Regional Anesthesia for Hip Replacement Surgery
Common Questions and Our Answers
This handout explains to most common anesthesia used for hip replacement surgery.
What type of anesthesia will I have?
Hip replacement surgery is often done
under regional anesthesia. If for some
reason, this is not the best option for you,
you will have general anesthesia. When
you have general anesthesia you will be
fully asleep and have a breathing tube.
At the end of surgery, we will take the
breathing tube out and wake you up. On
the day of surgery, your anesthesia
doctor will talk with you about the pros
and cons of both types. Together you
will make the best plan for you.
What is regional anesthesia?
This type of anesthesia uses a shot of
medicine to numb part of your body.
This is called a combined spinal epidural
(CSE). The medicine goes into the fluid
that is around your spinal cord through a
small catheter (tube). This tube is used
to send numbing medicines (local
anesthetics) close to the nerves.
They work in the same way as numbing
medicines that are used at the dentist,
except it numbs nerves where the
surgery will occur. You will become
fully numb below the waist from the
single shot of numbing medicine, or
spinal, for 2 to 4 hours. The epidural can
be used in the operating room (OR) if
more numbing medicine is needed.
What is the process?
The catheter is put in while you sit up or
lay on your side. You may get medicine
to help you relax when it is being placed.
The process is:
1. Your back is cleaned with germ-
2. A numbing medicine is placed in
your skin where the needle will
3. The needle is gently pushed into
your back and the small, plastic
catheter is placed (this catheter is
about the width of a guitar string).
You should feel very little pain
4. The needle is taken out and the
plastic catheter is taped in place.
You may be sedated while the CSE is
If I get a CSE, will I still be asleep for
Usually with a CSE you be sedated
during surgery. You should not feel any
pain because you will be numb from the
CSE. Most patients remember very little
with sedation. They wake up faster and
feel less groggy vs. general anesthesia.
When can I get a CSE?
On the day of surgery, after you check
into First Day Surgery, an anesthesia
doctor will talk with you about your
anesthesia plan and possible CSE.
What are the risks CSEs?
Although very safe, there is a small risk
Common risks include:
Other risks include:
A drop in blood pressure
(easy to fix but needs to be
Numbness to one side of
One side of your body not
working at all
A “spinal” headache (1 out
of 100 patients). This type
of headache gets worse
when you sit up and better
when lying flat. These
headaches can be severe,
but are treatable and have
no long-term side effects
Infection or bleeding
around the spinal cord
Nerve injuries (rare)
The epidural can be placed
into blood vessel (rare)
which can have serious
effects on heart rate and
Who should not get CSEs?
Patients with bleeding problems
Patients with severe infections
Patients with prior back surgeries
may have a harder time getting a
CSE. This warrant a talk with the
anesthesia doctor. (If you have
had major back surgery, it may
be helpful to have prior x-rays or
surgical records for the doctor to
On the day of your surgery you and your
anesthesia doctor will talk about whether
or not a CSE is right for you.
Your health care team may have given you this information as part of your care. If so, please use it and call
if you have any questions. If this information was not given to you as part of your care, please check with our
doctor. This is not medical advice. This is not to be used for diagnosis or treatment of any medical condition.
Because each person’s health needs are different, you should talk with your doctor or others on your health
care team when using this information. If you have an emergency, please call 911. Copyright © 8/2016
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