Anaesthesia for hip replacements

During your hip replacement, your comfort is our top priority. Throughout your operation, you’ll be under the care of a skilled anaesthetist with experience in joint replacement surgery.

Anaesthetic has been used since the 18th century to help make medical procedures pain-free for patients. Hip replacements can be carried out under a general anaesthetic or spinal anaesthesia with sedation. In most cases, you’ll be able to choose your preferred anaesthesia.

The role of your anaesthetist

Anaesthetists are doctors who specialise in providing pain relief to patients during operations. Their specialist training takes a minimum of seven years and includes pain management and intensive care medicine.

Mr NiravShah works closely with an excellent team of anaesthetists and will liaise with your specialist doctor before, during and after your surgery. You’ll have the opportunity to meet your anaesthetist before your hip replacement to discuss your anaesthesia and post-surgery pain relief.

Your anaesthetist will be present throughout your operation to keep you comfortable and monitor your progress. They’ll continue to supervise you after your surgery while your anaesthetic wears off.

Choosing your anaesthetic

Before your surgery, Mr Shah will carefully explain your options for anaesthesia. He may recommend an anaesthesia based on your medical history. Otherwise, you’ll be able to choose between:

  • Spinal anaesthesia with sedation
  • A general anaesthetic

Spinal anaesthesia

Spinal anaesthesia is an increasingly popular alternative to general anaesthetic for operations performed below the waist.

Your anaesthetist will give you an injection in your lower back, which will make you completely numb from the waist down. Once you’ve lost all sensation, they’ll provide you with sedation drugs, which will help you feel relaxed and sleepy – but still conscious.

An injection near your spine sounds intimidating, but it takes just a few minutes and shouldn’t be any more painful than a blood test.

Your anaesthetist will stay with you during your hip replacement. In rare instances, they may need to give you a general anaesthetic mid-surgery, for example, if you start to regain any feeling.

It will take around four hours for you to recover from your anaesthesia, and you’ll be a bit unsteady on your feet at first. Our ward staff will be on hand to support you and answer any questions or concerns.

Most of our patients choose spinal anaesthesia because of the advantages it provides compared to a general anaesthetic:

  • More effective pain relief immediately after surgery
  • Fewer side effects during the first 24 hours
  • Lower risk of a chest infection
  • Less impact on your lungs and breathing
  • Faster return to eating and drinking
  • Less chance of confusion following surgery

The side effects of spinal anaesthesia don’t usually last long but can include low blood pressure; itching; pain during the injection; a headache; and bladder problems. A rare complication is nerve damage; however, most patients go on to make a full recovery.

Some patients confuse spinal anaesthesia with an epidural. They both numb the nerves below your waist, but there are some key differences. Spinal anaesthesia involves a single injection and lasts around four hours.

An epidural is where a thin plastic tube (an epidural catheter) is inserted between the bones in your back. Local anaesthetic is then injected through the catheter. Epidurals can remain in place for 2–3 days.

General anaesthesia

A general anaesthetic will put you into a state of controlled unconsciousness during your surgery. You won’t feel any pain, and you won’t be aware of the operation.

You’ll be given a general anaesthetic as an injection or a gas that you breathe in. You’ll start to feel a bit light-headed as you fall unconscious.

Your anaesthetist will make sure you remain unconscious throughout your surgery. They’ll also give you medication to make you more comfortable after your operation.

General anaesthetics have some side effects, which we’ll discuss with you before your hip replacement. Common side effects, which are usually short-lived, can include sickness and vomiting; confusion; dizziness; shivering and coldness; and bladder problems.

If you receive an injection, this may cause some bruising. Sometimes a tube is used to help you breathe, which can damage your mouth or teeth, or give you a sore throat.

If you have any questions about anaesthesia for hip replacements, please don’t hesitate to contact us for advice.

This information was put together with help from www.rcoa.ac.uk.

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