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Anesthesia for all closed procedures on humerus and elbow

CPT4 code

Name of the Procedure:

Anesthesia for Closed Procedures on the Humerus and Elbow
Common Name: Humerus and Elbow Anesthesia
Technical Term: Anesthesia for Closed Reduction and Manipulation of the Humerus and Elbow

Summary

This procedure involves administering anesthesia to numb the area around the humerus (upper arm bone) and elbow to allow for the non-surgical treatment of fractures or dislocations. It ensures that the patient feels no pain during the manipulation and alignment of bones by the healthcare provider.

Purpose

This procedure addresses broken or dislocated bones in the humerus or elbow that do not require open surgery. The goal is to reposition the bones correctly while minimizing pain and discomfort for the patient.

Indications

  • Fractures of the humerus or elbow that can be treated without surgery.
  • Dislocations of the elbow joint.
  • Severe pain or inability to move the arm due to injury.
  • X-ray confirmation of closed fractures or dislocations.

Preparation

  • Patients may be instructed to fast for several hours before the procedure.
  • Adjustments to medications as advised by the healthcare provider.
  • Pre-procedure assessments, including a physical examination and imaging studies like X-rays.

Procedure Description

  1. The patient is positioned comfortably, and an intravenous (IV) line is inserted.
  2. An anesthesiologist administers either local, regional, or general anesthesia, depending on the extent of the procedure and the patient's medical history.
  3. Once anesthesia takes effect, the healthcare provider manually manipulates the bones to restore their proper alignment.
  4. X-rays may be taken during the procedure to confirm correct bone positioning.
  5. Immobilization devices like splints or casts are applied to maintain bone alignment during healing.

Duration

The procedure typically takes 30 minutes to 1 hour, depending on the complexity of the manipulation required.

Setting

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

Personnel

  • Anesthesiologists or nurse anesthetists for administering anesthesia.
  • Orthopedic surgeons or emergency medicine physicians for performing the bone manipulation.
  • Nurses and radiologic technologists for patient support and imaging.

Risks and Complications

  • Common risks: Nausea, vomiting, and allergic reactions to anesthesia.
  • Rare risks: Nerve injury, infection, improper bone healing, and adverse reactions to anesthesia.
  • Complications may require further medical or surgical intervention.

Benefits

  • Relieves pain and facilitates proper healing of fractured or dislocated bones.
  • Helps in restoring arm function and mobility.
  • Benefits are often realized immediately after the procedure with reduced pain and discomfort.

Recovery

  • Post-procedure care includes monitoring in the recovery room until anesthesia effects wear off.
  • Instructions include keeping the arm immobilized, managing pain with prescribed medications, and attending follow-up appointments.
  • Recovery time varies but typically involves several weeks of immobilization, followed by physical therapy.

Alternatives

  • Conservative treatment using immobilization without manipulation.
  • Surgical intervention if closed manipulation is not sufficient or indicated.
  • Each alternative has its pros and cons, such as longer recovery times for surgery versus potential inadequate healing with conservative treatment.

Patient Experience

  • Patients may feel groggy or disoriented as the anesthesia wears off.
  • Pain management includes medications and keeping the arm elevated.
  • Comfort measures include ice application and rest.
  • Follow-up care includes physical therapy and regular check-ups to monitor healing progress.

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