Name of the Procedure:

Anesthesia for all closed procedures on the lower one-third of the femur, also known as regional anesthesia for femur surgeries.

Summary

This procedure involves administering anesthesia to numb the lower part of the thigh (the lower one-third of the femur) for various closed procedures, such as setting fractures. Closed procedures mean that no surgical incision is made; instead, the bone is manipulated from the outside.

Purpose

• Medical Condition: Pain management during closed procedures on the lower femur, such as fracture reduction.
• Goals: To provide pain relief and patient comfort during the procedure without the need for general anesthesia, which affects the whole body.

Indications

• Fractures or dislocations in the lower third of the femur.
• Patients requiring pain management for closed reduction of femur fractures.
• Situations where general anesthesia poses higher risks or is not preferred.

Preparation

• Instructions: Patients may be required to fast for a specific period before the procedure.
• Medication Adjustments: Adjustments may be necessary for patients on blood thinners or other medications.
• Diagnostics: Pre-procedure assessments including blood tests, imaging studies (X-rays or MRIs), and a review of medical history.

Procedure Description

1. Initial Assessment: The anesthesiologist reviews the patient's medical history and conducts a physical exam.
2. Positioning: The patient is positioned to allow access to the femoral nerve area.
3. Sterilization: The procedure site is cleaned with antiseptic solution.
4. Local Anesthetic: A local anesthetic is injected to numb the skin and deeper tissues.
5. Anesthetic Block: The anesthesiologist uses a needle to inject anesthetic near the femoral nerve.
6. Confirmation: Proper placement and effectiveness of the block are confirmed, usually via ultrasound guidance.
7. Monitoring: Vital signs are monitored throughout the procedure to ensure patient safety.
8. Procedure Completion: Once numbness is confirmed, the closed procedure on the femur is performed.

Duration

• The anesthesia procedure itself typically takes about 10-20 minutes.
• The entire procedure, including the closed procedure on the femur, may take 1-2 hours.

Setting

• This procedure is usually performed in a hospital, surgical center, or outpatient clinic with appropriate facilities.

Personnel

• An anesthesiologist or nurse anesthetist.
• Supporting nurses and medical assistants.
• Orthopedic surgeon if a reduction is being performed.

Risks and Complications

• Common Risks: Temporary numbness or muscle weakness, bruising at the injection site.
• Rare Risks: Infection, bleeding, nerve damage, allergic reactions to the anesthetic, failure of the block leading to inadequate pain relief.

Benefits

• Effective pain relief during the procedure.
• Reduced need for general anesthesia, leading to faster recovery times.
• Potentially lower risks compared to general anesthesia.

Recovery

• Post-Procedure Care: Monitoring until the anesthetic wears off, which can take a few hours.
• Instructions: Avoid operating machinery or driving until full sensation and muscle control return.
• Restrictions: Follow specific activity restrictions as advised by the healthcare provider.
• Follow-Up: Typically involves follow-up appointments to monitor healing and progress.

Alternatives

• General Anesthesia: Involves anesthesia affecting the whole body but comes with higher risks and longer recovery.
• Local Anesthesia: Only numbs a smaller, specific area but may not provide enough pain relief for femur procedures.
• Pros and cons of alternatives vary based on the patient's medical condition and procedure specifics.

Patient Experience

• During Procedure: The patient will feel an initial pinch and pressure from the needle. After that, the area should become numb, and they should not feel pain.
• Post-Procedure: Patients may feel drowsy or groggy as the anesthesia wears off. Some mild discomfort or bruising at the injection site is possible.
• Pain Management: Pain relief measures, including medications, will be provided as needed.