Hip and knee replacements are usually performed under a spinal anaesthetic which will numb you from the waist down.  We offer our patients intravenous sedation so that you are snoozing lightly during the procedure.  We use the same drugs that we use for general anaesthesia, just in much lower doses.  While we try and have everyone asleep for the full duration of the surgery the level of sedation is such that it is possible for a small number of patients to have some recollections of parts of the procedure.  This is usually some of the conversation between the surgical team or other noises.  You cannot see any of the operation due to the sterile drapes that are in place, and you are not able to feel any painful sensation, although it is common for you to feel some movements and light touch, particularly to those parts above the waist where there is no spinal block.


Most shoulder surgery is performed with a combination of a general anaesthetic and a local anaesthetic block.  The local anaesthetic block is inserted before the surgery starts and will last for many hours after the surgery so that you are comfortable in the post operative period.  We perform the block using an ultrasound machine so that we can see exactly where the tip of the needle is in relation to the large nerves in the side of your neck that supply your shoulder.  This decreases the likelihood that the nerves can be damaged by the needle, but even using this technique there is still a small chance that this can happen.


Most other orthopaeic procedures are performed with a general anaesthetic, many of them as a day case.  We will use short acting drugs so that you wake up quickly. While you are asleep we will put a soft rubber breathing mask in the back of your mouth so you can breathe air and oxygen. This mask can give you a dry or raspy sore throat for up to a day afterwards. Once the operation is finished, the anaesthetic drip is turned off you will wake up very quickly. Some people can remember the breathing mask being in place as they wake up, do not worry, this is perfectly normal.

If you are going home the same day we will give you a prescription for pain relief to take home with you. If you are staying in hospital then we will prescribe pain relief and anti nausea medication for the duration of your hospital stay, as well as further medication for you to take home when you are discharged from the hospital.

You should not take an anti inflammatory if you have had previous problems with gastric ulcers. If you have had ulcers please let us know so we can prescribe an alternative for you. Similarly you should stop taking anti inflammatories if you notice they are causing stomach upset.