Spinal Anaesthesia

For most lower limb surgery, which includes hip and knee replacement surgery, a spinal anaesthetic may be recommended/offered. In my own practice more than 97% of lower limb joint replacements will be performed under this technique. The alternative is a general anaesthetic and consent information regarding this can be found by following this link. 

PLEASE READ THIS VERY IMPORTANT DOCUMENT.

The Royal College of Anaesthetists has produced a wonderful generic poster highlighting the essential information for patients receiving a spinal anaesthetic. It can be found here following this link. 

PLEASE READ THIS VERY IMPORTANT DOCUMENT.

With modern drugs even daycase surgery can be undertaken with a spinal anaesthetic. This is an option for knee and ankle arthroscopic surgery for example.

The same systems are in place for general and spinal anaesthesia until after the cannula has been inserted. At this point I will examine your spine and mark the area before giving it a clean with an antiseptic solution. I will anaesthetise the skin with a small amount of local anaesthetic before performing the spinal injection. Once the drug/s have been injected there is nothing left in the spine. A small sticky plaster is applied, and the anaesthetic will begin to take effect straight away, reaching peak effect in approximately 20 minutes. Usually at this stage an oxygen mask is attached to the patient and a sedative is administered for the duration of the surgery.

At the end of the procedure the patient is woken and transferred to the recovery room for approximately 30 minutes before being returned to their room. The heaviness in the legs will last a few hours but the painkiller drugs will last significantly longer. 

Most patients will be given antibiotics, anti-sickness and anti-inflammatory medicines during surgery. Painkillers will be prescribed for regular use on the ward and after discharge home.