anesthetic for knee surgery

[wiscan]

I am having a diagnostic scope of my knee to determine if I am a candidate for a partial knee replacement or need a complete knee replacement.  The orthopedic surgeon mentioned that the most likely anesthesia would be an epidural rather than a general anesthesia.  There is little information on epidurals online.  Is it given directly into the spine, like the spinal they sometimes give during labor?  Someone told me that, for knee surgeries,  the epidural is actually given below the spinal cord and there is no risk of injury to the spinal cord.

Could someone please comment on the risks of epidurals vs general anesthesia and if this is the most common anesthesia for knee surgeries.

Thanks.

[Michael L Gross, MD]

Both general and regional anesthesia are inherently safe for knee arthroscopy.  One or the other may be preferable for you depending on your general health and the specifics of your medical history.  This is usually determined by your anesthesiologist.  I know of no study that documents the frequency of one anesthesia technique over another for simple knee arthroscopy.  My personal preference is general anesthesia for knee arthroscopies; I find it is quicker and can give the anesthesiologist greater control.

However, for knee replacement surgery, there is a definite preference for regional anesthesia.  There is a decreased risk of post operative deep vein thrombosis (blood clots), and the spinal catheter can be left in for postoperative pain management, which allows for a clearer head and faster mobilization.

[wiscan]

Thank you, once again, for your advice.  It is definitely helpful for patients to be able to run specific questions past a doctor who is completely objective.