I'm Having Joint Replacement Surgery

Anesthesiologists with Presbyterian Anesthesia Associates perform anesthetics for over 9000 orthopedic surgeries each year. Our anesthetic procedures and techniques for orthopedics are cutting-edge and have gained national recognition

Types of Anesthesia for Joint Replacement

There are two categories of anesthesia used in total joint surgery: general and regional. Your wishes and those of your surgeon, and well as your baseline medical condition, are important when selecting the type of anesthesia and pain management techniques you will receive.

• General anesthesia is a deep anesthesia resulting in the loss of consciousness and pain sensation. It is administered using your IV and anesthetic gases.
• Regional anesthesia includes neuraxial (spinal) anesthesia and/or peripheral nerve blocks. These techniques involve placing medications near a cluster of nerves that temporarily block sensation to a region of the body.

Even with regional anesthesia and nerve blocks, most patients prefer to be sedated during the operation. However, since the area being operated on is insensate (numb), sedation is not a requirement. We usually let patients decide what level of sedation they will receive. This allows you to have some control over your anesthetic experience while we provide excellent care.

Spinal Anesthesia

A spinal anesthetic is placed in your lower back. You will either be sitting up or lying on your side. We provide sedation to relieve any anxiety, but you will be awake enough to cooperate. Before the block is performed, your skin will be cleansed with an antiseptic (bacteria-killing) solution. Using a sterile technique your anesthesiologist will numb the area where the spinal needle will be placed. Then he inserts the spinal needle in the back and Injects a local anesthetic solution. This medication bathes the nerves and blocks all sensation and pain. You will normally feel numbness, weakness and an inability to move your legs.

Spinal anesthesia has several benefits, Including a reduced risk of bleeding and a lower incidence of phlebitis (blood clots). In addition, there is less nausea and patients generally awaken more quickly. Regional blocks such as spinal anesthesia may be used to reduce the pain after surgery. Generally, regional nerve blocks and catheters provide superior pain control and fewer side effects than intravenous or oral narcotics.

As with any medical procedure there are risks associated with regional anesthesia. While every effort is made to reduce these risks they can never be completely eliminated. Common side effects include a drop in blood pressure, numbness and weakness of the extremity. Although not common, a headache may develop following a spinal. The area where the nerve block was administered may be sore and tender for a few days. These discomforts will disappear within a few days. If they do not disappear or become severe, additional treatments are available. There are also remote risks not unlike general anesthesia such as infection, bleeding, nerve injury, seizure, or even death.

Controlling Pain after Joint Replacement

Your anesthesiologist with Presbyterian Anesthesia Associates goes to great lengths to minimize the pain you will experience after surgery. We have a nationally recognized program designed to prevent the pain using nerve blocks and nerve block catheters directed at the painful surgical site. Local anesthetics we inject will “block” pain and other sensation over the region of the body where surgery is performed.

These blocks and catheters are placed before the surgery even begins. If the pain blocks provide incomplete pain relief, intravenous and oral pain medications will be used to keep you comfortable. To read more about this program, click here.