Anesthesia for Hip and Knee Surgery
What is Anesthesia for Hip and Knee Surgery?
Anesthesia for hip and knee surgery is the use of medicines called anesthetics to prevent pain during hip and knee surgery/procedures. It may be administered in the form of injection, inhalation, or topical spray or ointment. Anesthesia causes you to have a loss of awareness or feeling. Anesthesiologists are physicians who administer anesthesia and manage pain.
Pre-Anesthesia Preparation for Hip and Knee Surgery
In general, pre-anesthesia preparation may involve the following steps:
- A thorough physical examination and review of your medical history to ascertain your health status.
- Tests and imaging may be ordered to detect any abnormalities that could compromise the safety of the surgery/procedure.
- You will be asked if you have experienced allergic reactions or side effects to any specific medications or anesthesia.
- You need to inform if you have any specific conditions such as heart or lung disease or if you are being treated for any condition.
- You will be asked about your lifestyle habits such as smoking, alcohol, or recreational drugs.
- You should inform your doctor of medications, vitamins, herbal products, or supplements you are taking.
- Arrange for someone to drive you home after surgery/procedure, as you may feel groggy due to the effects of anesthesia.
- A signed informed consent will be obtained from you after the risks and side effects of the anesthesia have been explained.
Types of Anesthesia for Hip and Knee Surgery
Anesthesia for hip and knee surgery is broadly classified into 3 categories: local, regional, and general.
- Local anesthesia: This type of anesthesia numbs only the particular region being treated. The region is numbed with an injection, ointment or spray that is only effective for a short period of time. Individuals remain conscious during this anesthetic technique. This type of anesthesia is employed only for minor procedures. For major procedures, such as knee or hip arthroplasty (replacement), local anesthesia may be utilized to complement the principal type of anesthesia that is utilized.
- Regional anesthesia: This type of anesthesia involves blocking the nerves to a particular region of the body, without impacting your breathing or brain function. As you remain conscious of this technique, you will be administered sedatives to relax you and put you to sleep. Regional anesthesia is most often used in joint arthroplasty surgery and comprises of 3 types, namely spinal blocks, epidural blocks, and peripheral nerve blocks.
- Spinal block: In a spinal block technique, the anesthetic medicine is injected into the fluid surrounding the spinal cord in the lower region of your back. This causes a swift numbing effect that lasts for several hours.
- Epidural block: An epidural block utilizes a catheter (a thin tube) placed in your lower back to dispense local anesthetics over a variable time period. The spinal block and epidural block are delivered in a very similar manner; however, the epidural catheter is positioned in a slightly different region around the spine as compared to a spinal block.
- Peripheral nerve block: This type of anesthesia involves injecting a local anesthetic directly around the key nerves in the thigh, like the sciatic nerve or femoral nerve. The nerve block numbs only the leg that is injected and does not affect the other leg.
- General anesthesia: General anesthesia is commonly utilized to perform major surgery, such as joint arthroplasty. It may be selected based on the preference of the surgeon, patient, or anesthesiologist, or if the regional or local anesthesia is not advisable. Unlike local and regional anesthesia, general anesthesia impacts the entire body, including the brain and nervous system, and makes you temporarily unconscious. General anesthesia is administered through inhalation or injection. A breathing tube is placed down the throat to administer oxygen and assist with breathing during surgery.
Post surgery, you will be transferred to the Post-Anesthesia Care Unit (PACU), also referred to as the recovery room. Your nurse will monitor your vital signs and level of consciousness. If you have had general anesthesia, an oxygen mask may have been used. It is not unexpected for you to experience some grogginess and nausea. Experiencing sore throat post general anesthesia is also normal and may last 3 to 5 days. If you have had spinal anesthesia, your ability to move your limbs and sensation will gradually return. It is important to inform your nurses and physicians about any pain you have. Your nurse will closely monitor your pain level and will provide appropriate pain medication to ensure you are comfortable.
Benefits of Anesthesia
Some of the benefits of anesthesia include:
- Keeps you pain-free and comfortable during surgery
- Reduced risk of medical complications
- Allows a patient to tolerate surgery
- Enables performing a surgery safely
- Minimal blood loss
- Reduced risk of blood clots
- Enables complete control of the airway, the breathing, and the circulation
Risks and Complications
Some of the risks and complications of anesthesia include:
- Tingling sensation
- Bruising, bleeding, or soreness
- Blurred vision
- Muscle twitching
- Difficulty urinating
- Allergic reactions
- Nerve injury (rarely)
- Sore throat
- Fluctuations in breathing/heart rates
- Heart attack or stroke (rarely)