01758 Anesthesia for open or surgical arthroscopic procedures of the elbow; excision of cyst or tumor of humerus

Name of the Procedure:

Anesthesia for Open or Surgical Arthroscopic Procedures of the Elbow; Excision of Cyst or Tumor of Humerus

Summary

This procedure involves administering anesthesia to facilitate the removal of a cyst or tumor from the humerus bone via either an open incision or surgical arthroscopy. The goal is to ensure the patient remains pain-free and immobile during the surgery.

Purpose

The procedure addresses the presence of cysts or tumors within the humerus bone, which may cause pain, impingement, or other functional impairments. The expected outcome is the safe and effective removal of the cyst or tumor, alleviating symptoms and preventing further complications.

Indications

• Presence of a cyst or tumor in the humerus confirmed through imaging studies.
• Symptoms such as persistent pain, swelling, or reduced range of motion in the elbow.
• Failure of conservative treatments such as medications or physical therapy.

Preparation

• Patient may be instructed to fast for 8-12 hours before the procedure.
• Necessary preoperative imaging studies like X-rays, CT scans, or MRIs.
• Routine blood tests and assessments to ensure the patient is fit for surgery.
• Review of current medications, with instructions to discontinue certain drugs like blood thinners.

Procedure Description

1. Patient receives an intravenous (IV) line for medication administration.
2. An anesthesiologist administers general or regional anesthesia to render the patient unconscious or the arm numb.
3. The surgical site is cleansed and sterilized.
4. For open surgery, an incision is made over the affected area of the humerus.
5. For arthroscopic surgery, small incisions are made, and a camera and instruments are inserted.
6. The cyst or tumor is carefully excised.
7. Tissue samples may be sent to a lab for further analysis.
8. Incisions are closed with sutures or staples and dressed appropriately.

Duration

The procedure typically takes 1 to 2 hours, depending on the complexity and size of the cyst or tumor.

Setting

Usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Common risks: Infection, bleeding, allergic reactions to anesthesia.
• Rare risks: Nerve damage, blood clots, joint stiffness, complications from anesthesia.
• Management includes antibiotics for infections, medications for pain and clot prevention, and physical therapy for joint recovery.

Benefits

• Relief from pain and other symptoms caused by the cyst or tumor.
• Improved elbow function and range of motion.
• Preventing the growth or worsening of the cyst/tumor.

Recovery

• Post-procedure monitoring in a recovery room until anesthesia effects wear off.
• Instructions on wound care and activity restrictions.
• Pain management with prescribed medications.
• Physical therapy may be recommended to restore mobility.
• Follow-up appointments to monitor healing and remove stitches or staples.
• Average recovery time is a few weeks to several months, depending on individual factors.

Alternatives

• Watchful waiting with regular monitoring for changes in size or symptoms.
• Non-surgical treatments such as aspiration or injection therapy.
• Pros and cons depend on factors like severity, patient health, and preference. Non-surgical options may be less invasive but might not provide permanent relief.

Patient Experience

• The patient will be asleep or numb during the procedure and should not feel pain.
• Post-operative pain managed with medications.
• Some discomfort, swelling, and limited use of the affected arm can be expected initially.
• Patients may need assistance with daily activities during early recovery.

By following the above steps, patients can expect a comprehensive and clear understanding of what to anticipate before, during, and after the procedure.