The most common joint replacement surgery is for the hip or knee; however other joints are replaced on occasions.
A pre-anaesthetic consultation and a general medical workup are commonly provided to have the patient in the optimum condition for this major type of surgery.
Advice will generally be given regarding medications to be taken in the one to two weeks prior to the surgery and it may be necessary to stop or modify some medications as they may adversely affect the surgical outcomes.
Some medications need to be taken up to the morning of the surgery.
A pre-operative consultation by your anaesthetist should clarify your particular medication and when you may take them. This gives your anaesthetist the opportunity to assess you and your particular needs and requirements for surgery and also gives you the opportunity to discuss any concerns you may have.
The surgical procedure may take from one to three hours, or longer, especially if the joint has previously been replaced.
All patients will be monitored continuously during the surgery for the level of oxygen in the blood, blood pressure, heart rate and heart monitoring (ECG). If general anaesthesia is used, your breathing will also be continuously monitored.
A blood transfusion may be required during or after the surgery and your surgeon may have provided information on this.
The type of anaesthesia performed will depend on:
The anaesthetic techniques used for major joint replacements are spinal, epidural, general anaesthesia and peripheral nerve blocks: sometimes a combination of these.
The Epidural or Spinal technique requires a needle to be inserted in the lower back between the vertebrae. The anaesthetist will usually perform this with you awake or under sedation, have you either lying on the side or sitting and leaning forward. If the Epidural or Spinal anaesthetic technique is employed alone, sufficient Local anaesthetic is injected to provide pain-free surgery however some sedation may be given so that you drift off to sleep during the surgery.
General anaesthesia is used if other methods described are not suitable, if the operation is complicated or if the patient has a strong preference for being anaesthetised.
This is where local anaesthetic is injected to block the nerves that supply the operative area. Nerve blocks are often combined with general or spinal anaesthesia to provide excellent long-lasting pain relief.
Post-operative pain relief is an essential part of the procedure.
This may be provided by the Epidural/Nerve block/Tablets or by way of the Intravenous Drip and either continuously or intermittently using a Patient Controlled Analgesia (PCA) technique where you push a button when pain relief is required.
The apparatus is adjusted so that no matter how many times you push the button it will only supply a pre-designated amount of the drug in a set period of time.
You are encouraged to discuss side effects or complications associated with anaesthesia with your Anaesthetist – please contact us on (08) 8293 2077.