Expert: Ronald Levy, M.D. - 3/1/2010

Question
QUESTION: I will have arthroscopic knee surgery soon for torn meniscus, and I would rather have local anesthesia. Is this possible,and are there any 'downsides' to having this type of anesthesia? Could you also please comment on how this might be administered (right knee). Thank you for your time.

ANSWER: Generally local is not enough for arthroscopy because they also put a tourniquet on your upper thigh (to cut down on bleeding) and the local would not stop the pain from that area. The procedure can be done under spinal anesthesia where everything below your waist is numb. You can discussthis with the anesthesiologist.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: Is it possible that the pain from the tourniquet could be tolerable (more so than the arthroscopy site, since no incisions are being done there), thereby having just a local (and not a spinal). Thanks again for your time, and for sharing your expertise.

Answer
No. Not really. The problem is that they need to inflate the tourniquet to over 200 and leave it there for 30 min - 1 hour and that will be extremely uncomfortable (even 5 minutes is unbearable). Why would you want only a local anyway? If your fear is going to sleep, the spinal will avoid that. I suppose you could have a local if the surgeon doesn't use a tourniquet, but I doubt they would do that because it makes their job more difficult.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston