01832 Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement

Name of the Procedure:

Anesthesia for Open or Surgical Arthroscopic/Endoscopic Procedures on Distal Radius, Distal Ulna, Wrist, or Hand Joints; Total Wrist Replacement

Summary

This procedure involves administering anesthesia for surgical interventions on the distal radius, distal ulna, wrist, or hand joints. It is commonly used for total wrist replacement surgeries as well as other open or endoscopic procedures on these areas.

Purpose

The anesthesia is given to prevent pain and ensure patient comfort during surgical procedures on the wrist and hand. The primary goal is to enable surgeons to perform complex operations while keeping the patient pain-free and stable.

Indications

• Severe arthritis or degenerative joint disease
• Traumatic injuries or fractures that require surgical repair
• Conditions like carpal tunnel syndrome, wrist instability, and deformities
• Failed conservative treatments for wrist pain or dysfunction

Preparation

• Patients are usually advised to fast (no food or drink) for at least 8 hours before the procedure.
• Adjustments to current medications, especially blood thinners, will be discussed.
• Preoperative diagnostic tests like blood work, ECG, and imaging studies (X-ray, MRI) may be required.

Procedure Description

1. Preoperative Assessment: An anesthesiologist evaluates the patient's medical history, allergies, and anesthetic risks.
2. Administration of Anesthesia: Depending on the procedure, general anesthesia or regional anesthesia (such as a nerve block) is administered. For wrist surgeries, a regional block is often preferred.
3. Monitoring: Continuous monitoring of vital signs (heart rate, blood pressure, oxygen levels) is performed.
4. Procedure Execution: Surgeons perform the required surgical technique, which may involve open surgery or arthroscopy/endoscopy.
5. Postoperative Care: After the surgery, anesthesia is gradually reduced and stopped, and the patient is monitored in the recovery room.

Duration

The anesthesia administration and the entire surgical procedure can last from 1 to 3 hours, depending on the complexity.

Setting

The procedure is typically performed in a hospital, outpatient surgical center, or specialized orthopedic clinic.

Personnel

• Anesthesiologist
• Surgeon specializing in orthopedic or hand surgery
• Surgical nurses and technologists
• Recovery room staff

Risks and Complications

• Common risks: Nausea, vomiting, sore throat (if intubated), minor allergic reactions.
• Rare risks: Adverse reactions to anesthesia, regional nerve damage, infection, blood clots, and respiratory issues.

Benefits

• Effective pain control during surgery
• Better surgical outcomes due to stable and pain-free operative conditions
• Quicker recovery times in some cases due to minimally invasive techniques

Recovery

• Pain management with prescribed medications
• Instructions on wound care, activity restrictions, and physical therapy
• Typically, patients can expect a recovery period ranging from a few weeks to several months, depending on the surgery's complexity.
• Follow-up appointments for monitoring healing progress and removing sutures or immobilization devices.

Alternatives

• Non-surgical treatments such as physical therapy, medications, and joint injections
• Partial wrist fusion or other less invasive surgical options
• Each alternative has different implications for recovery time, pain management, and overall effectiveness.

Patient Experience

• Patients will be unconscious (general anesthesia) or have numbness in the arm (regional anesthesia) during the procedure.
• Postoperative pain is managed with medications.
• Some discomfort and swelling are expected, which gradually improve with proper care.
• Rehabilitation may involve physical therapy to restore function and strength.