Meniscus :

anesthesia for arthoscopy? - - Posted by blackbeltgirl (blackbeltgirl), 7 December 2004

I had knee surgery back in 1991, and my choices for anesthesia were general or epidural.  I have surgery scheduled for tomorrow, and I'm wondering if they now do meniscectomy using local.  What choices were you given for anesthesia?
Posted by sjugradgirl (sjugradgirl), 7 December 2004

When I had mine done in October, I was given the choice of local or general. I got general. I hope this answers your question.
Posted by SallyW (SallyW), 7 December 2004

I'm scheduled for Thursday; I have been told to not eat after midnight tomorrow, so I'm assuming I'll get a general.

Epidurals are easier on the body, and you do wake up faster. But - maybe I'd rather have a general so I'm not aware of them poking around down there. And - do the docs like generals because that way you are quiet and out of their hair (so to speak) while they're working?

If you had the choice of a local, wouldn't they have you make that decision ahead of time so you wouldn't have to starve yourself before?
Posted by blackbeltgirl (blackbeltgirl), 7 December 2004

You have to starve yourself no matter what form of anasthesia you choose.  You need an empty stomach for the sedation as well.

I've had all 3 (general, epidural, and local), and prefer epidurals.  I'd like to stay awake and watch the surgery (I just want enough sedation to keep me from messing up their work).  But with a local you get to leave sooner.  I'm not sure if there's more pain with a local - I had that for foot surgery.  I just wasn't sure if it was even an option.  

Good luck with your surgery.
Posted by blackbeltgirl (blackbeltgirl), 7 December 2004

And Sally - you can be fully sedated no matter what you choose.  You can have local, and have no idea what's going on until you wake up ini the recovery room.  Drugs are wonderful things.  
Posted by bwalling (bwalling), 7 December 2004

Call me nuts, but I'd like to be awake and able to watch.  I find it very interesting, especially when it's me that's being operated on.

I would imagine that if you get a local, you can get something to help you relax.  I had a local for my vasectomy, and I was given a couple of Valium and instructed to take them an hour before arriving.
Posted by SallyW (SallyW), 7 December 2004

Hmm. Okay. That's interesting. You learn something new every day!

Another question (which I hope will be helpful to the original poster as well) - are there limits as to what types of procedures can be done with a local and/or epidural?

I too am scheduled for meniscus clean up (not repair). That's what the MRI indicated. But - if he finds something else (I don't know what else, but I've been really uncomfortable) - I want him to fix it so I don't have to come back for another procedure. I wouldn't want them to not be able to completely fix me because they started out with the wrong kind of anesthesia...if that makes sense?
Posted by blackbeltgirl (blackbeltgirl), 7 December 2004

I don't think there are any limits on the epidural, as long as it's below the waist.  Doctors prefer it, it's much easier for the patient, etc.  YOu can stay awake, be partially sedated, or completely sedated.  (When  I had my 1st surgery I told the anesthesiologist to hit me on the head with a frying pan if he couldn't sedate me, because otherwise I'd drag myself off the table.  Now I want to watch.)

I think local has more limitations.  It may be preferred for shorter duration procedures.  I hadn't heard of it being used on knees, but that's why I was asking.

My surgery is tomorrow afternoon.  If I get the chance to post Thursday morning, I'll let you know what I find out.
Posted by bwalling (bwalling), 8 December 2004

A spinal and an epidural are two different things.  They are similar, but the spinal actually involves the needle going little deeper (into the dura), and doesn't require the constant flow that an epidural does.  

If you've had an epidural, you may have noticed that they brought in a pump and hooked it up to keep the juices flowing into your back, and keep the pressure constant.  There is risk with an epidural that it can come loose during the procedure, and you will begin to feel pain again.  This sucks (it happened to my wife when she was in labor), but it can be put back in.

With a spinal, there is a fairly significant risk of a "spinal headache".  This is caused by a loss of fluid pressure in the spinal column.  Sometimes, the hole from the needle doesn't quite close up, and the fluid leaks out.  It is fairly easy to resolve with a procedure called a blood patch (they take some of your blood, and inject it into the spinal column where they did the spinal, and it clogs the hole).  The headache is incredibly vicious.


I'm writing this from memory from my wife's two childbirths.  Her first was an epidural, which came loose and had to be reinserted.  With the second, she opted for the spinal out of fear that the epidural would come loose again.  The spinal worked great, but she ended up with the headache.  I don't have much information on the frequency of either of these complications, but we were told the headache occurs 10-20% of the time.
Posted by HockeyAirHead (HockeyAirHead), 8 December 2004

Hi. I'm new here, but I just had mine done last week and due to having sleep apnea and the procedure being done at a surgery center, they would not use general anesthetic.  I had a knee block done and was also sedated.  

I was scared to death when I found out I'd be having either a spinal injection or a knee block thinking I'd be listening to the whole procedure, but I was out cold within minutes of entering the operating room.  

I hope that helps.
Posted by SallyW (SallyW), 9 December 2004

What is a knee block? A local type anesthesia or more? I ran a google on it just now and saw a web site that mentioned a knee block being administered through 4-5 different knee injections? True? Or can they do the whole thing through your IV? I do NOT like needles in the knee - I had one once that sent me through the roof - never again!!!!!

Compared to my other knee operations, this one should be easy, but I'm still a wimp about knee stuff - I hurt now, and I really don't want any more discomfort tomorrow morning than I can avoid!

I'm starting to think about an epidural, although I'm having a few doubts - having the thing come loose during child birth would be bad enough - I'm scared to think about that happening while they are cutting! Yeow!

I've never heard of an outpatient center not doing generals...I've had them before and found them easy. Kind of a long day at home shaking the grogginess, but being so sleepy makes me get the rest that I know I need.

Posted by HockeyAirHead (HockeyAirHead), 9 December 2004

The knee block they did on me was exactly that, several injections into the knee.  They put lidocaine in first, and they do the injections at the same spots where they will be inserting the arthroscopic instruments.

They had given me some sedative medication before they started these injections, and I can honestly say that the first shot, where they put in the lidocaine, hurt a little, but I don't even remember the others.  

I hear you about not wanting shots into your knee and like I said, I was absolutely terrified about having this done without a general.  I don't like needles much, especially when they are put into an already sore area!

I didn't sleep at all the night before the surgery, but it went quite smoothly and I found that most of my fears were largely unjustified.

Oh... and the outpatient place does normally do generals, but won't give them to people who have Obstructive Sleep Apnea.  For me to have had a general I would have to have had to reschedule the procedure and had it done in the hospital.  They now want anyone with Sleep Apnea who has general anesthesia to stay overnight in the hospital as a precaution.
Posted by blackbeltgirl (blackbeltgirl), 9 December 2004

Thanks for all your answers.  Turns out, my surgery center prefers to use general, because they can send you home faster.  Because I have gotten sick from general in the past, they gave me something for the nausea, and lower doses of the narcotics.

Pain was non-existent yesterday(surgery day), but worse today.  And they wouldn't let me stay up to watch, but I have the surgery on dvd.  heading downstairs to watch that soon.

Good luck healing.

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