After you're asleep, the most common airway tube used for knee arthroscopy is a laryngeal mask airway (LMA). The LMA in inserted into your mouth, behind your tongue and past your uvula, to a depth just superior to your voice box. The majority of patients will breath on their own during surgery.
We will give you medicine through your vein that will put you to sleep. Once you are asleep, the anesthesiologist will place a breathing tube down your windpipe. You will be breathing a mixture of oxygen, air and anesthetic gas that will make sure you stay asleep throughout the surgery.
Once sedated and asleep under general anesthesia, you will be intubated with an endotracheal tube that will be connected to a ventilator to assist you with breathing during the surgery. You will not feel anything.
Regional anesthesia is a common option for arthroscopic surgery. It numbs only the area of the body that requires surgery. You remain awake and aware. Regional anesthesia includes spinal or epidural anesthesia and peripheral nerve blocks.
Nasotracheal intubation is attempted for head and neck surgery, oral surgery, or for keeping the airway safe while preventing further damage in some trauma patients [1–3]. Nasotracheal intubation is a common airway management method used for anesthesia.
It may be deemed unnecessary for brief procedures involving healthy patients. Nonetheless, intubation is frequently essential during general anesthesia, particularly for lengthy procedures or when patients have medical conditions that increase their risk for complications.
Laryngeal Mask Airway (LMA) – When possible, the anesthesiologist will use a Laryngeal Mask Airway device instead of intubation because it is quicker and causes less discomfort for the patient.
A knee replacement is major surgery, so is normally only recommended if other treatments, such as physiotherapy or steroid injections, haven't helped reduce pain or improve mobility.
Most knee or hip replacement surgery is performed under regional anesthesia, when patients are awake.
For the knee, this would typically be an injection of local anaesthetic into the fluid that surrounds the spine (a spinal anaesthetic) to numb both legs. During this time, the patient is typically aware of some pushing or pulling, but no pain.
Recovery is slow
While it's different for everyone and depends on the type of knee surgery you've had, many people are surprised by how long it takes to recover. The time it takes to start doing simple tasks around the home, get back to work and importantly bending your new and improved knee may catch you by surprise.
Placement of the ETT is referred to as intubation. Before a patient is intubated, the vital sign monitors are attached. The ETT is then placed after the patient is rendered unconscious following the administration of either intravenous (iv) medications, inhalation of anesthetic gases or both.
If you're having general anesthesia, an anesthesiologist will give you medications that make you lose consciousness. After the surgery is complete, he or she will reverse the medication so that you regain consciousness — but you won't be wide awake right away.
The breathing tube is removed at the end of the procedure as you start to awaken. Someone from the anesthesia care team monitors you while you sleep. This anesthesia team member adjusts your medicines, breathing, temperature, fluids and blood pressure as needed.
Because you remain conscious (awake), you will be given sedatives to relax and put you in a light sleep. The three types of regional anesthesia used most often in joint replacement surgery are spinal blocks, epidural blocks, and peripheral nerve blocks.
The surgery itself depends on the type of knee operation. A total knee replacement, for example, will likely take between 2-3 hours. Whereas a partial knee replacement normally takes around an hour. Most knee surgeries take between 1-3 hours.
You can expect some pain and swell for a few months after surgery. Improved surgical techniques and new technology, such as robotic arm-assisted technology, makes the knee replacement recovery process quicker and less painful.
Generally, it takes about 15 to 20 minutes for the patient to become fully conscious and alert.
Try to avoid any negative thoughts about the surgery and use calming techniques, such as baths, meditation and breathing exercises, to calm your anxiety. Keeping yourself busy and active will help keep your mind from worrying about you upcoming surgery.
TKA patients begin rehabilitation during the seven-day bedrest period, with the goals of decreasing swelling, increasing ROM, promoting normal leg control and promoting normal gait with an assistive device.
Patients who can walk on level ground without much difficulty, or who only have pain when going up and down stairs, are not good candidates for knee replacement surgery.
Doctors do sometimes recommend that people under age 60 wait to undergo a knee replacement procedure, because these artificial joints typically last only about 15 to 20 years. If someone younger gets the procedure, it's likely that the joint will need to be replaced again down the line.
Complications of difficult or failed airway management include hypoxia, aspiration, esophageal intubation, emergency surgical airway, cardiovascular instability, cardiac arrhythmias, ischemic encephalopathy, and death.
How Long Can Someone Be Intubated? Most people who are intubated stay on a ventilator for a matter of hours, days, or weeks. However, people on life support or those with chronic hypoventilation caused by severe neuromuscular disorders and other conditions might stay on a ventilator for months or years.