Your Anaesthetic

Who will your anaesthetist be?

In most cases it will Dr Amisha Mehta.

I graduated in 1988 from the University of Wales College of Medicine and was appointed Consultant Anaesthetist in Llandough Hospital and the University Hospital of Wales in 1997. My main interests are in orthopaedic anaesthesia and day case surgery and I have been working with Mr Morgan-Jones for 5 years.

What types of anaesthesia are commonly used?

Regional Anaesthesia

The most common regional anaesthetic that we use is a spinal anaesthetic. This involves injecting a small volume of anaesthetic near to the nerves in the lower back (see picture),

which will feel totally numb from the waist downwards. This feeling will last for between 2-4 hours. It is possible to remain awake during your operation (you will not be able to see any of the operation) however many people prefer to have some 'sedation'. If this is your preference we are usually able to give you drugs that will help you feel sleepy and relaxed whilst your operation is taking place.

This is the usual anaesthetic I will use for your knee replacement (usually in combination with a nerve block)

The next most common regional anaesthetic is an epidural (it is similar to, but not identical with. a spinal). A small plastic tube (an epidural catheter) passed through a needle and placed close to where the nerves leave your spine. Local anaesthetic and other pain relieving drugs are injected through this tube and will numb the lower half of your body. It is generally used for operations which will take longer (say over 3 hours) or operations, which are expected to be very painful afterwards. The catheter will remain in your back (you will not feel it there) and we can use a machine to keep giving you pain killers through this tube for up to 72 hours after your operation.

General Anaesthesia

This is a state of controlled drug-induced unconsciousness. Anaesthetic drugs injected into a vein are carried to the brain by the blood. They stop the brain recognising messages coming from the nerves into the body.

This is the usual anaesthetic I will use for your arthroscopy or ACL repair.

Nerve Blocks

This is an injection of local anaesthetic close to the nerves, which go to your leg. Part of your leg will feel numb and pain free for up to 24 hours after your operation. This means that you should need less strong pain relieving medicine both during and after your operation which should make you feel less drowsy and/or sick afterwards.

If you are having a knee replacement or an ACL repair your will usually have a nerve block in addition to your regional or general anaesthetic to give you extra pain relief.

Local Anaesthesia

A local anaesthetic numbs a small part of your body. It is used when the nerves can be easily reached by drops, sprays, injections or ointments. You stay conscious but free from pain. If you are having a knee arthroscopy we usually inject local anaesthetic into the joint to provide extra pain relief.

The choice of anaesthetic depends on many things including:

Side effects, complications and risks

Using modern anaesthetic techniques, serious problems are uncommon. Risk can never be removed completely but modern equipment, training and drugs have made anaesthesia a much safer procedure in recent years.

The risk to you as an individual will depend on:

Everyone varies in the risk they are willing to take. I will be happy to advise you if you are concerned.