Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder
CPT4 code
Name of the Procedure:
Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder.
Summary
This procedure involves administering anesthesia to facilitate surgical repairs or treatments on the tendons between the elbow and shoulder. It ensures that the patient remains pain-free and comfortable while the surgeon performs the necessary interventions.
Purpose
The primary purpose of this procedure is to repair or reconstruct damaged tendons in the upper arm and elbow region. It aims to alleviate pain, restore function, and improve the range of motion in patients suffering from tendon injuries or conditions affecting the upper limb.
Indications
- Tendon tears or ruptures
- Chronic tendonitis
- Degenerative tendon conditions
- Traumatic injuries to the upper arm or elbow
- Pain and impaired function due to tendon abnormalities
Preparation
- Patients may need to fast for several hours before the procedure.
- Medication adjustments may be necessary, especially for blood thinners.
- Diagnostic tests, such as MRI or ultrasound, may be required to assess the extent of the tendon damage.
Procedure Description
- Pre-operative assessment by the anesthesiologist to determine the best type of anesthesia.
- Administration of regional anesthesia, typically a brachial plexus block, to numb the upper limb.
- Monitoring of the patient's vital signs throughout the procedure.
- The surgeon makes an incision to access the injured tendon.
- Surgical repair, which may involve stitching or grafting, is performed on the damaged tendon.
- The incision is closed, and dressings are applied.
Tools and equipment include needles for administration of anesthesia, monitoring devices, scalpels, sutures, and grafting materials.
Duration
The procedure typically takes 1 to 2 hours, depending on the extent of the tendon damage and the complexity of the repair.
Setting
This procedure is usually performed in a hospital or a specialized surgical center.
Personnel
- Anesthesiologist
- Orthopedic surgeon or specialized surgeon
- Surgical assistant
- Nursing staff
Risks and Complications
- Anesthesia-related risks (e.g., allergic reactions, respiratory issues)
- Infection at the surgical site
- Nerve damage
- Blood clots
- Incomplete healing or recurrence of tendon issues
Benefits
- Pain relief in the affected area
- Improved mobility and function of the upper arm and elbow
- Enhanced quality of life
- Faster recovery with modern surgical techniques
Recovery
- Post-procedure observations for a few hours.
- Pain management with prescribed medications.
- Instructions for wound care and activity restrictions.
- Physical therapy may be required to restore full function.
- Follow-up appointments to monitor healing.
Alternatives
- Non-surgical treatments such as physical therapy, medications, or steroid injections.
- Extracorporeal shock wave therapy (ESWT).
- Platelet-rich plasma (PRP) injections.
Each alternative has its pros and cons. For example, non-surgical treatments may offer relief without the risks of surgery but may not be effective for severe tendon damage.
Patient Experience
During the procedure, the patient should not feel pain thanks to the anesthesia. Post-operatively, there might be discomfort and swelling around the surgical site, which can be managed with painkillers and ice packs. Full recovery may take several weeks to months, depending on the individual's adherence to rehabilitation protocols.