Name of the Procedure:

Anesthesia for procedures on arteries of shoulder and axilla; Axillary-Brachial Aneurysm Repair

Summary

This procedure involves administering anesthesia to patients undergoing surgery to repair an aneurysm located in the arteries of the shoulder and axilla (armpit area). An aneurysm is a balloon-like bulge in an artery that can be life-threatening if it ruptures.

Purpose

The purpose of this procedure is to ensure the patient feels no pain and remains unconscious during the surgical repair of an axillary-brachial aneurysm. The primary goals are to repair the aneurysm to prevent rupture, restore normal blood flow, and prevent complications such as blood clots or tissue damage.

Indications

• Presence of an axillary-brachial aneurysm diagnosed through imaging studies.
• Symptoms like localized pain, swelling in the shoulder or arm, or signs of compromised blood flow (e.g., numbness, coldness).
• Patients who cannot undergo less invasive treatments or for whom aneurysm size and location necessitate surgical repair.

Preparation

• Patients may be instructed to fast for 8-12 hours before the procedure.
• Medication adjustments might be necessary, particularly with blood thinners.
• Pre-procedure diagnostic tests typically include blood work, imaging studies like CT scans or MRIs, and cardiovascular assessments.

Procedure Description

1. The patient is escorted to the operating room and placed on an operating table.
2. Monitoring devices (heart rate, blood pressure, oxygen levels) are attached.
3. An intravenous (IV) line is inserted into a vein to deliver medications.
4. The anesthesiologist administers a combination of medications to induce general anesthesia.
5. Once the patient is unconscious, a breathing tube is inserted to manage breathing.
6. Continuous anesthesia is maintained throughout the surgery using an anesthesia machine.
7. The surgery team performs the aneurysm repair, which may involve removing or bypassing the aneurysm.

Duration

The entire procedure, including anesthesia administration, typically takes about 2-4 hours, depending on the complexity of the aneurysm repair.

Setting

The procedure is performed in a hospital operating room equipped for vascular surgery.

Personnel

• Anesthesiologist or Certified Registered Nurse Anesthetist (CRNA)
• Vascular Surgeon
• Surgical Assistants
• Scrub Nurses
• Circulating Nurses

Risks and Complications

• Common risks include nausea, vomiting, and grogginess post-anesthesia.
• Rare but serious risks include allergic reactions to anesthesia, breathing problems, heart complications, or blood clots.
• Potential surgical complications can involve infection, bleeding, or damage to surrounding tissues.

Benefits

• Prevents the aneurysm from rupturing, which can be fatal.
• Restores normal blood flow and prevents complications from poor circulation.
• Relief of symptoms related to the aneurysm.

Recovery

• Patients are monitored in the recovery room until they regain consciousness and stable vital signs.
• Hospital stay may last from a few days to a week.
• Follow-up appointments to monitor healing and ensure no complications.
• Restrictions may include avoiding strenuous activities for several weeks.

Alternatives

• Endovascular repair (minimally invasive) may be an option for some patients.
• Medications to manage symptoms and reduce aneurysm growth, although less effective for large aneurysms.
• The pros of surgery include definitive treatment, while cons may include more significant recovery time and risk.

Patient Experience

• Patients will be asleep and unaware during the procedure due to general anesthesia.
• Post-procedure, discomfort or pain is managed with pain medications.
• Patients might feel drowsy, have a sore throat from the breathing tube, and experience some initial disorientation as they wake from anesthesia.