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Your Anaesthetic

Anaesthesia stops you feeling pain and other sensations.
It can be given in various ways:

Local anaesthesia involves injections which numb a small part of your body. You stay conscious but free from pain.

Regional anaesthesia involves injections which numb a larger or deeper part of the body.
You stay conscious but free from pain.
The most common regional anaesthetic for Shoulder surgery is an Interscalene Block.

General anaesthesia gives a state of controlled unconsciousness. It is essential for some operations.
You are unconscious and feel nothing.
The most common type of General Anaesthetic we use is know as Total Intravenous Anaesthesia (TIVA). TIVA has the advantages of being very short acting and safe. It is a quick anaesthetic and wears off quickly, with almost no after-effects. So it is ideal for Day Case shoulder and elbow surgery and you should be able to go home less than 6 hours after your operation.

We generally use a combination of a General anaesthetic (TIVA) and a Local anaesthetic or Interscalene block. This ensures the best post-operative pain relief is achieved and you can go home earlier. Sometimes an Interscalene block alone is used if you would prefer to be awake throughout the operation or if a General Anaesthetic is not suitable.

Your anaesthetist will see you before your operation and discuss your anaesthetic with you. Please indicate any preferences and concerns then. If you would like to meet your anaesthetist before the day of your operation please let us know and we can arrange it for you.

Interscalene Block

An Interscalene Block involves a small injection into your neck which numbs your arm. You will usually already be under anaesthetic before this is done, although sometimes it is done whilst you are awake. A local anaesthetic is used so you don't feel the injection and it only takes a few minutes to do.

The block usually numbs your whole arm and also makes it unusable until the block wears off. This can take 12 hours.

It is essential that you take your painkillers before the block has completely worn away, so that you continue to have pain relief.

You should take care not be come in contact with extremely hot or cold items because you will not be able to protect yourself from injuries of extremes of temperature. You should wear a sling while your arm is numb to protect over extension of your shoulder or elbow.

This procedure is safe. However, with any procedure there are risks, side effects and the possibility of complications. The most common side effect is pain at the site of injection, which is temporary.
Other risks involve bleeding, infections, spinal block and injection into blood vessels and surrounding nerves. Fortunately, the serious side effects and complications are uncommon.
Very rare complications are epidural or subarachnoid injection, vertebral artery injections resulting in convulsions(seizures), and rarely pneumothorax (collapse of lung) these complications are lessened by placement of block with use of a nerve stimulator.
 

16/03/2004

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