ANAESTHESIA AND PAIN MANAGEMENT FOR ACL RECONTRUCTION
Anaesthesia for this surgery is a combination of a full general anaesthetic and local anaesthetic techniques for pain relief. The general anaesthetic is delivered into your drip via a computer assisted total intravenous anaesthetic (TIVA) without anaesthetic 'gases' which reduces the risk of nausea and improves wellbeing after surgery. A brain wave monitor will also assist with determining your depth of anaesthetic and dosage of anaesthetic agents.
Pain relief is important as this can be a painful operation to recover from. I will be giving you injectable long acting anti-inflammatory and a strong morphine based pain medication during the operation.
The surgeon will inject a large amount of local anaesthetic into the knee joint while you are asleep and I will supplement this with an ultrasound guided injection of local anaesthetic into your thigh. This is called a "nerve block". These should help keep you comfortable after your operation. The graft for the ACL reconstruction will be taken from the back of your thigh and so you may experience some moderate hamstring discomfort but this should not be severe.
If you have any discomfort when you awake, you will be able to tell us and additional intravenous medication will be given immediately until you are comfortable. Later on the ward you will have regular paracetamol, anti-inflammatory. For any additional discomfort, Tapentadol (Palexia ) IR (immediate release) tablets will be available every 2 hours during your 1st night in hospital.
This should be well tolerated but may make you feel drowsy. Nausea and itching are possible side effects of the pain medication but Tapentadol is general well tolerated and usually better than other strong pain relieviers such as ENDONE or TARGIN.
I will give x2 additional preventative medications to reduce your risk of nausea. Once you get through the first night your pain should be reasonably well controlled. You need to be careful when trying to mobilise especially during the 1st 24h due to risk of falls as a result of dizziness, and weakness of the thigh muscles. Please take care and wait for the nurses to assist you with mobilising.
On discharge you will be provided with paracetamol, anti-inflammatory and Tapentdol (Palexia) tablets. You may need the PALEXIA for 3-5 days but not usually longer than this. You can expect to experience swelling of the knee joint for at least 2 weeks and possibly up to 6 weeks after your surgery. This can be managed with resting and regular ice packs as needed. If there are any problems with your wound please contact the surgeon.