Light Sedation for battery replacement vs local

I have been in Safe Mode- pacing at 65- since August 15th.  Met with the PM people yesterday.  The schedule is so booked up I was looking at the end of Sept before I could have the surgery for a new pm.  I elected to forgo light sedation - you don't feel anything and are conscious but in Lala land- and go for local anesthesia as that could be scheduled faster.  Has anyone gone that route before?  I will have an echo before then and they did the labs yesterday.  Got it scheduled for next Thursday, Sept 7.  I shouldn't feel any pain.  But I'll hear everything.  



by AgentX86 - 2023-08-31 16:15:30

Had just a local for my pacemaker and AV ablation (done at the same time). The only pain was when they made the pocket.  That hurt but wasn't long.  Since yours is a replacement, you shouldn't need a new pocket.  You can ask.  Other than that, it was simple in and out.  I had to stay overnight because I was then dependent and my EP wanted more observation time.  I would have gone back to work the next day if I didn't stay overnight.

I certainly wouldn't tell anyone not to go the light sedation route but the locals were just fine for me.  I only had locals for two of my three ablations and carotid angioplastyn. It worked out well.

Local anaesthesia

by Gemita - 2023-08-31 16:31:12

Lulu, since they will only be opening your pocket, removing old device, and then re-attaching new device to old leads, you should be fine with a local anaesthetic.  I had a Reveal Linq Implant monitor removed left breast a few years ago under a local anaesthetic.  I tried asking for heavy sedation but they laughed and assured me I wouldn't feel a thing and they were absolutely correct.  They will make sure that you are comfortable and out of pain before beginning the procedure.

I think you have done well to get an early appointment to have your replacement.  Hope everything goes well for you.


by Penguin - 2023-08-31 17:04:12

I wouldn't worry about the pain as I'm sure that the local will be effective.  However, perhaps you need to consider how calm you are likely to feel. A sedative obviously makes you feel woozy and more relaxed. 

 I found it difficult to keep the fear under control until I had a sedative. I'm pretty sure that this would have been unhelpful if I'd opted for a local. You sound a great deal braver! 

Good luck 


Knock me out please

by Daedalus - 2023-09-01 00:38:51

I know for myself the anxiety would trigger my AFib so I'm going for heavy sedation, pleasant sleep, and don't wake me until it's all done.  :-)

I still have a few years until that time, but that will be my request.  

Know thyself

by Gotrhythm - 2023-09-01 14:47:11

My friend underwent hip replacement surgery a couple of weeks ago with only spinal block anesthesia. She is a practiced meditator and was able to maintain a calm, relaxed frame of mind for the 45 minutes or so that the surgery took.

She was able to hear things as you say. Also to smell things. Although there was no pain, she did feel some things, like a nose-itch what started after her hands were tied down. It went fine. The upside was that, after surgery, there was no recovery from anesthetic which is usually hard for her.

My question to you is can you remain calm and dispassionate for 30 minutes or so. This time they won't be threading the wires into your heart, so there really shouldn't be more to it than a dental procedure. They're not "opening you up," they are just going under the skin.

I much prefer the consious sedation, but if there were some reason the local would really be better for me, I'd do it.

Hip replacement

by AgentX86 - 2023-09-01 17:01:06

Certainly not as dramatic but they just used a local and some sort of nerve block (didn't understand it because the surgeon and anesthesiologist were discussing a "nerve block" vs something, and they did the "something") and a local when they did the second surgery on my wrist.

I had sedation (and a nerve block) for the first.  I could still hear bone crunching and smell burning, even though I wasn't "supposed to".  I also remembered what they ordered for lunch, so the stuff didn't put me that far under. They didn't belive me that I was lucid until I repeated what they ordered for lunch. 😁


by piglet22 - 2023-09-02 08:42:56

Personally, I don't want anything that tinkers with my awareness. Exception a glass or two of a nice red.

I suspect that this goes back to early childhood and brushes with dentists/nurses/doctors.

A visit to the dentist would be a single working dentist, plonked in the chair, rubber mask and out of it. Can you imagine now, a person on their own, administering a general anesthetic?

Plus needles the size of a knitting needle. I remember the three polio injections. If you were lucky, you got the sharp one.

I've some painful stuff like core biopsies and nerve conduction tests and could have done with a local, but sedation wouldn't have helped. No-one is ever going to do those procedures again without a local or some warning. A nerve conduction test is pure torture.

A GP once said to me it's the fear of fear. Now I quite enjoy going for my 6-monthly Covid jabs and take the positive view that it's there to help, not inflict pain. Modern single use needles and syringes are painless, for upper arms at least and 0.5-ml. I do finger pricks for glucose, but I'm not sure about insulin injections myself.

A device insertion shouldn't need sedation but just a local. Usually, if you get through the first 10-minutes, you're good for the rest.

On my first PM they asked what music I would like. I said, you choose. It was Iggy Pop The Passenger.

Where I have made exceptions is when in severe pain like a broken pelvis. Yes, bang the morphine in and I'll have a swig of that gas and air.

However, it's down to you what you have. At least you should have a choice. Again, in the PM suite, a sedative was never offered or mentioned when I've been there.

Again, personally, as you get older, you need to reduce the risks.

I think it all comes down to attitude. Go in with the "I'm going to enjoy this because it's going to make me better" Take some music, maybe "Mend my broken heart"?


by AgentX86 - 2023-09-02 22:53:25

Piglet, I could have written what you did.

I hated going to the dentist as a kid.  There was always excrutiating pain involved.  Enough that I avoided going to the dentist for years (bad move).  Now, it's nothing.  The advances in dentristry are amazing.

I had nerve conduction tests in both arms and hands. There was some pain but not enough that I'd want any meds for it. To me, finger pricks are among the worst.  It feels like a large splinter (not good).  I'm glad that I don't have to do it.  I don't know how my wife does it.

I was given morphine two weeks after my CABG.  My wife gave me bronchitis the day after I  came home from the hospital.  Coughing was really bad.  A sneeze would take me right to my knees.  After two weeks I was in pretty bad shape.  I was given morphine for the pain and albuterol in a steam inhaler.  I can understand how people can get hooked on the stuff.  It was great.

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