Hi Rebecca,
I recently had a RBHR (1/22/08). I opted for a general anesthesia. My reason was that I had a microdiscectomy in 1990 and was afraid of scar tissue. My anesthesiologist talked with me right before surgery and I was able to communicate to him about the pain issue and possible nausea with general anesthesia.
Regarding the pain, I asked the anesthesiologist to inject my incision before closing with a numbing agent or if I could have a pain pump at the incision site, which essential bathes the wound with an anesthetic numbing agent. Some anesthesiologists are totally in charge of pain issues while sometimes the surgeon is. This time it was up to my surgeon. However, because I had expressed my issue of pain with him, he said he would let the surgeon know. I woke up with the pain pump on the incision area. This was left in until the 3rd postop day. I did not have any incisional pain. I did have numbness on the inside of my thigh for probably 7 or so days. But, this numbness was a small price to pay for being pain free. I was able to get out of bed and do everything with this pain pump. I would recommend this.
Probably the biggest drawback with general anesthesia is the nausea issue. You have no history to fall back on as to your reaction to general anesthesia. However, again there is medication that combats this side effect. It is given to you through the IV before you go under and before you wake up. Also, you can have this medication given to you periodically throughout your hospital stay, also through the IV.
For me a general anesthesia would be my recommendation with a pain pump on the incision. Also, I had a PCP (patent controlled pump) that I was able to administer myself by pushing a button, also, through the IV. You administer your own pain medication on your need and it is automatically calibrated to deliver a certain amount of medication within an hour time span. If you push the button too much, it will not administer the pain medicine until the appropriate time. An alarm goes off if you press the pump too often within the hour. I believe mine was calibrated to give me a dose of Morphine every 6 minutes. I cannot remember the exact dose at this time.
Good luck with your surgery. We are all nervous about the procedure whether or not we had previous surgery. You will be most happy with the results and the quality of life you get back with this procedure.
Elaine Y.
RBHR -- Dr. Lopez -- 1/22/08