Patients having hand surgery have several options when it comes to anesthesia. As with other types of surgery, these include local, regional and general. The patient, surgeon and anesthesiologist will work together to determine the best type to use. The type and duration of surgery as well as the health and medical conditions of the patient will all be considered to make the best choice. Below, you can find descriptions of each kind of anesthesia.
“Local anesthesia” generally refers to anesthesia used on a small area of the body. As you’ve probably experienced in the dentist’s office, this involves injecting numbing medicine directly into the area on which you’ll be operated. This type also includes medications that are administered intravenously, which help you to relax before a surgery.
By injecting numbing medicine near a path of nerves, regional anesthesia makes a whole part of your body “go to sleep.” It can be used near the collarbone, under the arm or through a vein in your arm. Like with local anesthesia, a medication that induces relaxation may also be used in conjunction. The benefits of regional anesthetics include lessened post-op pain (which results in a decreased use of post-surgery narcotic need), less nausea, quicker post-op wake up time, and sometimes even less blood loss and a lowered risk of blood clots.
For some, the actual injection of the anesthesia can be slightly uncomfortable or painful. That’s why the accompanying relaxing medication is often used. Anesthesiologists may even utilize a bit of local anesthesia in the area where the IV needle will be injected to minimize pain.
Depending on the type of medication used, regional anesthesia can block pain for anywhere from 1 to 24 hours. When the medication wears off, you may feel that your muscles are weak or difficult to control, which is normal. You will also typically be given additional pain medication to prevent post-op pain after the effects of the anesthesia wear off.
Preferences about the level of awareness during surgery vary from patient to patient. You and your doctors can decide exactly how “awake” you’d like to be. Regardless of your level of consciousness, you will not be able to watch the surgery happening, as a sterile curtain is put between your face and the site of the surgery in order to protect it from any possible contamination.
Just like with all anesthetics, some risks are associated with the benefits. The possible risks include bruising around the needle, tingling that lasts for days after the surgery, or pain relief that isn’t complete. Although there is a chance of serious complications such as excess bleeding, infection or nerve injury, these problems are very rare.
Regional Anesthesia Types:
- Supraclavicular Block: Injection of medication is done above the collarbone. This type of block is more widely used now than it used to be, as new developments in technology have made it increasingly safer. It is typically used for the wrist, hand, elbow, and upper arm.
- Axillary Block: Medicine is injected under the armpit and is good for numbing the elbow, forearm, wrist and hand.
- Interscalene Block: Injected near the scalene muscles, this kind of anesthesia works well for the shoulder, upper arm, forearm and wrist.
- Bier Block: Delivered through an IV in the arm, this anesthesia is employed most for short operations like carpal tunnel surgery.
- Wrist Block: Used to numb the hand and fingers, this anesthesia is injected by the wrist nerves.
- Rescue Block: This medication helps ease your post-op transition or to complete pre-op treatment in conjunction with one of the other types of anesthesia described above.