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Anesthesia for procedures on bony pelvis

CPT4 code

Name of the Procedure:

Anesthesia for Procedures on Bony Pelvis
Common Name: Pelvic Anesthesia
Medical Term: Regional Anesthesia for Pelvic Surgery

Summary

Anesthesia for procedures on the bony pelvis involves administering anesthetic agents to block sensation in the pelvic region. This allows surgical procedures to be performed without the patient feeling pain.

Purpose

Medical Condition or Problem: This type of anesthesia is used for surgeries involving the bony structures of the pelvis, such as hip replacement or pelvic fracture repair.
Goals/Expected Outcomes: The procedure aims to ensure the patient remains pain-free during surgery, facilitates the surgeon's work, and minimizes overall stress on the patient's body.

Indications

Symptoms/Conditions: Pelvic fractures, hip dysplasia, tumors, or degenerative joint disease requiring surgical intervention.
Patient Criteria: Individuals undergoing surgery on the bony pelvis who are fit for regional anesthesia.

Preparation

Pre-Procedure Instructions: Patients are typically advised to fast for at least 6-8 hours before the procedure. Certain medications, especially blood thinners, may need adjustment.
Diagnostic Tests: Preoperative assessments may include blood tests, imaging studies like X-rays or MRIs, and an evaluation by an anesthesiologist.

Procedure Description

  1. Initial Assessment: The anesthesiologist reviews the patient's medical history and conducts a physical examination.
  2. Positioning: The patient is positioned appropriately to access the pelvic region.
  3. Administration of Anesthesia: Depending on the specific surgery, regional anesthesia such as spinal, epidural, or peripheral nerve blocks is administered. For spinal or epidural blocks, a needle is inserted into the appropriate area of the spine.
  4. Monitoring: The patient is continuously monitored for vital signs and comfort throughout the procedure.
  5. Surgical Procedure: While under anesthesia, the surgical team performs the necessary procedure on the bony pelvis.

Tools/Equipment: Needles and syringes for delivering the anesthetic, monitoring equipment, sterile drapes, and possibly ultrasound for guidance.
Anesthesia/Sedation Details: Regional anesthesia involves agents like bupivacaine or lidocaine. Sedation may also be provided to help the patient relax.

Duration

The procedure typically lasts between 2-4 hours, depending on the complexity of the surgery.

Setting

Pelvic anesthesia is usually performed in a hospital, specifically in the operating room.

Personnel

  • Anesthesiologist: Administers and monitors the anesthesia.
  • Surgeon: Performs the surgery.
  • Nurses: Assist with preparation, monitoring, and post-operative care.

Risks and Complications

  • Common Risks: Low blood pressure, nausea, headache.
  • Rare Risks: Infection at the injection site, nerve damage, allergic reactions to anesthetics.
  • Management: Risks are managed through careful monitoring and prompt intervention.

Benefits

  • Expectation: Effective pain management during surgery, reduced need for general anesthesia.
  • Timeline: Benefits are immediate during surgery and include quicker postoperative recovery.

Recovery

  • Post-Procedure Care: Patients are monitored in a recovery room where vital signs are observed until the anesthesia wears off.
  • Recovery Time: Varies; may range from a few hours to overnight monitoring.
  • Restrictions/Follow-Up: Patients may have activity restrictions post-surgery and are advised to follow up with their healthcare provider for further evaluation.

Alternatives

  • Other Options: General anesthesia, local anesthesia with sedation, or non-surgical treatments like physical therapy.
  • Pros and Cons: Regional anesthesia allows for quicker recovery and fewer systemic side effects compared to general anesthesia but may not be suitable for all patients.

Patient Experience

  • During Procedure: Patients typically feel little to no pain; may experience pressure or movement sensations.
  • Post-Procedure: Discomfort as anesthesia wears off; pain management provided through medications. Patient comfort is continually assessed and managed.

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