Spinal or general anaesthetic?
The two main options for hip and knee replacement, what each feels like, and the risks to discuss.
A patient guide · Australia
Anaesthesia and pain relief for bone and joint surgery
For adults having a joint replacement, an arthroscopy, a fracture repair, or hand, shoulder or spine surgery, and the families who support them. Written in plain English from Australian guidance and published by Dr Walid Aly, Specialist Anaesthetist (FANZCA).
General information only. This guide is an education resource. It does not provide, book or recommend surgery or anaesthesia, and it does not replace advice from your surgeon, anaesthetist or GP.
The guides
Start with your question
Each guide answers one question in depth and lists the Australian sources it draws on.
Nerve blocks and a numb limb
How blocks work, how long the numbness lasts, and how to protect an arm or leg you cannot feel.
Getting ready for joint replacement
Your anaesthetic assessment, medicines, iron and anaemia, sleep apnoea and smoking.
Pain relief and the first two weeks
How a pain plan steps down, using opioids briefly, and what is normal at home.
Preventing blood clots
Why the risk rises after orthopaedic surgery, how it is reduced, and the warning signs.
Delirium: a guide for families
Sudden confusion in older people after surgery: what to watch for and how to help.
Worth knowing
Three things to know before orthopaedic surgery
-
You may not need to be asleep
ANZCA describes regional anaesthesia, which includes spinals and nerve blocks, as the most common form of anaesthesia for joint replacement. You can stay awake or have sedation. Ask what your anaesthetist recommends, and why.
Spinal or general anaesthetic -
A numb limb needs protecting
A nerve block can leave an arm or leg numb for many hours. Support a weak arm in a sling, keep heat and ice off skin you cannot feel, and do not walk on a weak leg without help.
Caring for a numb limb -
Sudden confusion is an emergency
Delirium is common in older people after surgery, especially after a broken hip. If someone becomes suddenly confused or unusually drowsy, tell the staff straight away, or call 000 at home.
Delirium: a guide for families
Sources: ANZCA, Anaesthesia for joint surgery (2025); Townsville Hospital and Health Service, What is a nerve block? (2026); healthdirect, Delirium (2024). Full references are on each guide.
A resource by
Ahpra registration MED0001193673. Dr Aly's main website, drwalidaly.com.au, covers his wider anaesthetic practice.
Contact
A question about this guide?
Questions about your own operation and anaesthetic are for your surgeon and anaesthetist, who know your health. For a general question about this guide, phone or use the contact form, and please leave medical details out of website messages.