Anesthesia Methods for Knee Arthroscopy
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Choice of Anesthetic
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Four choices of anesthesia are available to knee arthroscopy patients: local, general, spinal and epidural. the choice of anesthesia is usually up to the patient, the patient's physician and the anesthesia staff, According to Drs. John McGinty and Stephen S. Burkhart, authors of Operative Arthroscopy. The choice will often depend on whether you want to be awake or asleep for the procedure.
Local Anesthesia
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Local anesthesia numbs only the knee area. Local anesthesia, in combination with sedation and monitoring by the anesthesia team, is a widely used anesthetic choice for knee arthroscopy, according to McGinty and Burkhart. However, the technique requires an experienced surgical team and a willingness to switch to an alternate method like general anesthesia if necessary. Drawbacks with local anesthesia include limited ability to use a tourniquet, and full manipulation of the leg may not be well tolerated by all patients. Patient satisfaction is high with local anesthetic and generally leads to an easy recovery, according to the physicians.
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General Anesthesia
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General anesthesia puts you to sleep for the entire procedure. According to McGinty and Burkhart, general anesthesia is often a good choice for anxious patients and children. Modern anesthetic agents are shorter acting and have fewer side effects than their historical counterparts. Anesthetics used for general anesthesia commonly include propofol delivered intravenously and nitrous oxide given via a laryngeal mask airway.
Spinal and Epidural
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With spinal anesthesia, the anesthesiologist injects an anesthetic into the spinal canal. The risk of a spinal headache with this method is quite high: the Mayo Clinic puts this figure at up to 30 percent. According to anesthesiologist Michael Mulroy, spinal anesthesia may also lead to itching and longer recovery time in a high number of cases. Mulroy said epidural anesthetics has lower risk of side effects than spinal anesthesia and results in the same level of patient satisfaction as general anesthesia. With epidural anesthesia, the anesthetic is injected into the epidural space in the spine.
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