<p> Arm and Hand Surgery, Marcus Fulcher, MD</p><p>Usually schedules cases according to anesthetic he wants, i.e. it will be on the posting slip (Block, MAC, General). </p><p>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.</p><p>If he schedules for General (not often), then he usually still wants a block, just ask.</p><p>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.</p><p>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. </p><p>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.</p><p>Bed will be turned 90° to the operative side.</p>