Hip surgery: watch a film or general anesthesia?

Christine Albert studied German linguistics and literature as well as Scandinavian studies at the Albert Ludwigs University in Freiburg. She is currently doing a traineeship at Hubert Burda Media and is writing, among other things, for

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For many operations, patients can choose whether they want general or regional anesthesia. Even with regional anesthesia, nobody has to experience the operation - thanks to modern technology.

The hip hurts all the time, everyday movements are torture, and driving a car is almost impossible. At some point the level of suffering is so great that the person affected decides to have an operation. A new hip joint should improve the quality of life again.

But when you talk to the surgeon at the latest, you have to make a decision: Should the operation take place under general anesthesia or regional anesthesia? In contrast to general anesthesia, regional anesthesia only numbs a certain area of ​​the body. This is usually possible especially on the lower extremities, for example during operations on the hip and knee joint.

Precise anesthesia

Doctors are advocating this variant more and more frequently. "Regional anesthesia helps older patients in particular to get back on their feet quickly," says Heiko Spank, chief physician at the Clinic for Special Orthopedic Surgery and Trauma Surgery at the Vivantes Auguste Viktoria Clinic in Berlin. "You don't have any problems afterwards, such as nausea, which sometimes occurs after general anesthesia."

But does the anesthetic work reliably? "Nowadays we do regional anesthesia controlled by ultrasound. This makes it easier for us to visualize the nerves that supply an extremity. So we can see precisely by ultrasound where the drug is spreading," explains Prof. Rolf Rossaint, President of the German Society for Anesthesiology and Intensive Care Medicine ( DGAI). The technology gives patients and doctors the assurance that the nerves are numb.

Experience surgery or overslept

Experience how your own hip joint is replaced by a new one: Some patients find the experience exciting, Rossaint knows from experience. "Some even want to see what the surgeon is doing on the monitor."

Others prefer to be given medication to put them to sleep. In contrast to general anesthesia, you continue to breathe independently, but are not conscious during the operation. This can be a relief, especially for people who are nervous.

Operations as a stress factor

"How patients deal with an operation is different. Some people are very thick-skinned, especially during an operation that is supposed to make stressful symptoms disappear," explains Christa Roth-Sackenheim, Chairwoman of the Professional Association of German Psychiatrists. Basically, operations with anesthesia are always a stress factor. "You hand over control of your own life to the medical team, just like leaving control to the pilot in an airplane."

Patients who are very excited the evening before the operation should try to relax consciously. "If you have techniques that also help you in other emotionally stressful situations, you can apply them here too," says Roth-Sackenheim. This could be autogenic training or a bath with lavender.

VR glasses as a distraction

If you stay awake during the operation, you can distract yourself with music, for example. Children in particular are often given the opportunity to watch a film on the side.

Technically well-equipped clinics also offer their patients video glasses. These completely cover the field of vision and are combined with headphones. "It's like a cinema screen right in front of your eyes. You see and hear almost nothing of your surroundings during the operation," says orthopedist Spank, in whose clinic the glasses have been used for several months.

The feedback from those who have been operated on has so far been almost consistently positive. "At first there is a certain skepticism. But when you have done it, most of them are very enthusiastic and say that they have hardly noticed anything," says Spank.

Everything except films depicting violence

Some even think it's a shame that the operation is shorter than the film they chose. At the Auguste Viktoria Clinic in Berlin, for example, there are 150 films of different genres to choose from. Only films with depictions of violence are not part of the repertoire. "An operation is nerve-wracking enough for patients, so we want to show them something relaxing," explains Spank.

When using the video glasses, you make use of the brain's ability to completely hide things like the ongoing operation, explains psychiatrist Roth-Sackenheim. "There is evidence that people need less pain medication when they think of something else."

Ask all the questions in your head

In addition to the distraction during the operation, it is important that patients feel that they are in good hands with their medical team beforehand. "A good explanation and preparation for the operation with positive words by the surgeon and the anesthetist are of considerable value," says Roth-Sackenheim.

This includes that the doctors explain, for example, how they proceed, what healing process they expect in the patient and what prerequisites he brings with him. "Conversely, nobody should be afraid to ask all the questions they have in their head and also to talk about their excitement," advises the expert. If patients feel that they and their doctors are in the same boat, it has a very good influence on the recovery process.

Your hip hurts too? In our article "Hip Pain" you can read what could be behind it. Hip operations are necessary, for example, in the case of advanced osteoarthritis or femoral neck fracture. One possibility is hip replacement, called hip replacement. You can read more about different anesthetic procedures here. (approx / dpa)

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