ANESTHESIA IN HAND SURGERY

Decreasing risks of anesthesia of patients during and after the operation and efficient pain killing as the main purposes has become effective in development of anesthesia alternatives. Local, regional and general anesthesia techniques may be used in hand surgery anesthesia. The technique is decided by evaluating operation area, health status, psychological status of the patient.

Local Anesthesia

Local Anesthesia is performed via drugs administrated subcutaneously for narcotizing small areas (finger, small skin cuts etc.). With this method, patient relaxation is provided through intravenous relaxing drugs. It is simple, easy to apply and less risky method. It is the best method for managing the pain in small surgical procedures. The patient may be discharged just after the operation. The patient may eat and drink water after the surgery with this technique.

Regional Anesthesia

Regional anesthesia aims to stop motor and sensory functions temporary by drugs administrated to locations close to main nerves. Wider areas are narcotized according to local anesthesia. Generally nerve passing ways are detected by ultrasound or nerve stimulator. This anesthesia type should be applied in operation room conditions. Intravenous relaxing (sedative) drugs may be administrated at the same time to relax the patient. By this method, early term pains are prevented as well as narcotizing the arm during the surgery. The patient does not take risks of general anesthesia with this method. The patient may eat and drink water just after the surgery. The patient may be informed by the surgeon and the anesthesia team in suitable situations during the surgery. If the patient wants to sleep during the procedure, sedative drugs may be administrated. Besides, continuous pain killing may be provided by putting a catheter on the narcotized area even to help to increase the blood circulation on the finger or to kill the pain for patients with circulation loss in the finger. Method application is comfortable and short. The patient does not feel discomfort while the method is applied. Regional anesthesia paralysis the extremity between 6-8 hours as showing personal differences. The patient is hospitalized until the patient feels his/her hand. Complications are seen very rarely. Insufficient level of anesthesia, pain and bruising in the needle area and fornication may be observed rarely. The anesthetist controls whether the pain is stopped and if there is a problem in areas where arm should re-narcotized. Supraclavicular block, axillary block, interscalenous block, infraclavicular block, elbow level ulnar block, wrist block are among the methods used in regional anesthesia.

General Anesthesia

The operation is done after the patient is intubated with this method. 5-8 hours of hunger period is required before the surgery. Risks are relatively more than regional anesthesia. It is generally used in children and adult patients who has a bad psychological situation and/or will have multiple operation. Postoperative pains of the patient are stopped by other analgesic methods and drugs. Eating and drinking water are not allowed for 4 hours as it may cause some complications after the surgery. .

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