Joint replacement surgery.

Your anaesthetic plan 📝

Shoulder Replacement:

Your anaesthetic will consist of 2 components working together -

General Anaesthetic plus Nerve block

Knee Replacement:

Your anaesthetic will consist of 3 components working together -

Sedation / General Anaesthetic plus Nerve block plus Spinal / epidural block

Hip Replacement:

Your anaesthetic will consist of 2 components working together -

Sedation / General Anaesthetic plus Spinal / epidural block

You can click through the above links to see what each of these involve!

Having a spinal / epidural / nerve block is considered very safe, and performing them will allow us to use a much lower dose of strong pain relief medication while you are asleep. This means less side effects from these drugs, and overall likely less stress on your heart during and after your procedure. The full breakdown of risks can be accessed here.
I will talk you through which combination suits your joint, your health and your preferences before we start, usually on a phone call on the evening prior to your surgery.

Waking up numb, and why that is expected

While the 'nerve block' or 'spinal' or 'epidural' is still working, the affected limb(s) will feel both numb and noticeably weaker. That is the block doing its job, not a complication. You will wake up with the arm / leg numb and you will be comfortable as a result of this. The nursing and physiotherapy team know to protect and support the limb until normal feeling and strength return.
After a spinal or epidural, it will take around 3 or 4 hours for that effect to wear off.
After a nerve block, we generally aim for that numbness to last around 12 - 18 hours.

Handing over to tablets

As the block wears off, pain relief passes from the block to your medications: the baton handover. Do not wait for the pain to build: ask for your strong pain relief as sensation returns, and stay ahead of it over the first day or two.

Moving early

Modern joint replacement care gets you upright and walking soon after surgery, because early movement protects the new joint, your lungs and your circulation. Good pain relief is what makes that possible, so tell us honestly how you are feeling.

What to expect with pain afterwards 💊

It is expected that after major joint surgery, there will be some discomfort in the first week or so. The aim post-operatively is not to eliminate pain entirely.. too much strong pain relief will cause over-sedation, nausea, constipation, & shallow breathing. These are better to avoid than a small amount of expected discomfort.

A call the day before 📲

I will call you on the day or evening prior to your surgery to answer any remaining outstanding questions.