Anaesthesia

Question

Dear ladies and gentlemen,
I have CF and I am 49 years old and I have given birth to 3 children. Last year I had a severe infection with pertussis, due to the strong cough over 3 weeks during day and night, my pelvic base suffered. After an urodynamic investigation in the university hospital, a descensus of the uterus has been diagnosed and they recommended an operation, a vaginal hysterectomy. Which kind of anaesthesia do you recommend and what has to be taken into account?
The operation is going to take about one hour.
The FEV1 value is between 48-52%, germs Staph. aureus, Achromobacter and Aspergillus from time to time. No Pseudomonas.
Many thanks

Answer

Hello dear questioner,
you want to know, which kind of anaesthesia would be optimal for the planned vaginal hysterectomy. We can not give a concrete recommendation via the internet, however we can give you advice that for the decision about the kind of anaesthesia besides the lung function and the status of germs also the overall health, the susceptibility for infections, special problems and the radiological finding of the lungs can play a role. In case of CF patients, generally (whenever possible) operations in local anaesthesia are recommended. If this is not possible, then a peridural anaesthesia (PDA) should be preferred to an endotracheal anaesthesia. For a vaginal hysterectomy a PDA could be used and that would be recommendable for your as a CF patient, if nothing speaks against it. This, however, you should also discuss with your gynecologist and your CF pyhsician in charge.
We hope to have helped you with the answer,
Yours sincerely,
Dr. med. Christina Smaczny

13.10.2014