Progressive Anesthesia at Medical City Plano

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The process used to manage pain during and after your joint repair or replacement procedure is a very complex one. The team at Medical City Plano employs some of the newest block techniques and medications to provide pain relief both before and after surgery, to improve rehabilitation, and to allow for an early dismissal from the hospital. In consulting with your surgeon and anesthesiologist, a number of factors must be taken into account, including:

  • Your current health and physical condition
  • The medications you're currently taking, including any nutritional supplements, pain medications, and/or herbal remedies
  • Your past history with anesthesia, pain medications, and allergies to specific medicines (if any)
  • The risks associated with each specific anesthesia drug or technique

Types of Anesthesia

There are three broad categories of anesthesia: local, general and regional.

Local Anesthesia

This is the kind of anesthesia delivered to the area being operated on in order to reduce sensation and pain. It is similar to the anesthesia your dentist uses when repairing your teeth. It numbs only the specific area being treated. Surgeons inject the soft tissues after joint surgery in combination with general or spinal anesthesia to lessen pain and expedite rehabilitation.

General Anesthesia

This method of anesthesia allows the patient to “go to sleep” and feel nothing during the surgery. The patient is placed on a breathing tube and vital signs are monitored very closely during the operation.

Effects

General anesthesia affects your entire body. It acts on the brain and central nervous system, placing you in a deep sleep. It is most commonly used if you are having a procedure that is expected to take a long time (more than 2-3 hours).

Administration

General anesthesia is usually given by injection or inhalation. Several different drugs are used for this purpose. Your anesthesiologist will discuss the specific options with you.
When using this method of pain management, the anesthesiologist will also place a breathing tube in your throat and administer oxygen to assist your breathing.

Risks

General anesthesia entails certain known risks.

  • Both your breathing and your heart rate will become slower. These and other vital signs will therefore need to be constantly and carefully monitored throughout your procedure.
  • Your blood vessels will tend to open wider (“dilate”), which may result in a heavier loss of blood during the surgery.
  • The breathing tube may cause you to have a sore throat or a hoarse voice for several days afterward.
  • Headache, nausea, and drowsiness are also not uncommon.

Regional Anesthesia

Regional anesthesia 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 during the surgery.

The two types of regional anesthesia used most frequently in hip and knee surgery are spinal blocks and pain catheters.

Spinal Block

With a spinal block, the anesthesia is injected into the fluid surrounding the spinal cord in the lower part of your back. It produces a rapid numbing effect that can last for several hours, depending on the drug used.

Pain Catheter

This method employs a small tube (catheter) that is inserted near the nerve being targeted in order to deliver local anesthetics over a longer period.

Regional anesthesia for hip or knee surgery offers several advantages compared to general anesthesia. Studies have shown that there is less blood loss, as well as fewer complications from blood clotting, and less nausea.

Pain Relief After Surgery

One of the primary goals of post-operative pain management is to make you comfortable enough that you can perform and succeed in physical therapy.

Throughout the post-operative period, you will be closely monitored to ensure that no anesthesia-related complications develop. The anesthesia team may follow your pain control for up to two days.

Appropriate pain management before, during, and after your joint surgery is a very important aspect of your treatment. Take time to discuss the numerous options with your surgeon and one of our expert anesthesiologists. Please feel free to ask questions about things you don't understand.