Information about General Anesthesia for Hip and Knee Surgery
Undergoing surgery is never an easy thing to do. For most people, it is a frightening experience and you'll do anything possible to get out of it. Although some people are able to do physical therapy, take pills, get some rest, and find other alternative treatments, for those who have sustained serious injuries to their knees and hips as the result of a car crash, slip and fall accidents, sports injury accident or other accident, surgery may be the best option.
Undergoing surgery also means having a general anesthetic, which can be one of the most frightening parts of having surgery, since this is the time when you lose control over what is happening to you and when you give up your right to know what is going on. Although surgery is supposed to be safe, there may be times when undergoing general anesthesia causes more harm than good.
General anesthesia is a combination of drugs that are provided either intravenously or through gasses that are inhaled. These drugs put the body into a deep sleep. The difference between a general anesthetic sleep and regular sleep is that, in regular sleep, the body still feels and can respond to pain and forced movements. While under general anesthesia, patients are not aware of what is being done or the pain that is being inflicted upon their bodies because the drugs block the pain receptors in the brain. General anesthesia is used in most major medical procedures.
Although there are some instances of major surgery where you may not need a general anesthetic, in most cases, your doctor will recommend it. In the case of hip and knee surgeries for accident victims, a general anesthetic may be recommended, although you may also be able to select a spinal block or epidural block, both of which have their own sets of complications and benefits.
When you are ready to undergo general anesthesia, you will either be injected with drugs intravenously or you will have a gas mask placed over your face. If you have a gas mask placed over your face, typically the doctor will put the mask into place and then ask you to count backwards from 100. In most cases, individuals fall asleep before reaching zero. In the majority of cases, individuals fall asleep after counting only 10 numbers.
When you undergo general anesthesia intravenously, the process is a bit different. A nurse certified to work with an anesthesiologist will likely prepare you for your anesthesia by find the appropriate vein in your elbow, hand or wrist and inserting the IV. Your anesthesiologist or his nurse will begin your anesthesia and may leave you alone while the drugs begin their descent into your body. You will likely never be wheeled into the operating room until after you have already fallen asleep.
When you undergo general anesthesia, your doctors are expected to monitor your condition and to take good care of you. Your anesthesiologist should talk to you before providing the anesthesia, explain the risks, and help you make the right decision, as should your surgeon. During the surgery, the anesthesiologist is responsible for monitoring your vital signs and ensuring that the anesthesia is not interrupting your breathing patterns. This doctor must, at all times, work to ensure that your breathing is not only under control but also assisted in the event of an emergency.
Anesthesiologists almost always ask a wide range of questions prior to putting you under anesthesia for a surgical procedure, but they cannot read your mind. If you have concerns or questions about the anesthesia, you should always ask the anesthesiologist well before you are hooked up to an IV or ready to slip a gas mask over your face. When talking to your anesthesiologist it is also important to go over your family and medical history and to talk about things like:
- If you've ever had a reaction to a medication.
- If you've ever had a reaction to any type of anesthesia, including lidocaine or other local anesthetic.
- If anyone in your family has ever had a reaction to an anesthetic, which is especially important if this is the first time you've had major surgery.
- If you have a heart condition.
- If there are any other anomalies in your medical history that could put you in danger when you are having surgery.
Although you may often hear stories of serious complications with general anesthesia, it is generally a safe method of keeping you asleep and unaware during surgery. However, roughly one or two out of every 1,000 people wake up for a moment or two while under general anesthesia. This does not stop the pain-numbing or other effects of anesthesia, but can cause the individual to develop psychological trauma from being aware of their surroundings and the surgical procedure being performed. In some extremely rare cases, pain is felt even after the patient falls asleep from the anesthesia and they are unable to communicate because of the other effects of the drugs that cause them to become immobilized. This is why anesthesiologists monitor all vital signs and watch for signals that the body is in distress. In addition to these less common reactions and risks, some of the more common troubles you may face when you undergo general anesthesia include:
- Damage to the vocal cords, which may be either temporary or permanent and require additional surgeries to correct
- Heart attack
- Heart stops from slowing down too much
- Infection in the lungs or fluid build up in the lungs
- Temporary mental confusion, which is common for most people who undergo general anesthesia via a gas mask
- In rare cases, death
- Traumas and damage to the teeth or to the tongue due to involuntary mouth movements while under general anesthesia, or from the chemicals
- Nerve injuries
It is important to keep an open dialogue with your anesthesiologist to ensure that you understand the risk of complications versus the benefits of general anesthesia so that you can make an informed decision before your hip or knee surgery.
Although there are times when the doctor gets it wrong or when there is something unknown that causes a reaction to a general anesthetic, there are also things in your own personal and medical history that could contribute to problems. This short list of risk factors does not include all of the things that could increase your risk of complications with a general anesthesia but provides a good start:
- Sleep apnea, especially obstructive
- High blood pressure
- A history of diabetes
- Not following the doctors orders regarding eating
- Heart disease
- Lung disease
- Kidney disease
- Long term or current use of drugs like aspirin
- Alcohol use, especially heavy, long term, or current heavy use
- Allergic reactions to some types of medications
- Personal or family history of reactions to anesthesia
While risk factors do not guarantee that there will be complications for your use of general anesthesia, it greatly increases your chances of experiencing complications.
Whenever you undergo any type of procedure that involves having a needle stuck into your body you run the risk of developing nerve damage. This is because there are nerves and nerve endings all over your body and some of the most vulnerable are those located nearest to the veins that are used for drawing blood and for introducing IV fluids and lines.
The ulnar nerve, located in the elbow, is a prime target for nerve damage during the general anesthesia process. Ulnar nerve damage is more common for male patients and is also known to have a delayed onset of symptoms making it difficult to determine whether the injury came from the anesthesia intravenous line or from another activity or injury all together. Some patients may also develop what are known as perioperative peripheral nerve injuries, which occur during the surgery due to the position of the arm. Some patients, especially those with a serious medical condition or poor medical history, are more likely to sustain these types of injuries.
As a patient, you can help yourself avoid nerve injuries by telling the anesthesiologist and his nurse ahead of time whether you have medical conditions like heart disease or diabetes, that could cause you to develop a perioperative peripheral nerve injury, or if your have weak nerves in your arms, or previous damage to your ulnar nerve.
However, it is up to the doctor to ensure that they are properly monitoring your vitals and ensuring they are following medical guidelines for arm positioning and paying attention to how your arm looks throughout the procedure to ensure that you do not sustain nerve.
Part of keeping yourself safe from injuries caused by general anesthesia is ensuring that you are completely informed of the benefits, the risks, and the alternatives when it comes to having anesthesia and undergoing surgery.
Before you have a procedure done, you have the right to meet or check the background on the anesthesiologist and decide whether or not you are comfortable with this individual. This can be a very important step in getting ready for your surgery. In many cases doctors do not tell you that you have the right to choose your anesthesiologist as long as they can work in the same surgical facility as your doctor. If you have time before your procedure, you should take the time to reduce your risk factors wherever possible, such as stopping drinking, losing weight, quitting smoking, and ensuring that your medications are up to standard with anesthesiology. You should also arm yourself with knowledge about your family and ensure that your medical history has nothing in it that will prevent you from safely accessing general anesthesia. The more prepared you are for your appointment and your surgery the less likely you are to experience complications.
Sometimes, no matter what you do, you will still sustain injuries as a result of having general anesthesia. If the doctor's negligence or mistake caused your injuries you may have a need for a skilled personal injury attorney. Phoenix injury attorneys Mark and Alexis Breyer at Breyer Law Offices, P.C. can help you get the information you need to get help after you've been injured. This information and advice can help you not only with your legal needs but also with personal and medical matters throughout the recovery process.
- General Anesthesia - Mayo Clinic
- Effects of Anesthesia on Brain & Body - When Seconds Count
- Side Effects of General Anesthesia: Short-Term and Long-Term Effects