01842 Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy

Name of the Procedure:

Anesthesia for procedures on arteries of forearm, wrist, and hand; Embolectomy

Summary

This procedure involves administering anesthesia to perform an embolectomy on the arteries of the forearm, wrist, or hand. An embolectomy is a surgical removal of an embolus (blood clot) that is blocking blood flow.

Purpose

The procedure addresses the issue of blockages in the arteries of the forearm, wrist, or hand caused by blood clots. The goal of an embolectomy is to restore normal blood flow to the affected area, alleviate pain, and prevent tissue damage or loss of function.

Indications

• Symptoms such as sudden pain, coldness, or lack of pulse in the affected hand or forearm.
• Conditions like acute limb ischemia where blood flow is obstructed.
• Patients who may have experienced a cardiac event leading to an embolus.

Preparation

• Patients are typically instructed to fast for several hours before the procedure.
• Regular medications might need to be adjusted, especially blood thinners.
• Pre-procedure tests may include blood work, ECG, and imaging studies like ultrasound or angiography.

Procedure Description

1. Anesthesia Administration: Local, regional, or general anesthesia is administered, tailored to the patient's condition and the surgeon's preference.
2. Incision and Exposure: A surgical incision is made over the artery in the forearm, wrist, or hand.
3. Embolectomy: The surgeon uses specialized instruments to remove the blood clot from the artery.
4. Closure: Once the clot is removed, the artery is sutured, and the skin incision is closed.

Tools used might include scalpels, clamps, catheters, and imaging devices for guidance.

Duration

The procedure typically takes 1-3 hours, depending on complexity.

Setting

Performed in a hospital operating room or a specialized surgical center.

Personnel

• Surgeon
• Anesthesiologist
• Surgical nurses
• Possibly a vascular technologist for imaging support

Risks and Complications

• Common risks include bleeding, infection, and reaction to anesthesia.
• Rare complications include artery damage, nerve damage, and recurrence of emboli.
• Management includes antibiotics for infection and clot prevention strategies post-surgery.

Benefits

• Immediate relief from symptoms caused by the blockage.
• Restoration of blood flow, reducing the risk of tissue damage.
• Improved hand and forearm function.

Recovery

• Patients are usually monitored for a few hours post-procedure.
• Instructions include wound care, activity restrictions, and possibly anticoagulant medication.
• Full recovery could take several weeks, with follow-up appointments necessary to monitor progress.

Alternatives

• Thrombolysis: use of medication to dissolve the clot.
• Angioplasty: balloon catheter to open up the artery.
• Each alternative has its own risks and benefits, with embolectomy often being the choice for immediate relief.

Patient Experience

• During the procedure, patients under general anesthesia will be unconscious and feel no pain. Regional or local anesthesia may still allow the patient to be awake but without sensation in the area.
• Post-procedure pain is usually managed with medication.
• Some discomfort and swelling at the incision site are expected and temporary.