01712 Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open

Name of the Procedure:

Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open

Summary

Anesthesia is administered to facilitate a tenotomy procedure, which involves making an incision to cut a tendon in the upper arm or elbow. This procedure aims to relieve pain and restore function in patients with tendon-related issues.

Purpose

The procedure addresses chronic pain, tendon inflammation, or restricted movement of the upper arm and elbow. The goal is to alleviate pain, improve mobility, and enhance the quality of life.

Indications

• Chronic tendonitis or tendon inflammation
• Tendon ruptures requiring surgical intervention
• Severe elbow and upper arm pain unresponsive to conservative treatments
• Restricted arm movement due to tendon issues
• Patients deemed fit for surgery after clinical evaluation

Preparation

• Fasting for at least 6-8 hours prior to the procedure
• Discontinuing certain medications as advised by the doctor
• Undergoing a physical examination and possibly imaging studies like MRI or ultrasound
• Arranging for someone to drive the patient home post-procedure

Procedure Description

1. The patient is positioned and prepped in a sterile manner.
2. Anesthesia is administered, typically regional (brachial plexus block) to numb the arm, or general anesthesia, depending on the case.
3. The surgeon makes an incision over the affected tendon.
4. The tendon is carefully exposed, inspected, and severed as needed.
5. Any necessary repairs or adjustments to surrounding tissue are performed.
6. The incision is closed with sutures, and a sterile dressing is applied.
   • Tools: Scalpels, forceps, scissors, sutures
   • Anesthesia: Regional or general anesthesia administered by an anesthesiologist

Duration

The procedure typically takes 1 to 2 hours.

Setting

The procedure is performed in a hospital operating room or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurse
• Operating room technician

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Damage to surrounding nerves or blood vessels
• Adverse reactions to anesthesia
• Incomplete relief of pain or recurrence of symptoms
• Blood clots

Benefits

• Significant pain relief
• Improved arm and elbow function
• Enhanced quality of life
• Faster recovery compared to non-surgical treatments in some cases

Recovery

• Post-procedure monitoring for a few hours in the recovery room
• Pain management with prescribed medications
• Instructions on wound care and activity restrictions
• Physical therapy to regain strength and flexibility
• Follow-up appointment within 1-2 weeks
• Full recovery typically within 6-12 weeks

Alternatives

• Physical therapy and rehabilitation
• Corticosteroid or platelet-rich plasma (PRP) injections
• Medications for pain and inflammation
• Minimally invasive procedures
• Pros: Non-surgical options have fewer risks and shorter recovery times
• Cons: May not be as effective in severe or chronic cases

Patient Experience

• During the procedure: The patient will likely feel groggy or sedated and should not feel pain if anesthesia is effective.
• After the procedure: Some pain and swelling around the incision site are expected, which can be managed with medications. Discomfort and limited arm movement are normal in the initial recovery phase.