1) A General Anaesthetic
If you have a general anaesthetic, you will be asleep throughout your operation. You will be given drugs to keep you asleep and also strong pain killers. A general anaesthetic can be used for any length of operation – from a few minutes to many hours. When the operation is finished, you will wake after about 5-10 minutes, although your may not remember much for the first half hour.
– You are completely unaware of anything at all during the operation.
Disadvantages and Side Effects:
– The anaesthetic itself does not provide any pain relief for after the operation. You will therefore need strong painkillers. These sometimes make people feel sick or drowsy.
– Many people develop a sore throat and dry mouth for a few hours after the operation
– Sometimes you can feel or even be sick. This is more common if you have suffered from it before, so please tell your anaesthetist if it has been a problem. There are medicines available to treat sickness should it occur.
– Older people may become confused and forgetful, but this is usually temporary
– Although uncommon, it is possible to damage your lips, gums or teeth (particularly caps, crowns and bridgework)
2) A Spinal Anaesthetic
A very fine needle is used to inject local anaesthetic around the nerves at the base of your back. This will make you go numb from about the tummy-button downwards. Your legs will go very heavy (in fact you may not be able to move them at all for a few hours).
– You will need less strong pain killers in the first few hours after the operation
– You are less likely to be sick or drowsy. This means you should be able to eat and drink much sooner
– You can be given sedation during the operation, which means that you do not see or hear things if you do not wish to! Some people like to listen to music through headphones, whilst others just catch up on some sleep
– You are less likely to suffer a blood clot in your legs or your lungs
– There may be less bleeding, and you may be less likely to need a blood transfusion
– If you suffer from any chest diseases you may have fewer problems with your breathing
Disadvantages and Complications:
– Sometimes it is not possible to perform the injection, particularly if you have any problems with the bones in your back
– Occasionally your legs do not go numb enough. If this happens, either the injection can be repeated or you can have a general anaesthetic as well
– The needle may leave a small bruise on your back, which may be slightly sore for a few days. It does not cause long term back ache
– There is a small chance of developing a headache afterwards (less than 1 in 100 patients suffer from this).
– Whenever a needle is put into any part of your body, no matter how much care has been taken, a few things can happen by accident such as letting in infection or causing bleeding. It is also possible to damage a nerve. This is so rare that it is not possible to give an accurate chance of it happening. It is estimated to be between 1 in 5,000 and 1 in 30,000.
3) A Nerve Block
This involves injecting local anaesthetic around one or more of the nerves in the leg. This is sometimes performed with you awake, although it may also be done after you have had some sedation or under general anaesthetic. After the operation, your leg may feel numb and heavy for some hours afterwards.
– The block should provide pain relief for a number of hours afterwards
– Because you need less strong painkillers, you may feel less drowsy and sick. If you have a general anaesthetic too, this is often “lighter”, so again you may feel less drowsy.
– Only the leg which has been operated on feels numb (unlike a spinal anaesthetic, which affects both legs)
Disadvantages and Complications:
– Sometimes the block does not work as well as expected. If this happens, you will still be given enough painkillers to make you comfortable
– Occasionally the numbness in your leg can last around 24 hours. This may mean you have to stay in bed after your operation for a short time
– Very occasionally, the nerve may be bruised or damaged. This is sometimes due to the needle itself, but may also be due to infection, bleeding around the nerve, poor blood supply to the leg, the position of your leg during the surgery or sometimes the operation itself. Symptoms such as numbness, pins-and-needles, pain or weakness lasting up to a week are seen after between 1 and 5 out of every 100 nerve blocks (1-5%). Around 95% of these fully recover within 4-6 weeks, and 99% have recovered within a year. Permanent nerve damage is so rare that precise numbers are not available. One estimate is that it might happen in between 1 in 5000 and 1 in 30,000 nerve blocks.