Name of the Procedure:

Anesthesia for procedures on the upper posterior abdominal wall, also known as regional anesthesia or epidural anesthesia for posterior abdominal wall surgery.

Summary

This procedure involves administering anesthesia to numb the upper posterior abdominal wall, enabling surgeries to be performed in that area without causing pain to the patient.

Purpose

The primary purpose of this type of anesthesia is to ensure that patients undergoing surgery on the upper posterior abdominal wall do not feel pain during the procedure. It is typically used for operations such as the removal of tumors or the treatment of hernias in this specific region.

Indications

• Chronic pain requiring interventional procedures.
• Tumors or masses located in the upper posterior abdominal wall.
• Complex hernias in the posterior abdominal region.
• Patients who cannot undergo general anesthesia due to health risks.

Preparation

• Patients are usually instructed to fast for at least 6-8 hours before the procedure.
• Certain medications may need to be paused or adjusted, as directed by a healthcare provider.
• Pre-procedure assessments including blood tests, imaging, and consultations with the anesthesia team will be required.

Procedure Description

1. Pre-Operative Assessment: The anesthesiologist will review the patient's medical history and perform a physical examination.
2. Positioning: The patient is typically positioned on their side or sitting up to allow access to the posterior abdominal area.
3. Sterilization: The administation site on the back is cleaned and sterilized.
4. Local Anesthetic: A local anesthetic is injected to numb the injection site for the regional anesthetic.
5. Epidural Catheter Placement: A needle and catheter are inserted into the epidural space in the spine.
6. Medication Administration: Anesthetic medications are administered through the catheter to numb the abdominal wall.
7. Surgical Procedure: Surgery is then performed, with the patient monitored continuously for vital signs and comfort.

Tools and equipment:

• Sterile gloves, gowns, and drapes
• Epidural needle and catheter set
• Anesthetic drugs and syringes
• Monitoring equipment (heart rate, blood pressure, oxygen levels)

Duration

The anesthesia administration typically takes around 30-60 minutes. The duration of the surgery may vary depending on the complexity.

Setting

The procedure is performed in a hospital or surgical center, typically in an operating room or a specialized anesthesia suite.

Personnel

• Anesthesiologist
• Anesthesia nurse or technician
• Surgical team including surgeon and nurses

Risks and Complications

• Common: Low blood pressure, headache, nausea, or temporary difficulty urinating.
• Rare: Infection, bleeding, nerve damage, respiratory complications, or an adverse reaction to the anesthetic.

Benefits

• Effective pain control during surgery.
• Reduced need for general anesthesia, which may be beneficial for patients with certain health issues.
• Potential for decreased postoperative pain and faster recovery.

Recovery

• Patients are monitored post-procedure until the effects of the anesthesia wear off.
• Pain management strategies are implemented as needed.
• Most patients can resume normal activities within a few days, but strenuous activities should be avoided for a recommended period.
• Follow-up appointments may be necessary to monitor recovery and manage any complications.

Alternatives

• General anesthesia: Provides complete sedation but carries risks for certain patients.
• Local anesthesia: May be used for minor procedures but may not be effective for deeper or more extensive surgeries.
• Spinal anesthesia: Similar to epidural but typically used for lower body procedures.

Patient Experience

Patients may feel a slight pressure during the injection of local anesthetic and the placement of the epidural catheter. After the anesthesia takes effect, the surgical area will be numb, but patients may feel some pressure or movement. Post-procedure, there may be mild discomfort or soreness at the injection site, which is usually managed with pain relievers.