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The Department of Anesthesia at St. Helena Hospital has worked with the Coon Joint Institute to refine and streamline the anesthesia process. We continue to meet our goal of high patient satisfaction through improved technics.

Before your Procedure

Prior to the day of surgery, you will receive a pre-anesthesia evaluation by a preadmission testing nurse. During this process, we will take your pertinent medical information and obtain medical tests necessary for surgery. The Department of Anesthesia has worked to eliminate unnecessary testing. In some cases, you may be interviewed by a physician anesthesiologist prior to the day of surgery.

The Day of Surgery

After your arrival to the hospital, a preoperative nurse will direct you to the pre-op area to change clothes. Following this, the pre-op nurse will take some admission information, start an intravenous line, and wash the surgical site. When this is complete, you will meet your anesthesia team.

Your Anesthesia Team

Your anesthesia team will consist of a physician anesthesiologist (MDA) and a certified registered nurse anesthetist (CRNA). The anesthesia team will review the preadmission information and conduct a brief interview with you. Keep in mind that there is some redundancy in the process. This is intentional so that we get the most accurate information possible. Following the evaluation, the anesthesia team will discuss the risks, benefits and alternatives of your anesthetic.

The Anesthesia

Most patients at the Coon Joint Institute receive a spinal anesthetic with sedation for their joint surgery. We prefer spinal anesthesia for 3 main reasons: simplicity, postoperative pain control, and avoidance of general anesthesia. General anesthesia is an option for most patients if a spinal anesthetic is contraindicated.

Prior to the spinal procedure, you will be given a sedative intravenously. This is not designed to make you unconscious, but rather provide relaxation and relieve the natural anxiety patients have prior to surgery. The spinal anesthetic is conducted in the sitting position. The low back is prepped sterilely and a local anesthetic (e.g. Novocaine) is injected to numb the skin and blunt all but a mild pressure sensation. A very small gauge needle is inserted through the numbed area, between the backbones and into the spinal canal. Local anesthesia and a small dose of narcotic are injected and the needle is removed completing the procedure. In most cases, the procedure takes less that 5 minutes.

Following the spinal your legs will begin to get warm and numb. The loss of sensation due to the local anesthetic generally lasts 4-6 hours. The pain relief effect from the narcotic usually lasts for 24 hours. This, combined with medications the surgeon will place directly in the knee joint, greatly improves postoperative pain control.

In the operating room you will receive an additional intravenous sedative. Most patients sleep for the duration of the surgery and awaken when the sedative is discontinued at the end of the procedure.

After a one-hour stay in the recovery room, you will be transported to your regular patient room. You will begin to regain normal sensation in your legs after 1-2 hours in your room.


Why do you prefer spinal anesthesia?

Spinal anesthesia has the advantage of avoiding the general anesthesia “hangover” as well as providing improved postoperative pain control.

Is spinal anesthesia safe?

Yes. For most patients, spinal anesthesia is as safe as any other technique for joint surgery. Some of the possible complications of spinal anesthesia include infection, nerve damage and spinal headache. The anesthesia providers at St. Helena Hospital are very experienced in this technique and have not had a significant complication from spinal anesthesia since the beginning of the Coon Joint Institute and thousands of patients.

What about a “spinal headache”

A spinal headache is a known complication of spinal anesthesia. Typically the headache is related to position—worst when sitting up and relieved by lying flat. The risk of spinal headache falls with increasing age and decreasing needle caliber. The spinal headache may resolve spontaneously or can be cured by another injection in the back called a “blood patch.”

Due to our techniques and patient population, we have a very low rate of spinal headache—currently about 1 in 3000 patients.

What if I need a general anesthetic?

Most patients can safely receive a general anesthetic if a spinal anesthetic is contraindicated. The postoperative pain regimen will be different and include higher doses of intravenous and oral narcotics.

Stop joint pain and get back to life!

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The Coon Joint Replacement Institute values your privacy and handles your personal information with care. Your email address and information is secure, confidential and will not be sold to any third party sources.

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To talk with someone immediately, call 877.747.9991

The Coon Joint Replacement Institute values your privacy and handles your personal information with care. Your email address and information is secure, confidential and will not be sold to any third party sources.

AHI Rebrand