Urgent Care

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Treatment

Anaesthesia

Several types of anaesthesia may be used, depending on the type and duration of the foreseen operation. Your surgeon (if he or she is the one performing the anaesthesia) or the anaesthetist will have told you which anaesthetic will be applied during the pre-operative consultation.

Local anaesthesia
It is better if you avoid fasting: you can have lunch or dinner normally before the operation.

The anaesthetic fluid is infiltrated under the skin. The injection is quite tolerable. The tourniquet is inflated and the operation can begin after checking that the anaesthesia is working well, i.e. you are not in any pain. Its duration depends on the tolerance of the tourniquet. 10 minutes are usually enough for the surgeon to perform minor procedures such as carpal tunnel or trigger finger). The tourniquet is then released and the blood returns to the tissue, causing a sensation of numbness which lasts for 1-2 minutes.

Risks: fainting with dizziness, decreased heart rate and blood pressure. Simple measures in which caregivers are trained can quickly restore the situation.

Intravenous anaesthesia
A light meal 2 hours before the operation can be tolerated.

A venous drip is inserted by a nurse before surgery. The area to be operated is partially drained of blood with an elastic band and the two tourniquets placed on the arm are inflated in order to prevent blood entering the forearm. The anaesthetist or surgeon then injects a diluted anaesthetic solution, the amount of which depends on your weight. Anaesthesia occurs in about 10 minutes. The two tourniquets are deflated in turn depending on their tolerance. The duration of the operation permitted for this type of anaesthesia is 40 minutes.

Risks: risks are minimal. However, if the tourniquet is loosened too quickly, the product flowing rapidly into the bloodstream produces short-term dizziness or fainting, which may be accompanied by seizures. The intravenous drip placed on the other limb allows the administration of the necessary medication. In all the time that we have been performing this operation, we have never experienced an accident of this kind.

Anaesthesia by axillary block
Fasting is preferable here since if insufficient anaesthetic is administered, general anaesthesia may become necessary.

The anaesthetist disinfects the armpit and then injects the anaesthetic solution around the nerves of the arm under ultrasound control. This manoeuvre is not particularly painful. Anaesthesia develops in approximately 30 minutes. If it is not total, the surgeon can complete it by directly infiltrating the tissues at the site of the surgery. Surgeons can operate by applying a tourniquet for two hours. Circulation must then be restored for 20 minutes in order to allow reoxygenation of the tissues. The anaesthesia lasts for 4-12 hours after the product is injected. Sensory and muscular paralysis is total during this period.

Risks: very low. Haematomas and nerve irritation with residual pain lasting several weeks have been described in the literature. Complications associated with the administration of anaesthetic substances are monitored by the anaesthetist or his or her assistants. Premedication is routinely administered in hospitals and for long operations. Oxygen and sedation may also be given if desired.

General anaesthesia
This type of anaesthesia is administered by an anaesthetist. This requires pre-operative consultation and assessment. By now, this type of anaesthesia is completely safe. The anaesthetist will provide you with all of the necessary information regarding anaesthetic procedures and possible risks.