Anaesthetics for hand surgery
One of the most common questions asked is “what type of anaesthetic will I be having?”
There are 3 main options.
For all anaesthetics, you will be advised regarding a “nil by mouth” period. This must be observed to decrease the risk of serious airway complications (eg. vomiting and aspiration of stomach contents).
Nb. Coffee, milk, soft drinks and orange juice are NOT considered clear fluids
Please note, the above information is a general guide only. It does not provide details or information on the specific risks of anaesthetics. Further information will be provided by your anaesthetist on the day of surgery.
There are 3 main options.
- Local anaesthetic and sedation
- the anaesthetist inserts a cannula in the opposite hand
- used for IV antibiotics and light sedatives/ pain medication
- Local Anaesthetic is infiltrated around the operative site
- this is well tolerated due to the sedation
- the surgical team then prepares and sterilises the operative field
- only the operative site is anaesthetised so you will still feel some “poking and prodding”
- if there is any discomfort or pain you are able to let the anaesthetist/ surgical team know
- ideal for small or relatively quick procedures
- safest anaesthetic for the elderly and medically frail
- allows a very quick recovery (from the anaesthetic) and minimal if any “hangover” effects from the drugs given
- has the advantage that the surgical team can ask you to move to check the surgical result eg. “make a fist” or “bend your finger”
- trigger finger and carpal tunnel releases and are routinely performed with this method and it can be used for many other procedures
- the anaesthetist inserts a cannula in the opposite hand
- Regional block (and sedation)
- the anaesthetist inserts a cannula in the opposite hand
- Used for IV antibiotics and sedatives/ pain medication
- the anaesthetist uses ultrasound to carefully inject local anaesthetic around the main nerves to the arm
- The injection can be in the shoulder region, axilla or proximal forearm depending on anaesthetist preference and what is required for the operation
- there is no feeling or movement in the hand or arm
- this is an excellent form of anaesthesia for hand surgery
- safe and effective
- avoids the risks and side effects of a general anaesthetic
- provides post operative pain relief until the block wears off
- the anaesthetist inserts a cannula in the opposite hand
- General anaesthetic (GA)
- the anaesthetist inserts a cannula in the opposite hand
- used for IV antibiotics and sedatives/ pain medication
- in children, anaesthetic gas may be given through a mask before inserting the cannula (gas induction)
- the GA is supplemented with local anaesthetic infiltration (or regional block) for post operative pain relief
- this is the most common type of anaesthetic and the standard for children
- more drugs are used so there is a higher rate of side effects including
- nausea and vomiting
- increase in post operative fatigue or “hangover” effect
- the anaesthetist inserts a cannula in the opposite hand
For all anaesthetics, you will be advised regarding a “nil by mouth” period. This must be observed to decrease the risk of serious airway complications (eg. vomiting and aspiration of stomach contents).
- No food for 6 hours
- Clear fluids only (water or apple juice) can be consumed until 2 hours prior to the expected procedure time
- usual medication or pain relief should still be taken with a sip of water
Nb. Coffee, milk, soft drinks and orange juice are NOT considered clear fluids
Please note, the above information is a general guide only. It does not provide details or information on the specific risks of anaesthetics. Further information will be provided by your anaesthetist on the day of surgery.
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