Opting to have a general anesethetic for removing a breast abcess?

Question

My sister has a breast abcess and needs to have it removed. She has chronic needle/procedure phobias. She went to see a doctor (her usual one was not there) who said removing it was usually done under a local anaesthetic but was not sure as the procedure was carried out at the hospital and not the local surgery. She is not getting it treated and is in more pain and its getting worse. Can she opt to have it removed under a general anesethetic on the nhs?

Answer 1

I'm sure its possible, ask nhs direct they will advise. Tell her the longer she leaves it the more pain and problems with infections will lead to a lot more than one injection not to mention scaring, good luck with that :o)

Answer 2

I had an abscess in the left breast (a complication from nursing in my case) and it was removed under a general. So it can be done, and if she explains her situation I bet they will. (It will cost a good deal more).

But, all things considered, the local is safer. Generals have many more opportunities for errors and problems (and they're far more serious when they occur). For one, under a general you often have to have a tube inserted into your trachea so they can keep you breathing (as you will stop on your own due to the paralytic portion of the cocktail you are given). I have had this done several times and the most I was ever aware of was the pinching on the neck and a sore throat.

They have to use needles for a general, too. They need to insert an IV, and the drugs are typically pushed through that. No escaping needles in that regard.

I think the local would be best, with someone to be there to hold her hand and keep her mind off what they are doing. They aspirated mine in the office with a needle without any kind of analgesic and I felt almost nothing. Cutting it out is a different story, obviously, but if you are looking at cost or invasiveness then the local is so much better. Mine was a general I think because it was massive (containing over 90 cc of fluid), so cutting into that with a local would have been difficult to ignore! But if it's small and near the surface I think the local should be fine.

But obviously it is her body and she needs to do what will work best for her so if a local is totally out of the question I'm sure they can get a doctor to do it under a general (it will be at the hospital).

As for the NHS portion- I don't know how that works so not sure if they will or won't. If she opts for general then she should call to make sure. (it's a health coverage of some sort, yes?)

Answer 3

She needs to speak to the surgeon (on the NHS time is the big factor) with a GA (general anaesthetic) the procedure will take longer and require a stay in hospital (depending on the time of the procedure) it will also need an anaesthetist an Operating department Practitioner (ODP) and recovery. the risks with a LA (local anaesthetic) are less than with a GA and either way she will require a needle either an injection into the Brest or a cannula in the hand/ arm, however there are topical La's this is a cream that can be applied to the area prior to the injection, my advice would be to speak to the surgeon and request a topical application before the injection, if she is still worried she could ask for a pre-med this is a BENZODIAZAPINE and will relax her midazolam can be given orally however if she is having a pre-med they will probably want a cannula in situ again request a topical anaesthetic before insertion. what ever she decides she needs to sort it out quickly. in short she can request but it is up to the surgeon to decide. for this operation it is unlikely she will need to be paralysed so s ETT (tube)would not be used, under a GA she would probably breath spontaneously she would just be unconscious and pain free.

Answer 4

I am guessing you mean "serious" rather than "chronic" - chronic just means you have had something "for a (long) time"

If you DO mean chronic in the proper sense, then if her phobia is not too extreme then she may find just something like entenox (nitrous oxide) plus a local anaesttheitc might work well for her.

If however she is determined to have a general, then usually the pre-med would still be given by needle though *may* be given orally.

The REAL problem with a general apart from the increased risk of death, is that depression lasting a few weeks or months is quite a common side effect - and as such, is not usually advised unless a general is REALLY needed - rather than someone who is worried about a needle.

If she continues as she is, she will end up having to be given antibiotics by IV anyway - so to avoid a needle in her for a few seconds, she will have one in her arm for a couple of days on a drip.

Might be worth asking your GP if he knows of any alternative meds which could be given to "chill her out enough" to have the local - as for the procedure part, she can be made to be quite "away with the fairies" and not be in the least bothered by what is going on.

I really would caution you/her against having a general - it makes a routine procedure with almost zero risk to one with "low risk" - and fro mhaving almost zero chance of triggering depression to "moderate chance" of triggering depression.

General is NOT a good idea usually just because someone doesn't like needles.

As I say, if things deteriorate, she will end up having needles in her for blood tests and venflons (long-term needles) stuffed in her anyway to get the antibiotics inside.

Sorry, but she might just need to be a big girl about this and get on with it. Not wishing to be unpleasant, but if she is avoiding a procedure because she dislikes them and needles, it IS going to be more unpleasant the longer she puts it off :(

Mark

Answer 5

I live in the US where we do not have NHS. The best that I can tell you is that while she may not have general anesthesia where you are so drugged they have to put a tube down your throat to breathe for you and all the risks that go along with it, she may be a candidate for "conscious sedation".

This is where she has an IV (she would with general too) and they give you a combo of meds that sedate you and also one that causes amnesia, she won't remember a thing. The procedure will still be done in a way as to be unpainful and much safer than general anesthesia. You would be amazed at the surgeries they do this way, cataracts, carpal tunnel, knee arthroscopes. Our Dr's. here do their cardiac caths under conscious sedation. Also GI stuff like endoscopy's where they put a tube down your throat to look at your stomach or a colonist to look inside your colon. They also do lung biopsy's this way with putting a tube into your lungs to try to obtain a biopsy with out opening you up. As you can see, there are alot of things done this way

I'm sure your sister could have her breast abscess done this way and she will feel much better after since she doesn't have to recover from general anesthesia.

I hope this helps.

Answer 6

She can yes but I fail to see the difference. She will need a needle in her hand if she has a general and a needle around the breast area if she has a local. She will very likely have antibiotics after the general in the same needle in her hand and if she has a local it will be more needles as they'll have to insert an extra one in her hand (venflon).

Answer 7

Yes, she needs to explain her fear of needle procedures, that she just can't tolerate a local, and adamantly refuse anything less than general anesthesia.

Answer 8

hi she should ask her doc to refer her to the hopital i would have thought the doc would have done that anyway.thats what usually happens.she should go back to her doc and insist on this.small lumps on the breasts are taken seriously.the procedure is done at the hosp.are they sure its an abcess.has she had a scan done.your not very clear on what she has had done.these things are done very fast.tell her to back to the doc and find out exactly what is going to happen thats what they are getting paid for.dont let her wait go straight away.

Answer 9

if she waits she can get a really bad infection. perhaps she can be given a tranquilizer to help her relax or even fall asleep. the Dr. should understand her fears. she needs to have a serious talk with her Dr as time is running out.. the best of luck to your sister

Answer 10

she should tell of her fears and there is nothing to putting her to sleep for the procedure