Before your surgery, your anesthesia provider will discuss the choices of anesthesia with you. Several factors will be considered when selecting anesthesia including your health conditions, allergies, medications, history of back issues or surgeries, and past experiences and preferences.
Types of Anesthesia
There are two broad categories of anesthesia used for joint replacement surgery of the hip or knee.
A type of anesthesia that causes a lack of sensation and movement from the waist, or mid-chest, down to the feet. It is accomplished by a special injection of a single dose of medicine in the low part of the back. This produces a rapid numbing effect that wears off after several hours. This type of anesthesia may not be available for you if you are on blood thinners/anticoagulation medications, if you have significant spine deformities, or have had certain spine surgeries. Discuss this with your anesthesia provider to find out if a spinal is the right choice for you.
Advantages to regional anesthesia include less blood loss, less nausea, less drowsiness and improved pain control immediately following surgery. There is also a reduced risk of serious medical complications, such as heart attack or stroke that — although rare — may occur with general anesthesia. Unless contraindicated, this is usually the preferred method of anesthesia for hip or knee replacement surgeries.
General Anesthesia is a medically induced state of unconsciousness. Although technically different from real sleep, most people think of general anesthesia as “going off to sleep” in order to have a surgery. General anesthesia causes temporary unconsciousness for as long as is needed for a surgery and prevents a person from having reflexive movements that could interfere with the performance of a surgery.
A peripheral nerve block places local anesthetic directly around the major nerves in your leg, such as the femoral nerve or the sciatic nerve. This will numb only the leg that is operated on, and does not affect the other leg. This is typically done as a one time injection which will decrease pain levels for about 18 hours after surgery. Peripheral nerve block is usually used in combination with either spinal or general anesthesia to provide longer lasting relief after surgery. A peripheral nerve block is commonly used along with general anesthesia when the shoulder is operated on.