Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast with internal mammary node dissection
CPT4 code
Name of the Procedure:
Anesthesia for procedures on the integumentary system on the extremities, anterior trunk, and perineum; radical or modified radical procedures on breast with internal mammary node dissection.
Summary
Anesthesia administered to facilitate surgical procedures on the skin, subcutaneous tissue, and related structures of the extremities, anterior trunk, and perineum. This includes specialized surgeries on the breast, particularly radical or modified radical mastectomies with internal mammary node dissection.
Purpose
- Addresses conditions requiring surgical intervention in the specified anatomical regions.
- Ensures patient comfort and immobility during surgery.
- Aims to achieve adequate pain control and manage physiological responses to surgery.
Indications
- Patients undergoing major surgeries of the skin and subcutaneous tissues on the extremities, anterior trunk, and perineum.
- Individuals requiring radical or modified radical breast surgery due to conditions like breast cancer with associated lymph node involvement.
- Symptoms such as significant tumors, extensive skin lesions, or severe trauma needing surgical correction.
Preparation
- Fasting at least 6-8 hours before the procedure, as per the anesthesiologist’s guidelines.
- Review of current medications, with possible adjustments for blood thinners or chronic conditions.
- Preoperative assessments such as blood tests, ECG, and chest X-ray.
Procedure Description
- Pre-operative preparation includes placing IV lines and attaching monitoring devices (EKG, pulse oximeter).
- Administration of anesthesia, which may include general anesthesia, regional anesthesia, or a combination, depending on surgical requirements.
- Continuous monitoring of vital signs throughout the procedure.
- Additional medications for pain control, muscle relaxation, and maintaining stable physiological conditions.
- Post-procedure transition to recovery room for monitoring as the patient regains consciousness and vital stability.
Duration
The duration varies, typically ranging from 2 to 4 hours, depending on the complexity and extent of the surgery.
Setting
Usually performed in a hospital operating room or accredited surgical center with full anesthesia support capabilities.
Personnel
- Anesthesiologist.
- Surgeon specialized in the relevant field.
- Surgical nurses and technicians.
- Anesthesia assistants or nurse anesthetists.
Risks and Complications
- Common risks: Nausea, vomiting, sore throat, mild allergic reactions.
- Rare risks: Anesthesia awareness, severe allergic reactions, aspiration, respiratory complications, cardiovascular events.
- Complications like excessive bleeding, infection, or prolonged recovery times, managed with appropriate interventions.
Benefits
- Relief from underlying conditions necessitating surgery (e.g., cancer removal, trauma repair).
- Improved quality of life post-surgery.
- Expected benefits are generally realized immediately to a few weeks post-operatively.
Recovery
- Initial recovery in a post-anesthesia care unit (PACU) until stable.
- Pain management via prescribed medications.
- Gradual return to normal activities, typically within a few weeks.
- Follow-up appointments to monitor healing and address any complications.
Alternatives
- Non-surgical treatments (e.g., medication, radiation therapy).
- Less invasive surgical options where applicable.
- Pros: Avoidance of anesthesia risks.
- Cons: May not be as effective or feasible depending on the condition.
Patient Experience
- Patients are usually asleep and unaware during the procedure if under general anesthesia.
- Potential for post-operative pain, managed with medications.
- Post-operative care focused on comfort, with measures such as warm blankets and pain management strategies.
This markdown text provides a comprehensive overview of the procedure, including all relevant aspects from preparation to recovery.