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What to expect regarding anesthesia for your shoulder or elbow surgery

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What to expect regarding anesthesia for your shoulder or elbow surgery

There are several different approaches to anesthesia, depending on the type of surgery you will be having. Prior to your surgery, you will have the opportunity to discuss any options and any particular concerns you might have with the anesthesiologist. Most patients get both a regional block plus general anesthesia, while other patients only get a regional block.

Regional block

A regional block puts a region of your body to sleep, typically your entire arm for shoulder and elbow surgeries.  This is similar to the type of numbing that you might experience at the dentist’s office, but in a much larger area of your body. A regional block can last up to 24 hours, so it keeps you from having pain immediately following surgery and lessens the amount of pain medication needed for surgery and postoperatively.   For outpatient surgeries, the regional block allows you to get home, get situated, and take some pain meds while your arm is still numb.

For some patients undergoing an certain procedures, particularly for elbow procedures, you may receive a regional block plus sedation but not need general anesthesia. Now, that might make some patients think, “I don’t want to be awake and hearing what’s happening during surgery!” While you won’t be under general anesthesia, you will still be heavily sedated. Most patients sleep through the entire procedure, while others may hear a few sounds here and there, although not much usually.

General anesthesia

For longer and more involved surgeries, such as shoulder or elbow replacements or rotator cuff repairs, you will most likely be under general anesthesia. Unlike a regional block that only puts a specific area of your body to sleep, general anesthesia affects your entire body, including your brain and nervous system.  Typically both regional and general anesthesia are used together for most of our procedures.

While you are under general anesthesia, your anesthesiologist will monitor your heart rate, breathing, blood pressure, and body temperature to ensure your body functions are safely regulated even though you are in a deep sleep. You may also have a breathing tube down your throat, which may result in some hoarseness or a sore throat following surgery.

Key considerations for anesthesia

Many patients prefer to be put to sleep under general anesthesia and awakened after it’s over. However, it’s important to consider the risks and benefits of a regional block versus general anesthesia and discuss them with your doctor. Here are a few things to consider when making a decision regarding anesthesia.

  • Current health status. Do you have any specific risk factors that might impact your body during surgery, such as smoking, being overweight, or other diagnosed medical conditions such as heart attack or stroke in the past?
  • Past exposure to anesthesia. Have you been under anesthesia before, and did you have any adverse reactions? How do members of your family react to anesthesia?
  • Reactions to medications. Are you allergic to any medications, or have you ever experienced significant side effects from a drug? What medications, including over-the-counter and herbal remedies, are you currently taking? In addition to medications, it is important for your team to be aware of allergies to latex and adhesives such as those in surgical tape.
  • Preferences of your surgical team. Your surgeon or anesthesiologist may have specific recommendations for your type of surgery and your health history.

If you have other questions about your options for anesthesia, be sure to discuss them with your doctor in advance.