Dear doctor, I'm very nervous about having a spinal anaesthetic and pain relief. What can I expect?

01 May 2018

Q: I am due to have a knee replacement surgery in a few weeks and am very nervous about having a spinal anaesthetic and pain relief. What can I expect?

A: These are common questions from patients having knee replacements. Before your surgery, you will be invited to attend 'joint school', as well as a one-to-one session with one of our pre-assessment nurses which will give you an opportunity to talk about your concerns.

When it is time for your operation you will be asked to sit on the bed in theatre. It’s a busy environment, but don’t worry, that’s quite normal. Once in theatre we usually offer you a spinal anaesthetic rather than a general anaesthetic. A spinal is considered safer and provides good pain control. The procedure is usually as follows.

As you won’t have been eating or drinking normally for a while, your anaesthetist will put a cannula into the back of your hand and give you some fluids along with antibiotics to help prevent post-operative infection.

The anaesthetist will then ask you to cuddle a pillow to make your back nice and round and spray your back with a cold spray before administering the injection. You will notice warmth spreading down your back and into your buttocks and be asked to lie down before being given additional medication to help you sleep.

The next thing you will be aware of is waking up in recovery and it will all be over. You should feel bright and awake and your pain will be well controlled.

Post-operative pain is acute at first but decreases over a few days, weeks and months. Your nursing team will do all they can to minimise and manage your pain through good pain relief. There are many options of drugs and treatment routes available to treat pain and your nursing team will find the right options for you. Everyone has different pain control requirements, therefore, to work out what is right for you and ensure good pain control, you should let your nursing team know what pain relief you are currently taking.

Don’t be a hero with pain; there are no prizes for not using pain relief! It is much more important to be comfortable so that you can begin your physiotherapy and recovery, and soon begin to feel the positive benefits of your surgery.

Carron Evans is a Clinical Pharmacist at Spire Portsmouth Hospital.


The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

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