Definition
Conduction anaesthesia is a local anaesthetic. Since the nerves are divided further and further from the spinal cord, an anaesthesia at one point can anaesthetize all areas further away from the trunk. This form of anaesthesia is used especially for operations on the hands or forearms and also in dentistry. The patient is awake and responsive during the procedure.
Indication
As in actually all areas of medicine, the principle in anesthesia is to intervene as little as possible in the body functions. For this reason, the anaesthetic procedure is usually chosen to be as minimal as possible for the planned intervention. If the purely local anesthesia is not sufficient, we choose the block anesthesia.
If this is also not sufficient, spinal or even general anesthesia is used. However, as long as a block anaesthesia is sufficient to perform surgery on the arms, legs or teeth, this option should also be used. Especially in areas far away from the trunk, such as the wrist, a block anaesthesia is recommended.
It is important that the affected nerves are easily accessible. Especially for elderly people who suffer more from the consequences of general anesthesia, conduction anesthesia offers great advantages because this method does not affect the central nervous system. Another field of application of the conduction anaesthesia is dentistry. In case of interventions on the teeth, a local anaesthesia of the responsible nerves in the area of the jaw is sufficient to anaesthetize the teeth completely and thus to carry out the treatment painlessly. Which method of anaesthesia is used is always a joint decision of the anaesthetist and the patient.
Implementation
For each type of anaesthesia, a precise planning is first carried out. This includes in particular a conversation with the person concerned, whether a conduction anaesthesia has already been performed earlier and whether it was well tolerated. Depending on the procedure, the position of the anesthesia and the appropriate local anesthetic are chosen.
In case of deeper nerve bundles, such as the arm plexus, the exact position can be searched for with an ultrasound device. The puncture site is disinfected and the medication is drawn into a syringe. The cannula is pierced into the skin and advanced to the appropriate position.
There it is first checked whether the cannula is outside of blood vessels, as the local anaesthetics should not enter the bloodstream. Then several depots of the local anesthetic are injected around the nerve. Depending on the area of application, an electrical measurement can be used to determine whether the anesthetic is successful or whether more medication is needed. The cannula is pulled out and a few minutes are waited until the full effect is achieved. Anxious patients can be given a sedative, e.g. Midazolam, before the anaesthetic, so that they do not notice much of the anaesthetic and the procedure.
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