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Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement

CPT4 code

Name of the Procedure:

Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; Total Shoulder Replacement

Summary

This procedure involves administering anesthesia to manage pain and ensure the patient's comfort during surgery on the shoulder and related structures. This can include arthroscopic procedures or a total shoulder replacement. Anesthesia can be regional (blocking sensation to the shoulder area) or general (patient is completely unconscious).

Purpose

This anesthesia is necessary to enable surgeons to perform complex shoulder operations without causing pain to the patient. The goal is to alleviate pain, restore shoulder function, and improve quality of life for individuals with severe shoulder conditions.

Indications

  • Severe arthritis or joint damage in the shoulder.
  • Rotator cuff tears.
  • Chronic shoulder pain unresponsive to conservative treatments.
  • Shoulder fractures or dislocations requiring surgical intervention.
  • Degenerative joint diseases.

Preparation

  • The patient may need to fast for several hours before the procedure.
  • Medication adjustments may be required, particularly blood thinners.
  • Pre-operative assessments such as blood tests, ECG, and imaging studies to evaluate the patient’s health status.

Procedure Description

  1. Preoperative Assessment: The anesthesiologist will review the patient's medical history and conduct a physical examination.
  2. Anesthesia Administration:
    • Regional Anesthesia: Injection near the nerves of the shoulder to block pain (e.g., interscalene nerve block).
    • General Anesthesia: Anesthesia is administered through an IV to render the patient unconscious.
  3. Monitoring: Continuous monitoring of vital signs (heart rate, blood pressure, oxygen levels) throughout the procedure.
  4. Procedure: The surgical team performs the shoulder surgery, with the anesthesiologist adjusting anesthesia levels as needed.

Duration

The entire procedure, including administration of anesthesia and surgery, typically takes 2 to 4 hours, depending on the complexity of the surgery.

Setting

This procedure is performed in a hospital or a specialized surgical center.

Personnel

  • Anesthesiologist
  • Surgeon
  • Surgical nurses
  • Anesthesia technicians

Risks and Complications

  • Common: Nausea, vomiting, drowsiness, sore throat (if general anesthesia is used).
  • Rare: Allergic reactions to anesthetic drugs, nerve damage (in regional anesthesia), cardiovascular issues, infections.
  • Possible complications include management of anesthesia-related issues and intraoperative monitoring.

Benefits

  • Effective pain management during and after surgery.
  • Allows for complex shoulder procedures that can significantly improve joint function and patient quality of life.
  • Patients can typically experience reduced pain and improved mobility soon after recovery.

Recovery

  • Post-procedure monitoring in the recovery room.
  • Pain management through medications as anesthesia wears off.
  • Instructions on wound care, physical therapy, and any activity restrictions.
  • Follow-up appointments to monitor healing and progress.

Alternatives

  • Pain management through medications or injections.
  • Non-surgical treatments like physical therapy.
  • Less invasive surgical options, if applicable.
  • Pros and cons must be discussed with the healthcare provider to determine the best treatment plan.

Patient Experience

  • During the procedure, the patient will either be unconscious (general anesthesia) or numb in the shoulder area (regional anesthesia).
  • Postoperative discomfort usually managed with medications.
  • Physical therapy might be necessary to regain full shoulder function.
  • Gradual return to normal activities as recommended by the healthcare team.

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