Had hip replacement, wondering about topical numbing agent

Posted by cindiwass @cindiwass, Mar 22, 2023

I had the hip replacement and it's slow but coming along, 7 months into the surgery. Instead of putting me out the surgeon decided to give me leg numbing agent and then after the surgery amnesiac so I wouldn't remember anything. I want to ask questions about that later, but now I wonder about the leg numbing agent. It was put on the thigh, I had anterior surgery. I'd like to know more about this, such as: how long does it take for my leg to recover full feeling, it's 7 months now and much of it is still numb but I am regaining feeling. And why would he do that instead of putting me out completely?

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@cindiwass, Normally anesthesia options are discussed with the patient prior to the surgery. I haven't had a hip replacement but when I had my knee replacement, my surgeon explained the process with me at a consult and then the day of the knee replacement, I met with the anesthesiologist just before the surgery and he discussed what the plan was. Here are a couple of articles on the topic but any real questions you have should be directed to your surgeon or care team.

"Before your joint replacement surgery, your doctor will discuss anesthesia with you. The selection of anesthesia is a major decision that could have a significant impact on your recovery. It deserves careful consideration and discussion with your surgeon and your anesthesiologist."
--- Anesthesia for Hip and Knee Surgery: https://orthoinfo.aaos.org/en/treatment/anesthesia-for-hip-and-knee-surgery/

"Is spinal or general anesthesia better for total hip arthroplasty?
Despite its single-center design, this study suggests that spinal anesthesia offers advantages over general anesthesia for primary THA, such as better pain control and fewer postoperative complications."
--- Spinal or General Anesthesia for Total Hip Arthroplasty: https://www.jwatch.org/na55394/2022/10/18/spinal-or-general-anesthesia-total-hip-arthroplasty

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The numbing agent used for the surgery only lasts at most a day or so, therefore it is not causing the current numbness.
Possible causes of this are a nerve that was moved, cut or irritated during the surgery or perhaps is now compressed somehow. I had 5 hip surgeries with varying amounts of numbness in my thighs afterwards. The most long-term one lasted about a year, and there was actually a small numb area for several years. Once the "pins and needles " sensation from the healing nerves went away I just ignored it.
Sue

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@johnbishop

@cindiwass, Normally anesthesia options are discussed with the patient prior to the surgery. I haven't had a hip replacement but when I had my knee replacement, my surgeon explained the process with me at a consult and then the day of the knee replacement, I met with the anesthesiologist just before the surgery and he discussed what the plan was. Here are a couple of articles on the topic but any real questions you have should be directed to your surgeon or care team.

"Before your joint replacement surgery, your doctor will discuss anesthesia with you. The selection of anesthesia is a major decision that could have a significant impact on your recovery. It deserves careful consideration and discussion with your surgeon and your anesthesiologist."
--- Anesthesia for Hip and Knee Surgery: https://orthoinfo.aaos.org/en/treatment/anesthesia-for-hip-and-knee-surgery/

"Is spinal or general anesthesia better for total hip arthroplasty?
Despite its single-center design, this study suggests that spinal anesthesia offers advantages over general anesthesia for primary THA, such as better pain control and fewer postoperative complications."
--- Spinal or General Anesthesia for Total Hip Arthroplasty: https://www.jwatch.org/na55394/2022/10/18/spinal-or-general-anesthesia-total-hip-arthroplasty

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I don’t remember my surgeon discussing anesthesia with me beforehand. I guess it is my fault. It didn’t occur to me that it would be something other than general. Imagine my surprise on the day of surgery when the anesthesiologist came in and told me I was having an epidural. They said that allows them to inject the anesthetic in a more precise and controlled area and they don’t need to use as much anesthetic. I am a little over 2 months post op right hip replacement with anterior approach. The pins and needles feeling has gone away, but I still have numbness in my thigh. My thigh is achy and sore in the morning until I get up and start moving. I was expecting a faster return to normal. I have returned to the gym, but my muscle strength is greatly reduced as is my cardiac endurance. My range of motion is much improved from before surgery.

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@walk4life

I don’t remember my surgeon discussing anesthesia with me beforehand. I guess it is my fault. It didn’t occur to me that it would be something other than general. Imagine my surprise on the day of surgery when the anesthesiologist came in and told me I was having an epidural. They said that allows them to inject the anesthetic in a more precise and controlled area and they don’t need to use as much anesthetic. I am a little over 2 months post op right hip replacement with anterior approach. The pins and needles feeling has gone away, but I still have numbness in my thigh. My thigh is achy and sore in the morning until I get up and start moving. I was expecting a faster return to normal. I have returned to the gym, but my muscle strength is greatly reduced as is my cardiac endurance. My range of motion is much improved from before surgery.

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What you are experiencing '"..My thigh is achy and sore in the morning until..." is absolutely normal at this stage. My friend and daily walking partner just passed 3 months, and she has the same.

And here is the most common complaint we get here, "I was expecting a faster return to normal. I have returned to the gym, but my muscle strength is greatly reduced as is my cardiac endurance."

I always remind people that joint replacement or any major ortho surgery "ain't for sissies" - let me describe what happens. You have been cut open, had everything - muscles, tendons and nerves, moved around or cut into. Then they brought in the reconstruction tools - essentially saws, drills and hammers to put in new parts made of foreign materials. Oh, yeah, and you lost a fair amount of blood. Finally, they sewed or stapled you back together, sent you home and told you to get moving.

Now tell me, if the doctor explained all that before surgery, in those terms, would you have run away? No surprise that your body wants some time to recover!

It sounds like you are doing great - keep walking and be kind to yourself when you are tired and achy. And remember, you can still use ice when you overdo it.
Sue

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@sueinmn

What you are experiencing '"..My thigh is achy and sore in the morning until..." is absolutely normal at this stage. My friend and daily walking partner just passed 3 months, and she has the same.

And here is the most common complaint we get here, "I was expecting a faster return to normal. I have returned to the gym, but my muscle strength is greatly reduced as is my cardiac endurance."

I always remind people that joint replacement or any major ortho surgery "ain't for sissies" - let me describe what happens. You have been cut open, had everything - muscles, tendons and nerves, moved around or cut into. Then they brought in the reconstruction tools - essentially saws, drills and hammers to put in new parts made of foreign materials. Oh, yeah, and you lost a fair amount of blood. Finally, they sewed or stapled you back together, sent you home and told you to get moving.

Now tell me, if the doctor explained all that before surgery, in those terms, would you have run away? No surprise that your body wants some time to recover!

It sounds like you are doing great - keep walking and be kind to yourself when you are tired and achy. And remember, you can still use ice when you overdo it.
Sue

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Thanks, Sue . Prior to the surgery I heard so many anecdotal reports of people “back to normal” in 4-6 weeks, that I think my expects were higher than they should have been. My physical therapist who is great, hears a lot of my whining. He did say that the body’s ability to recover is much slower after the age of 60 . Since I am 71 , I am guessing that is one of my issues! 🤣 I am hoping to be able to return to jogging.

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Hello
Everything Sue said is very true and beautifully said in my experience. Had THP in January this year. I’m 75 and know from experience on other hip that time patience and realistic expectations count most of all in recovery.
It sounds great you are back in gym as long as you do not overdo it, which might be a temptation for you. Guard against that with all your strength because it can set you back a lot. Enjoy whatever benefits your new hip is returning to you and accept the time it takes to recover fully.

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@sueinmn

The numbing agent used for the surgery only lasts at most a day or so, therefore it is not causing the current numbness.
Possible causes of this are a nerve that was moved, cut or irritated during the surgery or perhaps is now compressed somehow. I had 5 hip surgeries with varying amounts of numbness in my thighs afterwards. The most long-term one lasted about a year, and there was actually a small numb area for several years. Once the "pins and needles " sensation from the healing nerves went away I just ignored it.
Sue

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OK. I really need to call the surgeon and ask exactly how can I find out why I continue to have numbness, although it is departing slowly but it's taking months. The anesthesiologist came in just before the operation, told me about the numbing rather than total anesthesia, then said they would give me an amnesiac so I wouldn't remember anything. I protested but she told me it wasn't a good idea for me to remember. So I think I will go to the surgeon who probably owes me an explanation anyway. I think he was a good surgeon but on the other hand, he was not giving me a lot of time talking to me about before and after.

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@sueinmn

What you are experiencing '"..My thigh is achy and sore in the morning until..." is absolutely normal at this stage. My friend and daily walking partner just passed 3 months, and she has the same.

And here is the most common complaint we get here, "I was expecting a faster return to normal. I have returned to the gym, but my muscle strength is greatly reduced as is my cardiac endurance."

I always remind people that joint replacement or any major ortho surgery "ain't for sissies" - let me describe what happens. You have been cut open, had everything - muscles, tendons and nerves, moved around or cut into. Then they brought in the reconstruction tools - essentially saws, drills and hammers to put in new parts made of foreign materials. Oh, yeah, and you lost a fair amount of blood. Finally, they sewed or stapled you back together, sent you home and told you to get moving.

Now tell me, if the doctor explained all that before surgery, in those terms, would you have run away? No surprise that your body wants some time to recover!

It sounds like you are doing great - keep walking and be kind to yourself when you are tired and achy. And remember, you can still use ice when you overdo it.
Sue

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I realize I would have been afraid of surgery if the doctor told me how much pain there would be after the surgery. I might have waited longer. I should have had it earlier but circumstances were different because of my home situation. The reason I finally decided to have it no matter what is because of the pain. I have far less pain now, even though I am still limping and having some pain, but not in my hip rather by the knee which is no good. However I'm almost 80 and so probably will live the rest of my life on this side 🙂 with the knee problem. Or -- maybe I'll go through with it, don't know. I am using a walker quite often, sometimes a cane sometimes nothing. I am pushing myself to go to the pool by our apartment and moving gentle really does help. I appreciate the comments on the boards. Thanks, y'all!

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