Types Of Anesthesia

What sort of anaesthesia will I have?

There are three major types of anaesthesia: local, general and regional. They can be used individually or in combination as deemed appropriate in order to provide the best possible pain relief and surgical outcome.

To determine which type of anaesthetic – spinal, epidural or general – is best for you both the doctor and yourself will discuss it based on a variety of factors such as your medical condition before surgery, the kind of operation being done, plus other considerations that could affect your wellbeing.

Local Anaesthesia

Local anaesthesia is applied through an injection under the skin of the proposed surgical site. It is a very effective method in dealing with small surgeries such as simple fractures, dislocations of fingers or small lacerations. It can also be used in minor elective procedures such as the release of trigger fingers or removal of skin lesions.

Advantages:

  • Minimal side effects
  • Fast procedure
  • You can go home on the same day, often not long after the procedure is complete
  • Pain relief may last for a few hours following the surgery
  • It can be administered by the doctor themselves, there is no need of for an anaesthetist to be present
  • Administration doesn’t require hospital admission, it can be administered in the clinic or the emergency room

 

Disadvantages:

  • It has limited applications in terms of what surgeries it can be used with
  • The initial injection can sting for the first few seconds after it is administered
  • Only the site where the anaesthetic is injected is numb

General Anaesthesia

General anaesthesia is administered intravenously and by inhalation. This type of anaesthesia works on the brain, leaving you in a deep sleep. Usually application of a general anaesthesia starts in the anesthetic bay where the anaesthetist, along with their technician, connect you to several monitors and insert one or more intravenous access points into your limbs through which medications will be given that will make you drowsy. An oxygen mask is applied to your face and you will be asked to take a deep breath. You may notice a funny smell in the mask, don’t be alarmed this is only the anaesthetic. Once you are asleep the anesthetist will insert a tube into your throat and hook this tube to the ventilator.

It is our routine practice that we use specialised monitoring systems that keep us well informed of the depth of anesthesia at any point to ensure sure there is no chance you will wake up or become conscious during the operation.

Advantages:

  • You will be asleep during the procedure
  • There is no time limit for how long general anaesthesia can be administered which makes it ideal for extensive surgical procedures which require a lot of time in the operating theatre
  • While local anaesthesia only works on the area of the body in which it has been injected, general anaesthesia works on the whole body which allows for the possibility of operating on multiple parts of the body at the same time
  • Allows proper muscle relaxation for prolonged periods of time
  • Can be administered rapidly and is reversible

 

Disadvantages:

  • General anaesthesia is not appropriate for every patient
  • It has some risks, which may be increased if you have pre-existing heart disease or a chronic lung condition. Such risks include the increased risk of deep vein thrombosis
  • It may cause more blood loss
  • It increases the risk of deep vein thrombosis
  • The tube inserted down your throat can leave you with a sore throat and a hoarse voice for a few days following surgery
  • Other side effects such as headache, nausea and drowsiness are also common following surgery

Regional Anaesthesia

Regional anaesthesia involves numbing a specific area of the body, without affecting your brain or breathing. It requires the injection of local anaesthetic to major nerve bundles which supply a particular area of the body such as the leg, forearm, hand, shoulder or abdomen. With this type of you may remain awake and have the choice to watch the surgery on the monitor screen such as in case of knee arthroscopy. Or you may receive sedation to relax you and put you in a light sleep and state of semi-consciousness.

There are a number of different types of regional anaesthesia. The most common are spinal, epidural and plexus block anaesthesia. Spinal and epidural anaesthesia are commonly used for joint replacement surgery of the hip and the knee. Plexus blocks are commonly used for upper limb surgeries.

Advantages:

  • Decreased blood loss during the surgery
  • Decreased chance of lung problems
  • Fewer complications associated with blood clotting following surgery

 

Disadvantages:

  • Its effects don’t last as long as general anaesthesia and thus cannot be used for long, extensive surgeries
  • Requires a more technically demanding procedure of application
  • You will need a urinary catheter inserted during the surgery as you may have difficulty urinating until the effect of anaesthesia wears off
  • Other minor side effects like headache nausea and drowsiness can occur following surgery

 

Will I see my anaesthetist prior to them coming to deliver the anaesthetic?

The anaesthetist and their team will come to you in the anaesthetic bay, where monitors are connected to your chest and limbs, as well as a cuff for measuring your blood pressure. You’ll receive antibiotics for protection from infection, premedication drugs for making you sleepy, and any additional medications or fluids through intravenous access tubes. After this point, you are officially under anaesthesia, so you won’t be asked anything else.

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For further inquiries or to arrange a consultation, please contact Professor Al Muderis’ office at +61 2 88829011 or book an appointment online.

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Professor Munjed Al Muderis
Professor Munjed Al Muderis is an orthopaedic surgeon and a clinical lecturer at Macquarie University and The Australian School Of Advanced Medicine. He specialises in hip, knee, trauma and osseointegration surgery. He is a fellow of the Royal Australasian College of Surgeons and Chairman of the Osseointegration Group of Australia.
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Disclaimer

Information provided via this website is for educational and communication purposes only. The material presented is neither intended to convey the only, nor necessarily the best, method or procedure, but rather represents techniques and procedures used by Professor Munjed Al Muderis. Professor Munjed Al Muderis disclaims any and all liability for injury and/or other damages which result from an individual using techniques presented on this website. Professor Munjed Al Muderis, to the best of his knowledge, believes the information presented is current and applicable to work being done by orthopaedic surgeons worldwide.