What Type of Anesthesia is Provided with Bunion Surgery

One of the scariest things about any surgery is the recovery.  Is there going to be pain, can I walk, what activities can I do, can I work during recovery?   The answers to these questions vary by patient and procedure.   From an appendectomy, to brain surgery to any orthopedic surgery there is obviously going to be rules to help you recover as quickly as possible and safely as possible. 

Bunion surgery is of course no exception.  All too often patients will present for one condition, but it is obvious they are also suffering from a red inflamed bunion.   When they are pressed as to if it bothers them, they most common response is a clear “Yes,” but they have been told that the recovery from bunion surgery can be long painful, and may not deliver the results they are looking for.  Well I am here to let you know that that may have been your grandmother’s bunion correction but here is the recovery of bunion “osteotomy” surgery versus Lapiplasty® 3d Bunion correction™.    In this ten part series, we will discuss post-operative recovery in several key areas; anesthesia, pain, immediate post-operative care of surgical site, swelling reduction, bathing, scar care, items needed for recovery, weightbearing activity, rehab, and physical exercise/activity.

Anesthesia

The beauty of modern surgery is that we can make our patients comfortable during their procedures by administering anesthesia from an anesthesia professional.  Unfortunately, however, due to TV, movies and sensationalized articles there is a fear in the community that this comes with great risk.  That could not be farther from the truth. 

Before you are given anesthesia, several things are completed to ensure your safety. 

- A complete medical history is reviewed by both Dr. Steinke, and your anesthesia provider.  If you have any medical conditions that can put you at risk for healing, or past history of complications with anesthesia, Dr. Steinke will refer you to your primary care physician who will examine you and determine your risk for surgery

- Pre-operative screening - Prior to surgery you will be called or meet with a nurse who will again review your medical history, advise you to not eat after midnight the day prior to your surgery, which medicines to take and not take prior to surgery, and the risks if you do not follow these instructions.  If because of your age or past medical history there is concern for cardiac issues, you will receive an EKG (heart electrical activity test) and bloodwork prior to surgery

- IV access - The day of surgery a nurse will place and IV for the administration of pre-operative antibiotics, saline and drugs needed to induce anesthesia.  If you have an issue with needles the nurses are well versed in ways to numb the skin prior to insertion of the IV. 

- Anesthesiologist examination and discussion - The day of your surgery, your anesthesia provider will examine you, discuss your medical conditions and your history with anesthesia.  If you have had a history of nausea or other issue with anesthesia, he/she will cater an anesthesia plan for your special needs

- Marking the surgical site ­– The nurses in the pre-operative holding are will confirm which foot and procedures are being performed on your foot that day.  The other leg will be wrapped in a tall stocking, to prevent a wrong site surgery from being performed.   After Dr. Steinke arrives, he will discuss the procedure and mark the appropriate foot with his initials.  The anesthesiologist and the circulating nurse who works in the operating suite will also confirm the appropriate side is selected before you even enter the operating room. 

-  Time out – Before any surgical procedure is performed, the entire surgical team (surgeon, anesthesiologist, circulating nurse and scrub tech must stop what they are doing and agree on the following:  

o   Which patient in in the room,

o   Date of birth of patient,

o   side of body and procedures to be performed,

o   any allergies or intolerances to medication or materials the patient has,

o   that antibiotics have been administered

o   appropriate implants are available in the room.   

At this point if anything does not match the case is halted before incision. 

- Monitoring the patient – Your anesthesiologist will administer some sedating medication prior to entering the room and moving over to the table is the last thing you remember.  Technically, this sedation is considered general anesthesia since you are not responsive to commands during this time and are fully asleep. Throughout the procedure the anesthesiologist monitors all your vitals and administers medication to keep you comfortable and sleeping throughout the procedure.  Upon completion, most patients awake feeling rested and are already in recovery. 

-  Post-operative recovery monitoring – a detailed report of the patient’s procedure is given by both the anesthesiologist and circulating nurse to the team of nurses in recovery.  Your vitals will be monitored closely, and you will be slowly given ice chips then food to eat as you recover.   If you are experiencing any pain or nausea, medication will be given to reduce these symptoms.  Once you are stable, the nursing team will transport you to your vehicle in a wheelchair and you will head home.   The total time at the surgery center is about 3-3.5 hours; one hour before, 1 – 1.5 hours in surgery and then one hour in recovery.

- After surgery – The day after your procedure the center will typically call you to see how you are doing.  They can provide instruction or recommend you call Dr. Steinke with your concerns.  It is always recommended that you call Dr. Steinke’s office with any post-operative questions or concerns. 

The anesthesia providers used by Dr. Steinke are chosen by him based on their skill, bed side manner, and in network contracts.  Dr. Steinke does not work with anesthesiologists with whom he does not have a strong working relationship.

While it is always normal to be nervous prior to a surgery, understand that your safety and excellent outcomes are of the utmost importance to our surgical team.   Dr. Steinke always strives to treat all his patients like a member of his own family and works with those medical professionals that also share that sentiment. 

Click here to schedule an appointment with Dr. Paul Steinke, the 3Dbuniondoc