Orthopedic surgery offers a wide variety of procedures with many options for anesthesia.  For many surgeries a protocol has been established over time which provides safety and comfort for our patients while assisting the surgeon in obtaining a good result.

Anesthesia for orthopedic surgery frequently combines intravenous sedation of general anesthesia with regional anesthesia.

Regional anesthesia involves anesthetizing (numbing) the area of surgery.  The numbness may be complete (no sensation) or partial.  When an area is anesthetized, the muscles are also asleep and don’t work (or spasm) until the numbness wears off.  Regional anesthesia allows you to be comfortable during the procedure and provides pain relief after the surgery is over.  The duration of the pain control depends upon the local anesthetic (numbing medicine) where it is injected and how you tend to respond to local anesthetics.

There are several types of regional anesthesia:

• Local Infiltration: The surgical area is injected with local anesthetic (usually by the surgeon) after the patient is given intravenous sedation or general anesthesia.
• Nerve Block:  After sedating the patient, the anesthesiologist uses a special needle to precisely locate a nerve (or a group of nerves) and then injects local anesthetic next to the nerve.
• Spinal Block:  Local anesthetic is injected into the fluid around the spinal cord.  This is done in the low back where the nerves are least vulnerable to injury.  Thanks to improvements in medications and needles, spinal blocks are significantly safer and less uncomfortable than in years past.
• Epidural Block:       Medication is injected into the area around the spinal cord, but not into the spinal fluid.  A small flexible catheter is frequently placed so that pain-relieving medications can be given for a few days after surgery.

Any procedure has risks and benefits as well as side effects.  These vary with the type of anesthesia, the surgical procedure, and the patient.  We will discuss your options with you before your surgery, but your surgeon will know generally what forms of anesthesia are used most commonly for your particular surgery.  A nurse will call you at home or work in the days before surgery.  She will collect medical information that will help us plan your anesthesia.  She can give you basic information about your anesthesia options, and your anesthesiologist will fill in the details and answer your questions when you meet her/him.

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