Total Joint Center Anesthesia Options

Procedures for the hip, knee and shoulder at the Total Joint Center require patients to undergo anesthesia before surgery. The type of anesthesia is chosen based on the type of procedure and the best method for each individual patient.

The four main options for anesthesia care are:

In some cases, a combination of two or more types of anesthesia may be used. Here is an overview of these four types of anesthesia.

General Anesthesia

This method is likely the first thing one pictures when thinking of anesthesia. General anesthesia is administered through a combination of intravenous drugs and inhaled gases. It puts you into a sleeplike state and makes it so you will not have any feelings of pain during the procedure. General anesthesia has been the standard practice for many years, but newer methods are proving to be just as effective with more benefits. 

Pros:

  • Able to be administered rapidly
  • Reduces intraoperative patient awareness and recall
  • Allows proper muscle relaxation for prolonged periods of time
  • Permits surgery in widely separated areas of the body at the same time
  • Anesthesiologists have complete control of the patient’s airway, breathing and circulation

Cons:

  • Increased complexity of care and costs
  • Possible dental injury
  • Causes delayed return to normal mental functioning
  • Causes side effects such as sore throat, drowsiness, dizziness, airway problems, and nausea or vomiting in approximately 40% of patients

Spinal Anesthesia

For most knee and hip procedures, we recommend using a spinal anesthetic to numb the target area. After using a topical numbing solution on the skin, the anesthesia is administered through a needle placed in the lower back. The local anesthetic causes numbness and an inability to move your legs. This may be used with a light to deep sedation to make you sleepy for the duration of the procedure. Some patients may experience consciousness or awareness during spinal anesthesia; this is perfectly safe and the anesthesia will still ensure that you do not feel pain or sensation. 

Pros:

  • Quicker recovery times
  • Excellent pain relief post-surgery
  • Lower chance of experiencing side effects
  • Less risk of forming blood clots or losing blood

Cons:

  • Possibility of postoperative itching
  • Post dural spinal headache (with low incidence)

Interscalene Block

Shoulder surgeries typically call for an interscalene nerve block. Your anesthesiologist will use an ultrasound or nerve stimulator to identify the ideal area in the shoulder to administer the block. Interscalene blocks provide heavy numbness in the shoulder and arm that typically lasts 12 to 36 hours. This method is also combined with general anesthesia. 

Pros:

  • Reduced risk of nausea 
  • Postoperative pain control
  • Earlier intake of food and drink
  • Quicker recovery and release from the hospital

Cons:

  • Side effects may include shortness of breath or hoarseness

Adductor Canal Block

An adductor canal block is a type of nerve block that anesthesiologists prefer to use for knee surgeries at the Total Joint Center. It is a regional anesthetic that is administered via injection into the cluster of nerves surrounding the targeted area, usually in the mid-thigh area. It numbs the sensory nerves around the knee and lasts for 12 to 18 hours. An ultrasound or nerve stimulator may also be used with an adductor canal block to identify the ideal point of injection.

Pros:

  • Earlier mobilization
  • Quick recovery times
  • Reduces quadricep weakness when compared with femoral nerve block

Cons:

  • Small risk of bleeding

A team of physicians, surgeons and anesthesiologists will discuss which anesthesia option or combination of methods is best for each patient and procedure. 

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