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Discussion

Local without sedation

How local do you see patients have surgery with local anesthetic only without any sedation?

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    We see it quite frequently- temporal artery bxs, flexi cystos, CTRs, other finger cases, etc. Probably 5-6 times per week- and that doesn't include our day surgery unit who has a higher frequency.

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    Not every patient or every situation needs sedation. Most of the time patients do very well on marcaine or lidocaine. Sometimes sedation is a bit of a overkill.

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    Some of our ortho patients have an epidural and/or nerve block. I think its mainly when the pt isn't a candidate for a general or doesn't want to be sedated though.

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    Sometimes our general surgeons will do excisions of lipomas that are small with local only. It's pretty rare at our hospital though.

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    I've seen one in 3 yrs. at our hospital. Most of them are done at the ambulatory surgery center.

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    We have a minor procedure area where we do small cases under local only. (no anesthetist, only one nurse and the surgeon). There is no option for sedation here, so if a surgeon thinks their patient can't handle it, they have to book it in the main OR.

    We do cystoscopy, carpal tunnel, trigger finger release, many little "lumps and bumps" removals (lipomas, potential skin cancers, moles, etc), some smaller ENT things (occ. myringotomy, polyp remvoal, etc).

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