About 95% of the anesthesia for total joint surgery is done regionally, meaning that the specific limb is numbed and the patient is given enough sedative medicines that they do not need to have a breathing tube placed and do not remember the surgery. Regional anesthesia has multiple advantages over general anesthesia for joint patients, according to J.C. Gerancher, M.D., who is head of the Regional Anesthesia and Acute Pain Management Section of the Department of Anesthesiology at Wake Forest Baptist.

In addition to helping patients get back on their feet quicker to participate more in their own physical therapy, regional anesthesia also lets the patients awaken faster to communicate with their families, rather than being drowsy and sometimes nauseated after general anesthesia, Dr. Gerancher said. Other advantages of regional anesthesia are better post-op pain management, earlier and more complete joint mobility, lower risks of blood clots and blood loss, less extreme lung and heart responses to surgery and less long-lasting or chronic pain, he said.

“It’s a real challenge to ensure that patients have the benefits of pain management and yet can do their rehabilitation,” Gerancher said. “The goal requires a truly concerted team approach.” Dr. Gerancher and six other anesthesiologists including Pamela Nagle, M.D., and James Crews, M.D., evaluate patients for the best pain management strategies in the operating room and work together to develop a pain-control plan for their accelerated recovery on the joint replacement unit and at home.