01360 Anesthesia for all open procedures on lower one-third of femur

Name of the Procedure:

Anesthesia for all open procedures on the lower one-third of the femur
Common name(s): Regional anesthesia, femoral nerve block
Technical/medical terms: Anesthesia for femur surgery, lower extremity anesthesia

Summary

In cases where surgery is required on the lower third of the femur (thigh bone), anesthesia is administered to ensure the patient does not feel pain during the procedure. This can involve either regional anesthesia to numb the leg or general anesthesia to induce full unconsciousness.

Purpose

The procedure alleviates pain during surgical interventions on the lower femur due to fractures, infections, or other medical conditions requiring open surgery. Successful anesthesia aims to ensure the patient remains comfortable and pain-free.

Indications

• Lower femur fractures requiring surgical intervention
• Infections or malignancies of the femur that need surgical management
• Complex reconstructive or orthopedic procedures in the lower femur
• Any open surgical procedures involving the lower one-third of the femur

Preparation

• Patients are typically required to fast for at least 6-8 hours before the procedure.
• Medication adjustments might be necessary, especially for blood thinners.
• Pre-operative assessments, including blood tests, EKG, and imaging studies, are performed to evaluate the patient's overall health.

Procedure Description

1. Administration of Anesthesia:
   1. Regional Anesthesia: A local anesthetic is injected near the femoral nerve to numb the lower part of the leg.
   2. General Anesthesia: Intravenous medications are administered to render the patient unconscious for the duration of the surgery.
2. Monitoring: Vital signs are continuously monitored.
3. Surgery: While anesthesia is in effect, the surgical team performs the necessary procedure on the lower femur.

Duration

The entire process, including the administration of anesthesia and the surgery itself, can range from 2 to 4 hours, depending on the complexity of the surgery.

Setting

This procedure is typically performed in a hospital operating room.

Personnel

• Anesthesiologist
• Anesthesia nurse
• Orthopedic surgeon
• Surgical nurse
• Operating room technicians

Risks and Complications

• Common risks include nausea, vomiting, and temporary numbness or weakness.
• Rare but serious risks: allergic reactions to anesthesia, respiratory complications, nerve damage, or infection at the injection site.
• Complications can usually be managed with appropriate medical care.

Benefits

• Effective pain management during surgery.
• Prevents discomfort and distress during the surgical procedure.
• Facilitates a smoother surgical process, leading to better surgical outcomes.

Recovery

• Immediate post-procedure care includes monitoring in a recovery room.
• Instructions: Rest, limited movement initially, pain management with prescribed medications.
• Recovery time can vary but generally involves 6 to 12 weeks to return to normal activities, depending on the surgical intervention.
• Follow-up appointments are necessary to monitor healing.

Alternatives

• Conservative treatments (e.g., physical therapy, medications) may be considered for less severe conditions.
• Pros and cons:
  • Pros: Non-invasive, fewer immediate risks.
  • Cons: May not be effective for serious conditions requiring surgical intervention.

Patient Experience

• During the procedure, patients under regional anesthesia might be awake but will not feel pain in the operative area.
• If general anesthesia is used, the patient will be unconscious and unaware.
• Post-procedure, patients may experience grogginess, mild discomfort, and localized tenderness.
• Pain management strategies, such as medications and physical therapy, will be employed to aid recovery.