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Author Topic: General Anesthesia or Epideral for knee surgery? Meniscus repair success?  (Read 20879 times)

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Offline Durga

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I've decided to have my meniscus repaired, which was a huge decision because I'm petrified of surgery, but need to get back to dancing.  Now I have to decide whether I want to be knocked out completely and have a tube breath for me or risk nerve damage with an epideral...I'm petrified of both...I know the statistics are in my favor, but would like to hear from those about the anesthesia process.  Also, I'm looking for positive feedback for meniscus repair...do you really ever get back to normal?

shadehawk

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Durga,

Hi, I have had surgeries for other things aside from knees and have always had general anesthesia.  If you give them an accurate weight there are not many problems with this method.  The only think I can think of is being woosy afterwards sometimes, but that could be also from meds.....

Other people on here can tell you more about the nerve blocks and other forms of anesthesia.

Usually the anesthesologist will also help you with the decision making.

Good luck with whatever choice you make.  Let us know how everything goes.

Shade

Offline blackbeltgirl

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Durga -

I've had both for different knee surgeries.

Epidural:
+ They can give you sedativs so you sleep through the surgery, or you can stay awake
+ They give you a mild sedative before they give you the injection
+ I felt no pain from the procedure, and most people have no complications
- You cannot leave until you can get around on your own (with your crutches), go to the bathroom, and eat
- Meeting those requirements generally takes 5-7 hours
- A lot of people put do too much that first day, because they don't feel it yet

General:
+ It's very safe, as long as you provide accurate info
+ You generally wake up within 30 minutes of completing surgery.  That means you get to go home sooner
- Some people end up with a sore throat from the breathing tube
- Some people get pretty nauseated from the anesthetic.  If you have a tendency to be sensitive to drugs anyway, you can ask for an anti-nausea medication with the anesthetic

I was happy with the epidural I had ay 17.  I wanted to have one again for my next surgery at 30.  They talked me out of it when I realized it meant hours longer at the surgical center instead of at home.

You will meet with the anesthesiologist beforehand, and he/she will also be able to help you with your decision.  And while there are risks associated with any surgery, I wouldn't get too worked up about the anesthesia.  That parts over within a couple of hours, while rehab takes longer.  Focus your energies where you can help your own recovery.

Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
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Offline coldfeet

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I didn't really get a choice, the dr. really recommended an epideral when i was about to go under the knife...good idea to talk to them first, I didn't...all went well, sure you'll be fine whatever you choose...David

Offline Heather M.

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Since they anesthetize you during the epidural anyway (they want you relaxed and don't want your thigh muscles tensed, they told me), I just skip thw whole 'needle in the back' thing and go straight for the general.  As far as I'm concerned, it's the only way to go.  You get an injection of joy juice on the way back to the OR (or in the pre-op area, depending on the anesthesiologist) and for most people, it's lights out after that.  I stay awake until they give me the big stuff, because I'm pretty resistant--but that's me.  My anesthesiologist last time said he'd never seen anyone not go blotto after the Versed injection in the IV--I definitely felt loopy, but wanted to talk to my surgeon one more time....to ask if he would do microfracture on my knee, which he has adamantly refused.  But hey, it was 6am and I was loopy and it seemed like a good idea at the time  ;D  Anyway, we were cracking jokes and everyone was REALLY nice to me--got me blankets and adjusted my IV and chatted.  It was really no big deal.

The best part about the general for me is that you shut your eyes for a second and then it's OVER.  Time really flies when you're under general anesthesia, and the worries just go away.  I always wake up very quickly and have never really spent more than 30 minutes in post-op.  I've always asked for anti-nausea meds (Zofran) so I always feel really good when I wake up--just sleepy.  Last time, I had a post-op femoral nerve block because I've taken pain meds for so long they were worried about me not getting any relief.  So I felt absolutely fantastic--sitting up in bed, chatting, taking phone calls.  I even had a cheeseburger and fries for dinner post-op!

Anyway, there is no one method that is right for everyone.  Usually, the OS has his or her preference.  I've had procedures at a day surgery center where they didn't offer epidurals at all--so TKR and other 'big' surgeries that needed the epidural for post-op pain management had to be scheduled elsewhere.  That's one of the main reasons to do an epidural--so the anesthesiologist can control the patient's pain post op.  That shouldn't be a big concern with a meniscal surgery--you should do just fine with oral pain meds. 

This is something you definitely want to discuss before you get too wedded to one method or the other, as the choice may not be up to you.  As for the tube down your throat--I really wouldn't worry.  I've never even noticed that I had one--sometimes I wonder, because after an open surgery on my abdomen, my throat was sore for days.  But I had to be deeply under for that procedure, whereas surgery on a limb doesn't require the level of anesthesia...at least, that's how it was explained to me.  So I wouldn't worry about the trach tube--it doesn't go all the way down, and it's only there as a precaution--I don't think it really gets used for knee surgeries.  It's really never been a problem, and I've had 9 generals in my life, 8 of them in the last 3.5 years.

You're going to do just fine.  The surgery is really the easy part--you don't have to do anything but lie back and breathe!  The challenge begins with PT, and luckily your rehab should be fairly straightforward.  My brother has had two menisectomies, and he bounced back each time.  The first time it took five weeks to fully recover, because he had a very bad reaction to the epidural anesthesia (so-called spinal headaches due to the interruption of spinal fluid during the anesthesia), and the second time (he chose a general this time around) he was off his feet for a week or so.  Easy as pie--he doesn't even remember the name of his knee surgeon, that's how forgetable the experience was!

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
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Offline walkinboss

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I've had the epidural twice for knee surgeries and general 16 times for other surguries (incluing 1 knee).

I've got to tell you this.....I could walk and load bear for several days after the epidurals before I could stand up straight because of the pain in my lower back.  I've only been nauseated (sp) once from general anesthesia and that was in 86.

I've never been afraid of needles in my joints (other than the spine) or blood needles, but the thought of a BIG needle purposely being stuck into my spine gives me cold shivers now.  Being wide awake and not being able to move your DEAD legs certainly gives you something to think about too!


:-)

Offline Alla

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I had both a spinal block and a general for my ACL reconstruction.  The general was obviously to knock me out during the surgery, but the surgeon and the anesthesist both said that the spinal block (which was a one off injection in the spine) was for pain control after the surgery.  I was given the spinal block after I was already under the general.... They said that it has been shown that if you can prevent pain directly after surgery then you make the healing process speed up a bit.  I woke from my surgery not being able to feel my legs for about 6 hours... I can honestly say that I've had very little pain through the whole ordeal.... I'd not do it any other way. 

Alla 
   
Torn ACL December 04
ACL Reco May 05
Cleared to return to sport May 06

Offline Sharon

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For my first 2 knee surgeries which were scopes, I had general anesthesia. For the last 2 I had, which were major open surgeries, I had epidural anesthesia. There are positives and negatives to both. With the general they just put the "happy juice" into the IV and it feels like seconds later it's over. However, the general did make me feel very very tired and not so good for days afterwards. As for the epidural, I always insist that I get put to sleep with the sedative before they do the needle for the epidural so I've never had to feel that. With the sedation it also feels like the surgery lasts about a second and it's over. I know some people elect to stay awake with epidural anesthesia or have very light sedation but I don't want to know anything that's going on so I have to be given heavy sedation to insure I'm out for the entire thing. Epidural anesthesia also provides very good pain control afterwards. For my last surgery they left the epidural in for pain control after the surgery because I'm very sensitive to morphine(it gives me hallucinations)and it worked really well. They used a different medication in it for the pain management though in that it didn't numb my legs, it was more localized to just the surgical area. The only negatvie that I have with the epidural is that the numbness from the surgery takes a really long time to wear off on me. They don't let you out of recovery until you can feel your legs again so last time I was in recovery for over an hour waiting to get the feeling back in my legs. It was inpatient surgery but they didn't want to bring me up to my room until they made sure the epidural from the surgery was wearing off. I'm having another surgery on July 18 and I know I'm going to have epidural anesthesia again. My surgery is at the Hospital for Special Surgery in New York City and that's their method of anesthesia for most knee surgeries, unless there's a medical reason not to. Talk to the anesthesiologist and your OS and they will help you to make the decision that's best for you. Good luck!

:)
Sharon
Left knee:
LR-5/99 & 9/01
Distal realignment and LR 7/02
TTT revision 6/03
screw removal/MUA 10/03
d/x with severe patella baja
7/05 patellar tendon replacement w/piece of quad tendon
4/07 OATS

Offline keljims99

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I have had both types of anethesia for various things...I can tell you that you do get a bit of a "hangover" from the general for a few days, but the epidural can cause lasting back twinges that can be quite uncomfortable. I also have had very bad reactions to the epidural such as not acheiving total anesthesia and getting very hypotensive and nauseated. The general can cause nausea too, but if you ask for a scpalamine patch behind the ear, it usually doesn't become a problem. General anesthesia is very safe these days.( I've had it 5 times in the past year, and people in long-term treatment in burn units get it sometimes every other day for weeks and months.) Don't let fear guide you, becuase a lot of the old stories you hear just don't apply any more. Oh, I did have a minor sore throat after general, but it went away in a day. Good luck!  8)

Offline PattiAnn237

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I would go with the general.  I talked to an anesethiologist at my last knee surgery, and he said he actually prefers patients to have a general, he said they seem more calm before and after surgery. But to some people the fear of being "knocked out" is too much.  I have personally been under general 4 times and never had a problem.  Good luck! ~Patti
25 y/o
Left knee- lateral tilt, lateral tracking, arthritis
LR 8/5/04 (failed)
Diagnostic Scope- 5/2/05 (scar tissue removed)
Holding off on TTT till I can get through school!

Offline stgiles16

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I have had spinal, epidural and general for various surgeries (always general for the knee ones) and I highly reccommend general. I did not have good reaction to the other two.
good luck
ask for anti nausea meds before hand just to be safe.
missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012