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Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified

CPT4 code

Name of the Procedure:

Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified
Common Names: Regional anesthesia for upper arm and elbow surgery

Summary

Anesthesia for procedures on the upper arm and elbow involves injecting a numbing medication to block sensation in the specified area. This allows surgeons to perform various operations without the patient feeling pain in the targeted region.

Purpose

This type of anesthesia is used to manage pain during surgeries or treatments involving the nerves, muscles, tendons, fascia, and bursae of the upper arm and elbow.

  • Medical Problems Addressed: Injuries, chronic pain conditions, inflammation, and structural issues in the upper arm and elbow.
  • Goals: To ensure the patient feels no pain during the procedure, to promote a smooth surgical experience, and to potentially reduce the need for general anesthesia.

Indications

  • Symptoms or Conditions: Chronic elbow pain, nerve entrapment, tendon injuries, inflammatory conditions like bursitis.
  • Patient Criteria: Patients undergoing surgery or a medical procedure involving the upper arm or elbow who are good candidates for regional anesthesia as determined by their medical history and physical condition.

Preparation

  • Pre-procedure Instructions: Patients may need to fast for a few hours before the procedure. Instructions on medication adjustments, especially anticoagulants, will be provided.
  • Diagnostic Tests: Preoperative assessments may include blood tests, nerve conduction studies, and imaging like X-rays or MRIs.

Procedure Description

  1. Anesthesia Injection: A local anesthetic is injected near the nerves supplying the upper arm and elbow.
  2. Positioning: The patient is positioned comfortably, often lying down or semi-reclined.
  3. Monitoring: Vital signs are monitored throughout the procedure.
  4. Technology and Tools: Ultrasound or nerve stimulators may be used to guide precise injection.

Duration

The procedure typically takes 15 to 30 minutes.

Setting

The procedure is performed in a hospital, outpatient clinic, or surgical center.

Personnel

  • Healthcare Professionals Involved: Anesthesiologists, nurses, sometimes assisted by other surgical staff.

Risks and Complications

  • Common Risks: Bruising, temporary numbness, or weakness in the affected limb.
  • Rare Risks: Infection at the injection site, allergic reaction to anesthetic, nerve damage, or systemic toxicity if anesthetic spreads to other parts of the body.

Benefits

  • Expected Benefits: Effective pain control during and immediately after the procedure, reduced need for general anesthesia, quicker recovery.
  • Onset: Immediate relief from pain once the anesthetic takes effect, usually within minutes.

Recovery

  • Post-procedure Care: Monitoring in a recovery area until the anesthetic effect wears off, instructions for pain management at home.
  • Recovery Time: Varies depending on the underlying condition being treated, generally ranges from a few hours to a few days for anesthesia effects to completely subside.
  • Restrictions and Follow-Up: Specific activity restrictions and scheduling of follow-up appointments for continued care and assessment.

Alternatives

  • Other Options: General anesthesia, local anesthetic without nerve block, oral pain medications.
  • Pros and Cons: General anesthesia involves more risks and longer recovery times. Local anesthetic without a nerve block may be inadequate for extensive procedures.

Patient Experience

  • During Procedure: Minimal discomfort from the injection, sensation of numbness and loss of movement in the targeted area.
  • After Procedure: Temporary numbness, possible mild discomfort once the anesthesia wears off, with pain managed through prescribed medications.

Pain management and comfort measures are taken throughout the process to ensure the patient's experience is as pleasant and stress-free as possible.

Medical Policies and Guidelines for Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified

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