Interview with Drs. Hadzic and Vandepitte: The Advantages of Regional Anesthesia in Orthopedic Surgery


Anesthetize Differently During Surgery

Less side effects, faster recovery.

Fewer complications, a lower chance of chronic pain, and a faster process of getting back on your feet: for a lot of surgeries, locoregional anesthesia is a better choice than general anesthesia. How does it work? And do you ask about it if you have to go under the knife?

“In the past, all surgeries were performed under general anesthesia. Nowadays, we increasingly use locoregional anesthesia. After the procedure, you are less drowsy or nauseous. In addition, the pain is better controlled. This allows you to move again faster and start rehabilitation. The faster – the better, because that reduces the chance of blood clots and other complications. Here in Genk, locoregional anesthesia is a daily occurrence, especially for orthopedic procedures. Hip, knee, shoulder, hand, ankle, foot: all these surgeries are possible under locoregional anesthesia.”
– Dr. Admir Hadzic

“If done correctly, locoregional anesthesia is very efficient. The patient feels no pain. Anyone who wants to can even stay awake during the surgery and listen to music through headphones. People who are anxious or nervous and do not want to follow or hear anything live are given a short-acting sedative, or we put them into a light sleep. Most patients participate in the decision and opt for the latter.”
– Dr. Catherine Vandepitte

95% of orthopedic procedures are possible under locoregional anesthesia at Ziekenhuis Oost-Limburg (ZOL, Genk, Belgium). This has certain advantages for the patients:

  • The chance of chronic postoperative pain decreases
  • There is less or no need for opioids
  • Patients stay awake or recover immediately after a light sleep so they will not suffer from drowsiness, nausea, or confusion
  • Patients can eat and drink soon after the surgery
  • Patients experience less or no pain so they can start rehabilitation exercises immediately

“After surgery under general anesthesia, 20 to 30% of people experience a persistent, annoying feeling or chronic pain, even if the operated site has healed completely. With locoregional anesthesia, if you apply it according to the rules of the art, that can be reduced by half – especially if you also optimally control the pain in the first days after surgery.”
– Dr. Admir Hadzic

“That is because the pain impulses are really blocked. For example, if you operate on the hand, the pain stimuli are stopped at the wrist. They do not reach the brain. This is not the case with general anesthesia. The patient is not aware of it, but his or her body is. The brain is continuously bombarded with pain impulses during the procedure, and it responds to this. It is, among other things, to mitigate that violent physical reaction that anesthesiologists must administer narcotic medication. This is not necessary with locoregional anesthesia.”
– Dr. Catherine Vandepitte

Dare To Ask!

Can you ask your attending surgeon and anesthesiologist if they use locoregional anesthesia?

“Yes, I think you can. If I would be a patient myself, then I want to be operated by a highly specialized surgeon. For example, someone who only performs hip replacements or only operates the foot. That is the best guarantee for a good outcome, because the more often a surgeon does something, the better he or she gets. The same goes for the anesthesiologist. In the case of orthopedic procedures, I would want someone who is fully committed to locoregional anesthesia. It is only when you apply these techniques correctly and with a lot of expertise that you, as a patient, experience the benefits. So you can certainly ask this before the surgery.”
– Dr. Admir Hadzic

“We do not want to imagine locoregional anesthesia as heaven and general anesthesia as hell. Sometimes you have no other choice than general anesthesia. However, locoregional anesthesia, or the combination of locoregional anesthesia with general anesthesia, is preferred if possible. It is more natural, there are far fewer side effects, and the recovery goes faster.”
– Dr. Catherine Vandepitte

View the full article here.

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