Posts Tagged ‘Spinal’

Can You Have A Spinal When The Surgery Is Partial Knee Replacement.?

Your two options for a partial knee replacement in regards to anesthesia are general anesthesia or neuraxial (spinal, epidural) anesthesia.
General anesthesia means you are completely asleep. An IV will be placed and you will be drifted off to sleep. After you are asleep, a breathing tube will be placed into your windpipe or directly behind it (depending on factors such as your weight, the left of the procedure, and your history of heartburn or reflux). After the breathing apparatus is placed, inhaled agents will be used to keep you asleep and pain medication for pain relief. The disadvantages of general anesthesia include possible sore throat following surgery, increased chance of nausea and vomiting, and sometimes a groggy feeling. The advantage is that you are complete asleep.
For neuraxial anesthesia, you have two choices: a spinal and an epidural. A spinal is a one-time shot that is placed immediately prior to surgery; since it is a one-time shot, it has a time limit (anywhere from 30 minutes to 150 minutes depending on the drug used). On the other hand, an epidural is a small catheter the size of a pencil lead that remains ajdacent to your spinal column for a continous secretion of local anesthestics (similar to local anethestic at a dentist office). The advantage of epidural over a spinal is that it can be dosed for a period of time after your procedure to help with post-operative pain. The disadvantages of spinals and epidurals is dural headache (1/200) and also that the spinal/epidural not working. Reactions to the anesthetic and nerve damage is actually very rare.
Other options include regional anesthesia which would include numbing two nerves with two separate one-time shots. I also think an epidural with a light general anesthetic works well, especially people who are nervous and do not want to me awake but who still want the post-operative pain control of an epidural. Even with a spinal or epidural, most patient get some sedation so they are in a “twilight” sleep.
The decision for your anesthetic plan will be a decision made by your anesthesiologist and surgeon. Not all surgeons like epidurals for various reasons (eg. some feel they interfere with therapy or their postoperative exam). Although it is good to be informed and to know what you want, make sure you are flexible so you are not disappointed the day of surgery.

Did You Have A Spinal Block With Your Knee Replacement?

Wondering how people did who chose a spinal block over anethesia?