Arm and Hand Surgery, Marcus Fulcher, MD

Usually schedules cases according to anesthetic he wants, i.e. it will be on the posting slip (Block, MAC, General).

If he schedules for a block he prefers the case to be done under the block with sedation only, then the patient can bypass Phase I PACU and go straight to 8W post-op. Acute Pain Service will usually place this. Page Dr. Heyman at 1080 or Wendy Woods at 6901 if you have any questions.

If he schedules for General (not often), then he usually still wants a block, just ask.

He will use a tourniquet on almost all cases, block and sedation allows good tolerance of this by the patients. GA is not necessary just because a tourniquet will be used; however, tourniquets can become uncomfortable usually about 1.5hrs in due to ischemia, but increasing sedation helps with this.

MAC means he'll do the case under his own local. Usually for carpal tunnels and trigger finger releases, which he usually never wants blocked.

If the block will delay the case start he would prefer to proceed with GA and just block afterwards, but ask as he may prefer otherwise on some patients.

Bed will be turned 90° to the operative side.