This is question bound to stir up controversy. Many procedures such as heart surgery can only be done under general anesthesia. Peripheral procedures such as knee arthroscopy could be done under general or spinal/epidural. There have been many studies in the anesthesia literature examining the general vs. regional question. Most show no difference in outcome. The final choice will rest on the patient preference and type of procedure. In the case of knee arthroscopy some patients prefer to remain awake so they can watch the procedure on the monitor. This is the perfect case to use a spinal or epidural. Outpatients can’t be discharged home until the block has totally worn off. This a one major disadvantage of regional in this type of case. The possibility of headache after spinal anesthesia is another issue. Your anesthesiologist will be glad to discuss the risks and benefits of regional versus general for the planned surgery.