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Anesthesia for ACL Surgery (7162)

Anesthesia for ACL Surgery (7162) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Surgery


Anesthesia for ACL Surgery

It is important to partner with your surgeon and anesthesia doctor to choose the best pain relief
for you.

Types of Anesthesia
The two types of anesthesia used in ACL
surgery are general and regional. Your
options will be discussed with you on the day
of surgery.
ξ General: 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.
ξ Regional: Spinal and epidural
blocks are used. Medicine is put in
your back that will stop the feeling
in your legs for 2-3 hours. You will
also get medicine to help you relax.
Most people do not remember their
surgery; but, depending on your
level of sedation, there is chance
you could.

If I have regional, will I be awake for
You can either be awake or given
medicine to help you relax. You do not
see or feel the surgery take place. Your
anesthesia doctor will help decide the
right level of sedation for you. Sedation
can be light, moderate, or deep.

How is the epidural or spinal block done?
These types of blocks are given in your back.
You will be asked to sit up or lay on your
side for this. The process is:
1. Your back is cleaned with germ-free
2. A medicine is used to numb your skin
where the needle will go. (This may
sting, but after that you should not feel
much at all).
3. The needle is then pushed into your
back and is used to place either
numbing medicine (in the case of a
spinal) or a small plastic tube (in case
of an epidural). The needle is taken
out after the medicine is given or the
catheter is in place.
4. The medicine goes to your nerves and
blocks pain. You should feel numb.
You may not be able to move your
legs. This is normal.

What are the pros and cons of general?
Pro: You will be fully asleep for surgery
and have a breathing tube. Most people do
not remember anything.
Con: You may feel nauseous and sleepy
when you wake up.

What are the pros and cons of regional?
Pro: You should not remember much, but
you will not be fully asleep. You are more
likely to eat sooner and have less nausea.
Con: There is a small risk of a bad
headache after the block.
Your anesthesia doctor will discuss your
health issues that make one or the other type
better for you. Both are done often and for
most patients, equally safe and effective.
The risk of any big problems (heart issues,
trouble breathing, death, and paralysis) is
about equal for both types.

Other Options for Pain Relief
IV (given in a vein) or oral pain medicines
help dull your pain. They may not fully get
rid of the pain. These medicines are most
often used in the recovery room.

Femoral nerve blocks can be given as a
single shot or nonstop through a catheter.
They are used to help pain after surgery.
Local anesthetics and other medicines are
used to reduce pain from these blocks. The
femoral nerve (in your groin) supplies feeling
to the front of the knee and the knee joint. A
single shot lasts for 12-24 hours. If left in,
the block works as long as the catheter is in

How is a femoral nerve block done?
Before the block is done you will get
medicine to help you relax/sleep.
ξ A medicine is used to numb your skin
where the needle will go. (This may
sting, but after that you should not feel
much at all).
ξ A special needle or catheter is placed
near the femoral nerve.
ξ Local anesthetic is used block out pain.
ξ Your thigh/leg will be numb and your
leg muscles will be weak while the
nerve block is working.
ξ After the catheter is taken out, feeling
in your thigh should go back to normal
within a few hours.

What are the pros of a femoral block?
Femoral nerve blocks are used for nearly all
patients having ACL surgery. We feel it
lessens your pain and the amount of oral
pain medicine you use. Oral pain medicine
(narcotics) can make you feel sleepy and
nauseous, so we try to limit their use by
using nerve blocks.

Placing a catheter next to the nerves helps
the block last longer. While femoral nerve
blocks decrease pain in the front of the
knee, they do not work as well for the back
of the knee. This means that patients
having ACL reconstruction with hamstring
grafts may have pain in the back of the
thigh and knee despite the nerve block.

What are the risks of a femoral block?
Like any other procedure, there are risks.
Your anesthesia doctor works hard to avoid
them. These include:
ξ Nerve injury (rare). It can be caused
by the needle hitting the nerve,
bleeding or infection. To prevent this,
please tell your anesthesia doctor if you
have any sharp or radiating pain when
the needle is being placed or when you
get the medicine.
ξ New tingling, numbness, or motor
dysfunction after a nerve block has
worn off. If this occurs, you should call
ξ Falls. This is due to your legs being
weak from the block. You must wear
your knee immobilizer (locked into
position) any time you walk while the
block is working. You will need help
walking for as long as this block is

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 your 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. University of Wisconsin Hospitals and
Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7162.