title: The patient's experience of temporary paralysis from spinal anaesthesia, a part of total knee replacement.
abstract: OBJECTIVE
  The aim of this study was to describe the meaning of being temporary paralysed from spinal anaesthesia when undergoing total knee replacement.
  
  
  BACKGROUND
  Total knee arthroplasty is a common procedure, and regional anaesthesia is used as a method for anaesthetising the patient. The experience is highly individual in substance and duration, and it can extend far beyond care settings as intraoperative care and the postanaesthesia care unit that have been investigated so far.
  
  
  METHODS
  A qualitative phenomenological hermeneutic design was chosen to gain a deeper understanding of the experience of spinal anaesthesia, as a part of having a total knee replacement.
  
  
  METHODS
  Twelve patients were interviewed in March 2014 after undergoing an elective total knee arthroplasty under spinal anaesthesia. The interviews were analysed with a Ricoeur-inspired interpretation method.
  
  
  RESULTS
  Three themes were derived from the interviews: 'anaesthesia--an unavoidable necessity', 'an unrecognisable and incomprehensible body' and 'the body returns--joy and agony'.
  
  
  CONCLUSIONS
  The results reveal that trust in the health care personnel and knowledge of the course of events play a key role in the experience. The trust can be breached by unforeseen events, or if the patient's experiences were not taken into account. The ability of the health care personnel to be in contact, share relevant knowledge with- and compensate for the patient is crucial in the prevention of negative experiences.
  
  
  CONCLUSIONS
  The results of this study contribute to insights and deeper knowledge that can enhance staff's ability to provide care for patients undergoing total knee arthroplasty in spinal anaesthesia. The results provide perspectives that argue for care in accordance to individual needs.
authors.affiliation: Department of Orthopaedic Surgery, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
authors.forename: Louise
authors.initials: L
authors.lastname: Bager
authors.affiliation: Copenhagen University Hospital Gentofte, Hellerup, Denmark.
authors.forename: Hanne
authors.initials: H
authors.lastname: Konradsen
authors.affiliation: Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Pia Sander
authors.initials: PS
authors.lastname: Dreyer
mesh_terms: D000368:Aged; D000775:Anesthesia, Spinal / Q000009:adverse effects* / Q000523:psychology; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000139:chemically induced* / Q000523:psychology*; D036301:Qualitative Research; D035502:Trust
keywords: Ricoeur; knee replacement; nursing; nursing research; orthopaedics; patients' experience; qualitative study; spinal anaesthesia; temporary paralysis