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Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps

CPT4 code

Name of the Procedure:

Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps.

Summary

This procedure involves the administration of anesthesia to manage pain and ensure comfort during surgical repair or manipulation of the upper arm and elbow structures, specifically addressing tenodesis and ruptures of the long tendon of the biceps.

Purpose

The procedure is intended to provide pain relief and immobilization during the surgical correction of issues affecting the upper arm and elbow, such as tendon ruptures. The primary goal is to allow the surgeon to repair or realign the anatomical structures without causing the patient discomfort.

Indications

  • Painful, torn, or ruptured biceps tendon
  • Conditions requiring tenodesis
  • Inflammation or injury to surrounding muscles, tendons, fascia, and bursae
  • Patients experiencing significant pain or functional impairment in the upper arm or elbow

Preparation

  • Patients may be instructed to fast for several hours before the procedure.
  • Certain medications might need to be paused or adjusted.
  • Diagnostic tests like MRI or ultrasound may be required to assess the extent of the injury.

Procedure Description

  1. The patient is brought to the operating room and positioned appropriately.
  2. An intravenous (IV) line is placed to administer medications and fluids.
  3. The anesthesiologist administers local, regional, or general anesthesia based on the extent of the procedure.
  4. Once the area is numb, the surgeon performs the tenodesis or repairs the ruptured tendon.
  5. The anesthetic effect is maintained throughout the procedure to ensure patient comfort.

Duration

The procedure typically takes 1 to 2 hours, depending on the complexity of the surgery.

Setting

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

Personnel

  • Orthopedic surgeon
  • Anesthesiologist
  • Surgical nurses
  • Surgical technician

Risks and Complications

  • Common risks: Bruising, swelling, and temporary nerve numbness.
  • Rare risks: Infection, allergic reactions to anesthesia, prolonged numbness or nerve damage, complications from anesthesia.
  • Any complications would be managed by the surgical and anesthesia teams.

Benefits

  • Pain relief during surgery
  • Reduced discomfort and anxiety
  • Enabling precise surgical repair, which may improve functional outcomes

Recovery

  • Patients may need to rest at the hospital or clinic for a short period post-surgery.
  • Instructions on wound care, activity restrictions, and pain management will be provided.
  • Recovery time varies but typically spans several weeks to a few months.
  • Follow-up appointments are scheduled to monitor healing and recovery progress.

Alternatives

  • Conservative treatment like physical therapy and pain management.
  • Corticosteroid injections.
  • Surgery without anesthesia, though this is usually not feasible due to pain.

Patient Experience

During the procedure, patients will be sedated or under anesthesia, feeling no pain. After the procedure, they might experience soreness or numbness at the site, managed with prescribed pain medications and other comfort measures.

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