01234 Anesthesia for open procedures involving upper two-thirds of femur; radical resection

Name of the Procedure:

Anesthesia for Open Procedures Involving Upper Two-Thirds of Femur; Radical Resection

Summary

This procedure involves administrating anesthesia to a patient undergoing an extensive surgery to remove a significant portion of the upper femur (thigh bone). This type of surgery is typically performed to treat serious conditions like tumors or severe infection.

Purpose

This procedure aims to provide adequate pain relief and ensure patient immobility during a radical resection of the upper two-thirds of the femur. The expected outcome is the safe, effective removal of diseased bone tissue while maintaining patient comfort and safety.

Indications

• Presence of malignant or benign tumors in the upper femur
• Severe bone infections (osteomyelitis)
• Complex fractures
• Other conditions requiring major bone surgery

Patients appropriate for this procedure typically show symptoms like severe pain, limited mobility, or other complications directly related to the femur's condition.

Preparation

• Patients are usually required to fast for 8-12 hours before the procedure.
• Medication adjustments, like stopping blood thinners, might be necessary.
• Pre-operative assessments may include blood tests, imaging studies (X-rays, MRIs), and a thorough physical examination.

Procedure Description

1. The patient arrives at the surgical center and is prepped for surgery.
2. An intravenous (IV) line is placed for medication and fluid administration.
3. The anesthesiologist explains the anesthesia plan, which may involve general anesthesia (putting the patient completely to sleep).
4. Monitoring equipment is attached (e.g., EKG, blood pressure cuff).
5. Once the anesthesia takes effect, the surgeon begins the radical resection of the upper femur.
6. Throughout the procedure, the anesthesiologist monitors the patient's vital signs and adjusts anesthesia levels as needed.

The tools used typically include standard surgical instruments, bone saws, and specialized equipment for removing and managing the bone and any affected tissues.

Duration

The procedure typically takes 2-4 hours, depending on the extent of the surgery.

Setting

This procedure is performed in a hospital operating room equipped with advanced surgical and anesthesia equipment.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technician
• Radiologist (if imaging is required during surgery)

Risks and Complications

• Anesthetic risks: allergic reactions, respiratory issues
• Surgical risks: infection, bleeding, blood clots, damage to surrounding tissues
• Post-operative complications: deep vein thrombosis, delayed healing, need for additional surgeries

Benefits

The main benefit is the removal of diseased or damaged bone, which can help alleviate pain, improve mobility, and address serious medical conditions. These benefits can typically be observed once recovery begins.

Recovery

• Initial recovery in the post-anesthesia care unit (PACU) for monitoring.
• Pain management with prescribed medications.
• Gradual increase in activity as tolerated, guided by physical therapy.
• Follow-up appointments for wound care and to assess healing progress.

The complete recovery process may take weeks to months, with restrictions on weight-bearing activities and participation in rehabilitation programs essential for a successful outcome.

Alternatives

• Non-surgical treatments like radiation or chemotherapy (for tumors)
• Conservative management with antibiotics (for infection)
• Less invasive surgical interventions

The alternatives depend on the specific condition being treated, and each has its own set of advantages and drawbacks. Radical resection is typically considered when other treatments have failed or are deemed insufficient.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, patients might experience soreness at the surgical site, limited mobility, and the need for pain medication. Hospital stay post-surgery can range from a few days to a week, with a focus on pain management and gradual mobilization.