Anesthesia

Several types of anesthesia can be used, depending on the type and duration of the planned procedure. Your surgeon (if he or she performs the anaesthesia) or anaesthetist will have told you during the pre-operative consultation which anaesthetic will be used.

Local anaesthesia
It’s best not to fast: you can have lunch or dinner as normal before the operation.

Anesthetic fluid is infiltrated under the skin. The sting is very bearable. The tourniquet is inflated and the procedure can begin, after checking that the anaesthetic is working properly, i.e. that there is no pain. Its duration depends on the tolerance of the tourniquet. Generally, the surgeon needs only 10 minutes to perform minor procedures such as carpal tunnel or trigger finger.) Then the tourniquet is released and blood flows back into the tissues, resulting in a clotted sensation for 1-2 minutes.

Risks: vagal malaise with dizziness, drop in heart rate and blood pressure. Simple methods, which caregivers are trained to use, can quickly restore the situation.

Endovenous anesthesia
A light meal is tolerated 2 hours before the operation.

A venous line is inserted before the operation by a nurse. The area to be operated on is partially drained of blood by means of an elastic band, then the two tourniquets placed on the arm are inflated to prevent blood from entering the forearm. The anesthetist or surgeon then injects a dilute solution of anesthetic, the amount of which depends on your weight. Anesthesia takes about ten minutes. The two tourniquets are deflated in turn according to their tolerance. The authorized operating time for this type of anesthesia is 40 minutes.

Risks: risks are minimal. However, if the tourniquet is released too quickly, the product rapidly flowing into the circulation produces a short-lived dizziness or syncope, which may be accompanied by convulsions. A venous line is placed on the other limb to administer any medication required. We’ve never had an accident of this kind since we started using it.

Axillary block anesthesia
It is preferable to be fasting, because if anesthesia is not sufficient, it may be necessary to be put under narcosis (also known as general anesthesia).

The anaesthetist disinfects the axillary fossa, then injects the anaesthetic solution around the nerves of the arm under ultrasound control. This maneuver is not very painful. Anesthesia develops in about 30 minutes. If it is not complete, the surgeon can complete it by infiltrating the tissue directly at the site of the operation. We can operate with a tourniquet for two hours. The circulation must then be re-established for 20 minutes to allow tissue reoxygenation. The duration of anesthesia is 4-12 hours, depending on the product injected. Sensory and muscle paralysis is complete during this period.

Risks: very low. Haematomas and nerve irritation, with residual pain lasting several weeks, have been described in the literature. Complications related to the administration of anesthetic substances are monitored by the anesthetist or his assistants. Premedication is routine in hospitals and for long-term operations. Oxygen and sedation can also be given if desired.

General anesthesia
This type of anesthesia is performed by an anesthesiologist. It requires a pre-operative consultation and assessment. At present, this type of anesthesia is completely safe. The anesthetist will give you all the information you need about the procedure and any risks involved.