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Spinal anesthesia

Discussion in 'Knee Replacement Pre-Op Area' started by Sue4473, Oct 27, 2017.

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  1. Sue4473

    Sue4473 junior member
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    Hello, I'm having a Left TKR on November 2. Had the right one done in 2010, and had general anesthesia. Apparently having spinal anesthesia is now an option. Did anyone have this? How much were you aware of? I don't want to hear the surgery, but I understand spinal is supposed to be less risky. Thanks.


    Sent from my iPad using BoneSmart mobile app
     
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  2. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Hello @Sue4473 - and :welome:

    You'll notice that I have moved your post from the Knee replacement Recovery Area to the Knee Replacement Pre-Op Area. That's because you haven't yet had your surgery, although it will be very soon.
    We do find that people who have had their surgery still come back to the Pre-Op area, to offer advice about their experiences.

    Yes, spinal anaesthetics are now possible. In fact, many surgeons prefer them.

    Don't worry about hearing what is going on, Usually, you will be given a sedative as well as the spinal, and you will sleep through the whole operation.
    This article explains about the different types of anaesthetics:
    Anaesthetics - spinals, femoral blocks, GAs and everything else

    Here are some more articles, to help you prepare:
    If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
    Score Chart: How bad is my arthritic knee?
    Choosing a surgeon and a prosthesis
    BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
    Longevity of implants and revisions: How long will my new joint last?

    If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
    Recovery Aids: A comprehensive list for hospital and home
    Recliner Chairs: Things you need to know if buying one for your recovery
    Pre-Op Interviews: What's involved?

    Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

    And if you want to picture what your life might be like with a replaced knee, take a look at the posts and threads from other BoneSmarties provided in this link:
    Stories of amazing knee recoveries
     
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  3. Celle

    Celle FORUM ADVISOR Forum Advisor

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    And this is the approach to recovery that we recommend - together with some informative articles about the post-op experience:
    Knee Recovery: The Guidelines
    1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now; they are almost certainly temporary
    2. Control discomfort:
    rest
    elevate
    ice
    take your pain meds by prescription schedule (not when pain starts!)
    don't overwork.
    3. Do what you want to do BUT
    a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
    b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
    4. PT or exercise can be useful BUT take note of these
    5. Here is a week-by-week guide for Activity progression for TKRs


    The Recovery articles:
    The importance of managing pain after a TKR and the pain chart
    Swollen and stiff knee: what causes it?

    Energy drain for TKRs
    Elevation is the key

    Ice to control pain and swelling
    Heel slides and how to do them properly

    Chart representation of TKR recovery
    Healing: how long does it take?

    Post op blues is a reality - be prepared for it
    Sleep deprivation is pretty much inevitable - but what causes it?

    There are also some cautionary articles here
    Myth busting: no pain, no gain
    Myth busting: the "window of opportunity" in TKR
    Myth busting: on getting addicted to pain meds

    We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
     
  4. Fudge

    Fudge junior member

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    Hi
    I had a spinal for my hip op. Frankly I was terrified at the thought,the smells, the sawing,the needle into my spine, the fear list was endless. Only fuelled by my hyper imagination. I was majorly stressed prior to the procedure. On the day I told the anaesthetic guy to sedate me as far as was possible otherwise I would be leaping of the op table.

    So I walked down to the theatre feeling like I was on the way to my execution .I was crying unashamedly, my BP was high and I felt totally out of control. I sat on the theatre table and was told to lean forward. I couldn't believe I was going to allow someone to stick a needle in my spine. Then he said he would do it with me lying down,so gratefully I did exactly that.

    That was the last I knew. My next moment aware was being in the ward. I couldn't believe it. I remembered nothing whatsoever, no smells of cautery, no hideous sawing, all a perfect blank. No knowledge of needles being stuck in me, it was amazing. Would I have it done again like that? Definitely but I would still tell the anaesthetist to sedate as far as possible.

    Some people don't want sedation, some have a little, but for me I was totally happy being a complete woosey (in my eyes) and having the op done with absolute amnesia about the whole thing.

    So good luck with your decision and procedure, choose what you feel you can cope with!
     
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  5. Clipless

    Clipless post-grad

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    I had a spinal block for both TKRs. It's great- they will also give you IV sedation so that you will be essentially "out" during both the spinal block and the surgery, though you may have a few vague recollections of voices and such. I did, but it was nothing alarming.

    When you reach your room after surgery your legs (including your bum) may be numb for a while- maybe another hour or so. This is perfectly normal. You will probably be wearing SCD sleeves (calf squeezer thingies). I started wiggling my toes, performing ankle pumps, and doing heel slides as soon as I could. I was up with assistance and using the walker shortly after that. My daughter, who was with me for both recoveries, couldn't believe how quickly I was up and around after the second TKR.

    Best Wishes on your upcoming surgery!
     
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    Last edited: Oct 28, 2017
  6. Marilyn60

    Marilyn60 new member

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    I had tkr on Oct 9, 2017 with spinal anesthesia. I had the same concerns as you. But they gave me sedation and I wasn't aware of anything until I was in recovery. I felt great afterwards. My last knee surgery I had general anesthesia and woke up with dizziness, vomiting, and a very slow heart rate. This time, with spinal anesthesia was so much better.
     
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  7. altrky17

    altrky17 new member

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    I'm so worried about the spinal too. I need to spend more time focusing on what I will need to do to recovery, but I worry everyday about waking up and sitting still while someone give me a shot in the back.

    I have not yet met with the anesthetist, but I am going to tell him to give him the best drugs he's got! :)
     
  8. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    I, by far, prefer the spinal and sedation! GA left me throwing up for days afterwards. I hate it! Not so with the sedation/spinal. You will be fine!
     
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    Last edited: Oct 30, 2017
  9. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Nothing at all! Lots of people worry about this but it's a fact that most anaesthetists sedate their patients anyway as they know they are going to be jumpy and anxious. Never yet met a anaes doctor who didn't.

    However, when the anaesthetist visited me about 30 mins before time, as he was departing, he asked me if I had any last requests! (Fortunately I knew him pretty well!) so I just said that I didn't want to see the tourniquet going on or the theatre doors opening for anything! He was a good as his word and, like most other patients, first thing I knew was being wheeled out to the recovery room!
     
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  10. OCEANLOVER

    OCEANLOVER new member

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    I had GA with all my replacements, no issues. They gave me Exparel in the knee but that only lasted about 90 hours and when it wore off I wanted to die from the pain. This is coming from someone who has a freakishly high pain tolerance, well I almost passed out a few times. I hate Percocet and all the other stuff they gave me after. On April 10 I will be getting my fourth and hopefully last knee replacement in the same damn knee and this time also a post in my tibia. They are telling me they are going to use spinal anesthesia this time. I would love to know how long this block lasts?
     
    Last edited: Mar 15, 2019
  11. lovetocookandsew

    lovetocookandsew supremo

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    I've had many surgeries over the years with GA, and always had issues. But I never wanted to chance waking and knowing anything during a surgery, so always chose the GA. This last surgery, the anesthesiologist took a ton of time explaining the entire procedure, and then let me choose. When I found out that you can be sedated at different levels with the spinal, from light to deep, I opted for the spinal. I told him I wanted to be totally and thoroughly out with no chance of hearing or seeing anything, and that's what he did. I woke from the spinal completely awake and alert, no vomiting, no "hangover", nothing. Because I was also having an epidural for pain control after, it made even more sense to go with a spinal. I am very glad a doctor took a lot of time just before my surgery to actually explain what a spinal entails, and what can be done to be totally out which allowed me to choose it and am very glad I did. (granted, the staff prepping me were getting impatient at all the time the anesthesiologist was taking as they needed to finish with me, but I needed that time and made sure to tell my OS later how thankful I was for it, even though it delayed my surgery a bit).
     
  12. rosieNZ

    rosieNZ member

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    Hi. What a struggle you have had. I have 2 x TKR. First under GA was a miserable time for 2-3 weeks.
    The second was under epidural 11 days ago. Yippee.
    Im in New Zealand and our meds are a little different from what I see others post.

    At completion of the surgery the surgeon put 100 mls of lidocaine in the back of the knee. And the anaesthetist topped me up with Fentanyl. My spinal block wore off quickly but I was adequately medicated and up walking to the bathroom same day. I stayed in hospital for 3 days and had decided to take regular meds (Sevredol, Fentanyl, Tramadol). I mostly slept and had pain relief prior to getting up, having a shower etc. The only time it was tough was day2 with the PT(unescapable). I found myself having my first ever panic attack due to pain (Im 67).
    Ive found everything they say on this site about rest, ice and elevation and regular meds has been correct. I now take Celecoxib twice daily plus Acetaminophen 4x. I also have Tramadol which I take at night to settle. I have perfect extension and my knee bends well enough to sit in a normal chair. Im starting to get rid of all the mobility etc sids (no raised toilet seat or shower stool needed now). I could flick the crutches but I want to off load the knee as much as possible. I can raise my knee easily as well and it feels stable.

    Ive been out to a cafe (day after I left hospital), the local doctors, another cafe and the movies (used elevator).
    This is hugely different to my previous experience. I think the frequent icing (a hired Game Ready machine) has made the difference. That and resting has controlled swelling which causes additional pain.
    My Game Ready goes back in 3 days (Oh my) but I have an aircast to replace it with and an active ice wrap which was wonderful pre surgery. I wish I had these things with my previous surgery and can scarcely believe how good I am.
    Hope my current experiences are helpful to you. Best wishes. Rosie
     
  13. julie1968

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    @rosieNZ your doing great. I'm 7 days PO and no way I could sit thru a movie. Hope your recovery continues to be good. Best wishes
     
  14. rosieNZ

    rosieNZ member

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    Im pretty sure its the Game Ready (does ice and compression in 30 min cycles).
    The trick will be to see what happens when the rental periid ends in 3 days. I have an aircast but its not as good).

    How are you going?
    Xxx
     
  15. TasNettie

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    Wow thank you for this post, I’m pre op in April and in Tasmania, I hope I have the same experience .
     
  16. Celle

    Celle FORUM ADVISOR Forum Advisor

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    @TasNettie - You don't have to quote a post in order to respond to it.
    Just go down to the bottom of the page and start typing in the box where it says "Write your reply . . . "

    If you want to address your response to a certain person, you tag them, by putting the @ sign in front of their user name, as I tagged you at the beginning of this post.
    How to tag another member; how to answer when someone tags you

    That article is in this section
    https://bonesmart.org/forum/view/how-to-use-this-forum.74/
    where there are lots of other articles that explain how to do things on BoneSmart.
     
  17. rosieNZ

    rosieNZ member

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    I think the rest, ice and elevation are key. That and not demanding too much for those first few weeks. I am no longer taking meds because I don't need them and I'm walking 2000 steps a day (in 3 days I will be 3 weeks post op). Im still doing icing regularly and trying to walk nowmally and do things at home regularly thru the day. I so wish I knew these things last time.
    You will do just fine.Its a scary leap of faith eh. I hope my experienxe helps you Tassie mate. I will look forward to seeing your progress xxx
     
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