Anesthesia Techniques Used for Arm and Hand Surgery

During interventions on the hands and arms, many options are available for anesthesia, which includes two main types:

• General anesthesia: comparable to sleep, this state is induced by injecting drugs through an intravenous route;
• Loco-regional anesthesia: numbing of the part of the body on which the operation will take place.

It is during the pre-operative anesthesia consultation that the anesthesiologist will determine, with your agreement, the type of anesthesia most appropriate. 

Generalities

Hand and arm surgery can be used to treat conditions that affect:

• The hand;
• The wrist;
• The forearm;
• The elbow.

Hand surgery is in most cases performed under loco-regional anesthesia where only the affected limb is anesthetized. The duration of this anesthesia depends essentially on the type of product used and the volume injected and can vary from a few hours to 24 hours.

‍This intervention consists of injecting a local anesthetic in contact with one or more nerves concerned. This creates a blockage of the nerve communication between the hand and the brain and by extension, a paralysis and insensitivity of the limb. Local anesthesia is a reversible action since the local anesthetic will be resorbed by the body.

Is it Feasible to Combine a General Anaesthesia with a Loco-regional "anaesthesia"?

When a general anesthesia is essential ( for instance, for shoulder surgery), it is possible to combine it with a loco-regional anesthesia. This association allows:

• To attenuate the painful stimuli during the operation which decreases the quantity of drugs necessary for the general anesthesia;
• Easier waking recovery with fewer side effects such as nausea or vomiting;
• To reduce postoperative pain.

‍In this configuration, the loco-regional anesthesia is in fact a loco-regional analgesia. It does not aim to cut off the transmission of all nerve messages but only the transmission of the painful message. The big difference is that you do not feel the pain but you can mobilize your sleeping limb.