If you are having surgery you will need to have anesthesia. Anesthesia means without feeling. For hip replacement surgery, anesthesia can be either general or regional.
With general anesthesia, you are completely asleep. Regional anesthesia means you are awake but the lower part of your body is numb and you can’t feel any pain. Each has its advantages.
The doctor who gives you anesthesia is an anesthesiologist. An anesthesiologist specializes in relief of pain and administration of anesthesia to surgical patients. He or she does at least four years of training after medical school. One year is general medicine or surgery. The next three years are spent in an anesthesia residency. Many anesthesiologists also choose to do an additional year of fellowship in one area.
The anesthesiologist may be assisted during the procedure by a nurse anesthetist known as a CRNA. You will meet the anesthesiologist in the preoperative area before surgery. He will ask questions about your medical history. He will want to know if you have had anesthesia before or if you or anyone in your family has had problems with anesthesia in the past. He will want to know the medications you are taking and if you have any allergies. He will also do a brief examination and review your laboratory tests.
An intravenous line or IV will be started in the preop area. You may be given some medication before you go into the operating room.
In the operating room, the anesthesiologist will attach small devices to your arms and chest before he begins anesthesia. These instruments monitor your blood pressure, heart rate, electrocardiogram and the amount of oxygen in your body.
There are three main types of anesthesia for hip replacement surgery:
- general
- spinal
- epidural
With general anesthesia, you are put to sleep and you are completely unconscious. The anesthesiologist first gives medication to put you to sleep through the IV line. He will then place a device into the back of your throat or into your windpipe, This opens a channel to allow air and anesthesia gases to move directly into your lungs.
The device he places is either an endotracheal tube or an LMA. An endotracheal tube has been the standard in general anesthesia for many years. It is a tube placed into your windpipe or trachea to maintain a direct air-way to your lungs. LMA or laryngeal mask airway is a small mask inserted in back of the throat instead of the trachea. It has been used in the United States for 15 years. Use of an LMA means you are less likely to have a sore throat that can result from an endotracheal tube. The anesthesiologist will assist you with breathing while the ET tube or LMA is in place.
Spinal and epidural are regional anaesthesia. You are given an injection with medication in your lower spine. Your body loses feeling below the level of injection. You are given some sedation as well as oxygen during the surgery.
Spinal anesthesia is single injection placed inside the lining that surrounds the spinal cord. It can provide anesthesia for several hours. The medication given is usually morphine, a local anesthetic, or a combination of both.
Epidural anesthesia is a small catheter placed outside the lining of the spinal cord. Medication flows through the catheter. The catheter may be left in place for 1 or 2 days after surgery to help control pain in the postoperative period. Epidural anesthesia is familiar to many women as it is often used during childbirth.
After the procedure you will be taken to a recovery room, or PACU (Post Anesthesia Care Unit). You will remain there until you are completely awake or reacted, your vital signs are stable and you are ready to return to a regular hospital room.