General vs local anesthesia

Hope it's okay to ask this.

I need hand surgery on tuesday - inserting some pins and such to correct a weekend accident.

When surgery was first advised I asked about local vs general. The PA said that might be an option but was a little surprised by my request. Didn't say too much to guide me one way or another. He had heard of this approach being used but didn't know if the local surgeon ever did it this way.

Later I spoke with a physiotherapist who said: " do not do local when pins are involved. General is better unless you have a high threshold for pain".

Met the surgeon today. He said it's day surgery so I immediately asked about local. He said blocking from the shoulder down is an option. Unlike the PA he didn't seem surprised, however the nurses were.

I am getting mixed signals and maybe my expectation of local is wrong in this instance. Am I missing something?

thanks

[24601]

Anytime bone is involved, it HURTS. There also is the off chance you could move unintentionally, and cause damage if you have a local. Personally, I'd take the general, and I have a high pain threshold.

[swatsurgeon]

my advice....ask for an LMA general and local infultration with marcaine. No tube through the vocal cords to irritate the throat and you wake up with a comfortable hand.
The LMA has some field practical use in a pinch...ask to see it, it will make you wonder...but it works.

[ccrn]

Originally Posted by swatsurgeon

my advice....ask for an LMA

Laryngeal Mask Airway

Thats going to be more up to who does the induction wont it? Obesity and Hx of DM will contraindicate them Ive been told as well as posterior airway-

[NousDefionsDoc]

Don't forget to get pics!

Thanks for all the info. I will ask about the LMA.

Originally Posted by NousDefionsDoc

Don't forget to get pics!

LOL - How would I do that?