ANAESTHESIA FOR YOUR SURGERY
I work with Dr. Matt Harper, Dr. Carl Lee, Dr. Phil Dart and Dr. Jay White, who are all highly trained medical specialists.
BEFORE YOUR OPERATION
Before surgery we will discuss with you the type of anaesthesia that you will receive. The selection of anaesthesia is a major decision that could have a significant impact on your recovery. It deserves careful consideration and discussion with your surgeon and your anaesthetist.
We will discuss with you the following before deciding on the most appropriate form of anaesthesia, including;
- You’re past experiences and preferences. Have you ever had anaesthesia before? What kind? Did you have a reaction to the anaesthesia? What happened? How do other members of your family react to anaesthesia?
- Your current health and physical condition. Do you smoke? Are you overweight? Do you drink or use recreational drugs? Are you being treated for any conditions?
- Your reactions to medications. Do you have any allergies? Have you ever experienced bad side effects from a drug? What medications, nutritional supplements, vitamins, or herbal remedies are you currently taking?
- The risks involved. Risks vary, depending on your health and selection of anaesthesia, but may include breathing difficulties, blood loss, and allergic reactions. Your surgeon and anaesthetist will discuss specific risks with you.
Types of Anaesthesia
Most orthopaedic surgeries use either general or regional anaesthesia. Regardless of the technique chosen, the anaesthetist will stay with you during your operation to monitor you and manage both your medical problems and pain relief. Our intention is to ensure that you have the best possible outcome from your surgery.
General Anaesthesia
Effects
General anaesthesia affects your entire body. It acts on the brain and nervous system, leaving you in a deep sleep. Usually, it is given by injection or inhalation.
Administration
When general anaesthesia is used, the anaesthesiologist will also place a breathing tube down your airways and administer oxygen to assist your breathing.
Risks
As with any anaesthesia there are risks. The anaesthetist will discuss these with you prior to your operation but may include but not be limited to;
- Your throat may be sore and have a hoarse voice for a few days due to the tube inserted down your airways.
- Headache, nausea, and drowsiness are common.
- Rare but more severe adverse events can occur such as a severe allergic reaction or a heart attack. But death or major disability, resulting from anaesthesia is an extremely rare event.
Regional Anaesthesia
Regional anaesthesia involves numbing a specific area of the body, without affecting your brain or breathing. Because you remain conscious, you will be given sedatives to relax you and put you in a light sleep.
There are several advantages to using a regional anaesthesia during knee replacement surgery. Studies have shown that there is less blood loss during the surgery, better initial pain control and fewer complications from blood clotting afterwards.
The two types of regional anaesthesia used most frequently in joint replacement surgery are spinal blocks and epidural blocks.
Spinal Block
In a spinal block, the anaesthesia is injected into the fluid surrounding the spinal cord in the lower part of your back. This produces a rapid numbing effect that can last for hours, depending on the drug used.
Epidural Block
An epidural block uses a small tube (catheter) inserted in your lower back to deliver larger quantities of local anaesthetics over a longer time period. The epidural block and the spinal block are administered in a very similar location; however, the epidural catheter is placed slightly closer to the skin and farther from the spinal cord
In shoulder surgery, we regularly use an inter-scalene block. A needle is placed in the side of the neck near the nerves that exit the spine and allows for good pain relief for the shoulder and the arm. When you wake up you should have little or no pain in your arm and usually are unable to move your arm, wrist and fingers. This usually wears off after 6 to 12 hours and the sensation in your arm gradually returns as does the movement.
Side effects from regional anaesthesia include headaches, trouble urinating, and allergic reactions. Rarely would long term injury occur e.g. persisting weakness, pain, altered sensation or paralysis.
AFTER THE OPERATION
Your anaesthetist, with recovery room staff, will continue to monitor your condition well after surgery is finished to ensure your recovery is as smooth and trouble-free as possible.
You may feel drowsy for a little while after you wake up. You may have a sore or dry throat, feel sick or have a headache. These are temporary and usually soon pass.
To help the recovery process, you will be given oxygen to breathe, usually by a clear plastic facemask, and encouraged to take deep breaths and to cough. Only when you’re fully awake and comfortable will you be transferred either back to your room, ward or a waiting area before returning home. You will be offered either pain relief tablets or push button pain relief machine (PCA) to help you feel comfortable. We will discuss the best option for your pain relief before your operation.
The above information is intended as a brief overview of the anaesthetic component of your procedure. We hope this will help you to ask questions and enter a discussion with your treating doctors about the care that is best for you.
We look forward to seeing you soon.
Kind regards
The surgical team