The effect of local anesthetic injected into the axilla, is to cause numbness and weakness in the elbow, lower arm, hand, and fingers.
Axillary block is often a very good choice of anesthesia for patients having surgery of the arm at the level of the elbow and below. Its advantages include minimizing the risks and side effects of general anesthesia such as nausea, drug hangover, sore throat. Other advantages include the option of being awake during surgery, pain relief for some hours after surgery is over, and the likelihood of being ready to go home sooner. Axillary block is probably slightly safer than general anesthesia, and is preferred by many surgeons were applicable.
|Dr. Ken Garrod, Hand surgery|
Risks of axillary block include the small possibility of failure to achieve an adequate block, the small possibility of getting of bruise in the armpit were the axillary block is performed, and the extremely remote possibility of having temporary or permanent nerve damage.
And axillary block is performed in the operating room, after the patient has moved to the operating table and routine monitors have been applied. Most often patients will be asked to breathe supplemental oxygen through a small oxygen tube under their nose. Most often patients will receive medicine through the tubing of the intravenous to make them feel more relaxed and a bit sleepy prior to the injection.
Next the patient will be asked to put his hand under his head, the armpit will be washed with antiseptic solution, the anesthesiologist will gently probe the armpit to find the location for the injection, and the skin will been numbed with a very small needle and local anesthetic. Finally another small needle will be inserted through the numbed skin and carefully positioned. Local anesthetic will then be injected. At the time of this injection, the patient may feel pressure, and his heart may be more rapidly for several minutes. This is okay. Finally he will make an injection of local anesthesia just under the skin in a half ring around the arm again in the axilla.
It is very important to understand that the effect of local anesthesia administered this way does not begin immediately. It takes 15 to 20 minutes for an axillary block to have its full effect. During this time you may notice that you can still feel the nurse washing your arm. That's all right. The medicine has simply not yet had its full effect. The nurses will complete their preparations for surgery by covering your arm with drapes. These drapes may momentarily cover your face, but will shortly be removed from your face.
Sometimes the anesthesiologist will make you more sleepy for the beginning of the surgery. Often he will ask your preference of being awake, slightly sleepy, or totally unaware during the surgery. If he believes he can do it safely, he will sedate you according to your preference.
The anesthesiologist will stay with you the entire time you are in the operating room, and take you to the recovery room when the surgery is done.
Most often, when surgery ends, you will be awake and pain free. You will very likely go home with your arm still numb and weak. It is very important that you stay aware of where you are numb arm is until you're feeling returns. We rely on our sense of touch to protect ourselves. Also, you will find that you are unable to straighten your elbow. This makes it possible for you to strike yourself in the face with your anesthetized hand. Avoid this.
Your feeling and strength will return gradually to your arm as the local anesthetic wears off. Sometimes a good strategy is to begin with the oral pain medicine ordered by your surgeon when the discomfort begins, rather than waiting until the block is totally worn off.