuisance diarrhea.
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> RE the shoulder surgery.....
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> General anesthesia + MAOIs is 'traditionally' contra-indicated. Some anesthetists now believe that such anesthesia can be performed safely in experienced hands; this is what I posted to ace.
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> Anesthesia + Parnate is unlikely to be as safe as anesthesia w/o Parnate, you will have to weigh up the risks of d/cing the Parnate against the risks of continuing it. I honestly don't know how easy it will be for you to find an anesthetist who is willing to treat you while you're still taking Parnate. Best of luck :-)Well, shoulder surgery might not even be called for in the long run. I'll just have to pray that this will heal/become tolerable in time.
Thanks for all your great advice. By the way, are you in the medical profession? You seem to know more than a few dozen doctors combined.
cubbybear
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poster:cubbybear
thread:470781
URL: http://www.dr-bob.org/babble/20050317/msgs/473096.html