Total Joint Replacement

Anesthesia Alternatives for Total Joint Replacement

Within the Christiana Care Health System, Wilmington Hospital has been designated as a specialty center for Total Joint Replacement Surgery and Post-Operative Rehabilitation. The orthopedic specialists and the anesthesia personnel with the perioperative nursing team work together to provide a coordinated, efficient, and supportive perioperative experience for you, our patients.

What kind of anesthesia will I receive?

There are two modes of anesthesia utilized for Total Joint Replacement. These are General Anesthesia and Spinal Anesthesia.

General Anesthesia

This is the practice of making of a patient completely unconscious during the operative procedure. At this time the anesthesia team will make sure that the patient is asleep and safe.

Spinal Anesthesia

This involves the placement of numbing medicine and, sometimes pain medicines, through a needle inserted in your back in order to prevent you from experiencing any pain during the surgery and for a number of hours afterwards. For Total Knee Replacement patients, a pain medication (Morphine) is added to the local anesthetic to enhance pain relief in the post-operative period. This relief may last twelve to eighteen hours after surgery. Total Hip Replacement patients generally experience less discomfort and do not receive the narcotic medication in the spinal fluid. In addition to the spinal anesthetic, intravenous sedation is provided so that you are calm and comfortable during the surgery and only occasionally aware of being in the operating room. This form of anesthesia, spinal anesthesia combined with sedation, is the most commonly used for Total Joint Replacement patients. A member of the anesthesia care team is always there with you making sure you are sedated and safe.

What about nausea after surgery?

The surgical, anesthesia, nursing, and rehabilitation personnel do everything possible to assure your comfort throughout the perioperative experience. Pain control is a priority. Some of the medications used to control pain may cause nausea. To minimize this, additional special medications are administered by the anesthesia team before and during surgery. These additional medications may be continued as needed after surgery. We also employ medications, after surgery, that are less likely to cause nausea.

When will I meet the anesthesiologist?

The meeting with the anesthesia care team composed of an Anesthesiologist (a doctor specialty trained in anesthesiology) and a Certified Registered Nurse Anesthetist (a nurse specialty trained in anesthesiology) will take place on the day of surgery prior to your procedure. Before the day of surgery, all of your medical information will be processed by a team of pre-operative preparation personnel who will collect all of your medical data and prepare it for the anesthesia team members. If you have any remaining questions regarding your anesthetic, they may be answered at that time.

How long will I be asleep after the operation?

If you receive spinal anesthesia, the sedation will be weaned off at the end of surgery and you will be awake when you arrive in the recovery room (Post Anesthesia Care Unit). However, some of the medication may cause some temporary amnesia so that you might not recall your time in the recovery room.

If you receive general anesthesia, you will likely be more drowsy when you enter the recovery area. You will be kept there until you are awake enough to be safely transported to your post-operative bed on a specially staffed floor of the hospital where the nursing staff is expert in recovering and rehabilitating patients who have had Total Joint Replacement surgery.