The geko® will work with a central (spinal or epidural) anaesthesia or a regional block in place, however the geko® device will not work immediately after a muscle relaxant has been given.
Muscle relaxants are used to facilitate intubation, during this period the geko® device will not be able to activate the calf muscle pumps, until the muscle relaxant wears off, which is, in most elective surgery, after about 30 minutes. Most surgery does not need paralysis throughout, and modern ventilators support the patient breathing, so muscle relaxants are not required to suppress breathing. Therefore, the geko® device would be able to be used most of the time during surgery, and particularly in the critical period when a thrombosis is most likely to form.