Post-Anesthesia Pain and Swelling After Finger Reattachment Surgery

I would like to ask the doctor, the area where the anesthesia was administered is swollen and painful?

Hello Doctor, a couple of days ago I asked you a question.
My original message was about a friend of mine who had three fingers severed at work about ten days ago.
After surgery to reattach them, he is still hospitalized in Changde, Hunan, China.
Now the issue is that he has been experiencing swelling and pain in his arm from the shoulder to the elbow, making it difficult for him to sleep for several days.
The doctor prescribed medication, but it hasn't been very effective.
I would like to ask: 1.
He mentioned that the anesthesia was administered near the neck at the shoulder.
Is this swelling and pain related to the side effects of the anesthesia or his physical condition? 2.
After reattaching the severed fingers, what should he pay attention to in order to ensure proper recovery? 3.
What should be done about this swelling and pain? He is 48 years old.
Your response was: 1.
The effects of the anesthesia should have worn off by now (since it has been 10 days).
The swelling in the arm is mostly related to the prolonged immobilization of the arm after the injury, as it needs to be stabilized with a cast or sling.
2.
After reattachment of the fingers (is this referring to replantation or a fracture?), he should rest adequately post-surgery, and once the wound heals and the stitches and pins (plates) are removed, he needs to be patient and undergo several months of rehabilitation for proper recovery.
3.
For the swelling and pain in the arm, he can elevate the affected limb, rest more, perform gentle movements of the "non-affected" joints, apply heat, and do light massage.
* My friend's fingers were completely severed and reattached.
Now the area where he received the anesthesia in his shoulder has also swollen (it may have been swollen for a few days but went unnoticed).
It feels hard when pressed and is painful.
The local doctor said to wait two or three days to see if it resolves on its own; if not, surgery will be necessary.
My friend and I do not quite understand the reason for the surgery.
Could you please clarify this for my friend? Thank you very much!

Bing Lin Cheng Xia, 30~39 year old female. Ask Date: 2009/12/03

Dr. Zhou Hongzhang reply Plastic Surgery

1.
The inability to flex the thumb properly and apply force years after an injury may be due to: (1) the tendon cannot be reattached as described, (2) scar tissue contraction, (3) adhesive capsulitis of the joint, or (4) adhesion of ligaments and tendons.

2.
Given that several years have passed, reattaching the tendon may not be feasible; a tendon transfer surgery may be necessary, which involves sacrificing the tendon of another finger to provide function to the thumb.

3.
Health insurance may cover the procedure, and other costs should not be significant.

4.
A consultation and evaluation at a plastic surgery outpatient clinic is required.

Reply Date: 2009/12/03

More Info

Post-anesthesia pain and swelling after finger reattachment surgery can be concerning, especially when it affects a patient's ability to sleep and perform daily activities. In your friend's case, there are several factors to consider regarding the pain and swelling in the arm following the surgery.

1. Relation to Anesthesia: The pain and swelling your friend is experiencing are unlikely to be directly caused by the anesthesia itself, especially since it has been ten days since the procedure. Local anesthetics typically wear off within a few hours to a day after administration. However, the area where the anesthesia was injected may experience some localized swelling or discomfort, but this should not persist for an extended period. The more likely cause of the swelling and pain is the immobilization of the arm due to the surgical procedure. After reattachment surgery, it is common for the affected limb to be immobilized in a cast or splint to allow for proper healing. This immobilization can lead to stiffness, swelling, and discomfort due to lack of movement and circulation.

2. Post-Surgery Care for Finger Reattachment: After a finger reattachment (also known as replantation), it is crucial to follow specific care guidelines to promote healing and restore function. Your friend should ensure that the surgical site is kept clean and dry, and any dressings are changed as instructed by the healthcare provider. Pain management is essential, and your friend should take prescribed medications as directed. Additionally, once the doctor gives the go-ahead, gentle range-of-motion exercises may be introduced to prevent stiffness. It is vital to be patient, as full recovery can take several months, and rehabilitation is often necessary to regain strength and function in the fingers.

3. Managing Swelling and Pain: To alleviate the swelling and pain in your friend's arm, several strategies can be employed. Elevating the affected limb above heart level can help reduce swelling. Gentle movements of non-affected joints (like the shoulder and elbow) can promote circulation and prevent stiffness. Applying ice packs intermittently can also help manage swelling and discomfort. If the pain persists or worsens, it is essential to communicate this to the healthcare provider.

Regarding the hard lump and pain at the injection site, it is possible that this could be a hematoma (a localized collection of blood outside of blood vessels) or a reaction to the injection. If the local doctor suggests surgery to address this issue, it may be due to concerns about infection, persistent swelling, or other complications that could impede recovery. Surgical intervention might be necessary to drain any accumulated fluid or to address any underlying issues that could affect the healing process.

In summary, while the pain and swelling your friend is experiencing are common after such a significant surgical procedure, it is crucial to monitor the situation closely. If symptoms do not improve or if new symptoms arise, further evaluation by a healthcare professional is warranted. Your friend should maintain open communication with their medical team to ensure the best possible recovery outcome.

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