General anaesthesia or spinal block

Posted , 20 users are following.

I am due to have my TKR this Wednesday. I am considering having a spinal block instead of a general and would be interested in others experiences of this. 

I am very concerned about post surgery pain relief as my previous experiences of morphine and all other opioids has been dreadful. The only pain relief I am able to take is ibuprofen and paracetamol, which hardly seems adequate for this surgery. Anti sickness drugs also don't appear to work. Voltarol gives me stomach cramps so I'm really struggling with what to take. 

The pre op nurse suggested I might be better off with a spinal block, which could be left in and then topped up with pain relief as required. 

I have waited a long time for this surgery under the NHS so am relieved it is finally going ahead, but I'm getting very nervous. 

Any advice would be welcome. 

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  • Posted

    Hello Suzanne, I wish you luck with your surgery. I had the spinal block and did well with it. I appreciated the fact that there was no nausea etc, and It did delay the pain for a while. You will do just fine. 
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  • Posted

    I'm not familiar with NHS. Do you get to choose your surgeon? If so, get one with at least 10 to 20 years experience. 

    My wifes doc has 30 years so we are pretty comfortable with him.

    I think half the horror stories in this forum are due to the implant being incorrectly placed. So my advice is get the best surgeon you can find!

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  • Posted

    Spinal block. Best post-surgical experience I’ve ever had. Woke up clear headed, was able to talk to the nurse, didn’t feel any pain for at least 24 hrs.

    But I am worried about you after that. I did well with a strict schedule of when to take what, how much, and how often - Tramadol 5-10 mg  +1000 mg Tylenol/paracetamol (I’m in the US), gabapentin, Celebrex, ondansetron for nausea, and Xarelto to prevent blood clots. They also gave me oxycodone, but it kept me from sleeping and I didn’t think it helped any more than 10 mg of Tramadol +Tylenol. 

    Lots of meds at first because you will need them. By four weeks, I was just down to Tramadol and Tylenol. Now - at 10 weeks post - I take less Tramadol, less Tylenol, but am able to take ibuprofen also.

    Use lots of ice and hopefully a passive motion machine the first month. LOTS of pillows for comfortable positions.

    Prayers for a successful surgery and recovery!

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  • Posted

    I forgot muscle relaxers and stool softeners. It’s quite a lot, but helps so much through the first difficult days.
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  • Posted

    I had general anesthesia.  Wouldn’t have done it any other way.  But I don’t have post surgical problems like you apparently have....  good luck with your surgery
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  • Posted

    Hi Suzanne.

    my name is Carol I had the spinal block for both my left and right knee replacement surgery and I was great I also had some sedation as I didn't want to hear the hammering I was great I didn't have any feeling sick or being sick if I was going to have surgery again and I could have the spinal block I wouldn't hesitate.

    i hope this helps let me know how you get on.

    Regards 

    carol01845

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  • Posted

    Hi Suzanne I had a spinal block and sedative to keep me calm and it worked. I have severe nausea after general anaesthetic so this was great. Wouldn't have any other but spinal block if and when I get my other knee done. No nausea headache after surgery yes pain but that's to be expected. I can only take paracetamol so was given tramodyl and it worked along with the paracetamol. I'm 6 months now after my tkr and yes I am not 100% but I would say 80% and its worth it. Don't take any notice of the horror stories I had mine on the NHS and they were great. Good luck x

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  • Posted

    I'm due to have my left knee done in December and will have general anaesthetic. Dreading the pain and long recovery process after though. Scared stiff. I'm going into good hope hospital Birmingham UK. How can you pick a surgeon if you don't know any?

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    • Posted

      I think it depends where you live , in Australia we can pick a surgeon we want , so I asked around and picked one on good reports from patients and nurses . It’s a different system than uk but you should still know whose doing it as you see them before for mri etc ??
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  • Posted

    Hi Suzanne

    i also had my tkr on the national health 4 month ago and like you I was wondering if having a spinal block was a good idea the answer big fat yes. I asked to be heavily sedated as I didnt want to hear anything. When they were getting me ready  they were just great I took my music and had my head phones on they got me ready and the next thing I knee it was all over didn’t remember a think about the op I felt great. Don’t worry you will be fine. They will sort tablets out so they don’t make you feel unwell they did with me and I was ok. Pain I can honestly say the pain was no where near as bad as I was expecting in fact pain was not as bad as before the op but everyone is different . 

    The care I have received on the nhs as been excellent don’t worry you will be fine don’t worry about the spinal block best decision.

    take care

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  • Posted

    The spinal block will only last   a short while , what ever way you will have pain for weeks unless you are one of the very few , it’s up to how you take a general . I woke from mine feeling fine , and I had no pain for about 36 hours because what they put in my leg at op some sort of pain killer . If you can face it with spinal block then go ahead , I couldn’t . I found nerve pain the worst and took lyrica for it . Good luck 
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  • Posted

    Hi Suzanne

    I had rtkr in May and I had spinal block which I was nervous about having it as I didn’t want to wake up during surgery but they give you a sedative as well . I did  wake looked at anaesthetic guy and went back to sleep again. When waking from surgery there was no pain as you are still numb , but also no feeling sick as with anaesthetic. Hope you get on ok xx

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  • Posted

    I have had one knee with general and the other with a spinal block. Spinal block was much better, was awake listening to music with headphones most of the time. Recovery from general was not good. Spinal every time.
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  • Posted

    Suzanne,

    I had both - they gave me a spinal and also mild general.  The spinal wore off shortly after surgery.  They will try all types of pain relievers with you.  I had to go through a few different ones because of side effects.  Not sure if ibuprofen will be strong enough to get you through the first few days.  Don't be nervous - it was the best thing I have had done for my knee.  Long recovery with lots of PT.  Wishing you the best of luck and a speedy recovery.

    Sue

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  • Posted

    If you are not squeamish go for the spinal. But you know they use hammers and saws, right? I was under anesthesia for mine, but they injected pain killer into the knee before sewing me up, so I woke pain free and the pain didnt hit for 2 days. What about laudanum? I got that for a day, then got mild pain killers. They sent me home with oxycontin, which I only took before my physical therapy. You might want to look on YouTube and see what they do. I had 2 tkr and still cant watch. Good luck. Maybe head phones and a blindfold? Not kidding. Just imagining myself.
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