ANAESTHETICS FOR YOUR PROCEDURE

Orthopaedics

Arthroscopic knee operations

This will usually be done under a general anaesthetic. Local anaesthetic will be placed in the wounds by your surgeon when asleep. A post operative prescriptions for oral pain killers will be given in case you need them at home.

ACL/ knee reconstruction

This is the same as for any other arthroscopic knee operation but is more extensive. A femoral nerve block will assist with postoperative pain and this will be discussed with you in the preoperative visit. Postoperatively there will be injections for you if the pain is severe or tablets if the pain is not so bad. You will need to ask the nursing staff for these.

Femoral nerve Block

This is placing local anaesthetic around the femoral nerve in order to stop it working temporarily. This is usually done in the anaesthetic bay after you have some sedation. Using a needle, under sterile conditions, a special device called a nerve stimulator will be used to help locate the nerve. It is found in you groin near the femoral artery, which is the pulse you can feel at join between you leg and hip.You will fell your leg twitching and then the local anaesthetic will be injected. The front of your thigh will go numb as will most of your knee. It is not sufficient by itself for pain relief but does help significantly. I would expect it to work for approximately 8 hours but may work up to 36 hours.
There are potential risks with all procedures. The risks with this are

1. That it doesn’t work in which caes you will need more painkillers. This is uncommon.
   
2. That it works for longer than 8 hours which means that you need to be careful and use crutches until full function returns. This occurs quite frequently.
   
3. Permanent neve damage that may be permanent pain or loss of motor function ie paralysis. This is very uncommon.

Sciatic nerve Block

This is placing local anaesthetic around the sciatic nerve in order to stop it working temporarily. This is usually done in the anaesthetic bay after you have some sedation. Using a needle, under sterile conditions, a special device called a nerve stimulator will be used to help locate the nerve, which is found near your femur about 1/3rd of the way down the front of your leg. You will feel your leg twitching and then the local anaesthetic will be injected. The back of your and all of the area below you’re your knee will go numb. It is not sufficient by itself for pain relief but does help significantly. I would expect it to work for approximately 8 hours but may work up to 36 hours.
There are potential risks with all procedures. The main risks with this are

1. That it doesn’t work in which caae you will need more painkillers. This is uncommon
   
2. That it works for longer than 8 hours which means that you need to be careful and use crutches until full function returns. This occurs quite frequently.
   
3. Permanent neve damage that may be permanent pain or loss of motor function ie paralysis. This is very uncommon.

Interscalene Nerve Block

This is done placing local anaesthetic around the interascalene nerve in order to stop it working temporarily. This is usually done in the anaesthetic bay after you have some sedation. Using a needle, under sterile conditions, a special device called a nerve stimulator will be used to help locate the nerve,which is found in your neck. You will feel your arm twitching and then the local anaesthetic will be injected. Your arm will go numb. It is not sufficient by itself for pain relief but does help significantly. I would expect it to work for approximately 8 hours but may work up to 36 hours.
There are potential risks with all procedures. The main risks with this are

1. That it doesn’t work at all or is patchy in which case you will need more painkillers. This is uncommon
   
2. Permanent neve damage that may be permanent pain or loss of motor function ie paralysis. This is very uncommon.

Knee Replacement Surgery

This is major surgery.

It will usually been done with a general anaesthetic. You will be offered a femoral and sciatic nerve block for assitance with postoperative pain. These blocks help significantly and reduce the amount of strong painkillers you need.

You may need a blood tranfusion although this is unlikely and your blood from your drains will usually be reinfused into you.