Local anaesthetic and gel nails!

[FlipperSkipper]

I’m having cataract surgery on Tuesday under local anaesthetic and I have gel nail polish on. Does anyone know if I need to take it off before then? (I know I can ask the hospital, and I’ll phone them on Monday, but just thought I’d ask here.) Thanks

Yes you need it off

it’ll be fine (doi:anaesthetist)

Why would you need to take it off?

I would have thought almost certainly you would, don't they need to put that clip on your finger to measure your pulse? They usually keep nail varnish remover on hand if needed, but obviously, gel nails will need soaking off .

Incidentally, I was thinking about this the other day - if anyone knows what happens if someone needs emergency attention and have gel nails on, I'd love to know!

"Why would you need to take it off?"

For the pulse oximeter to work properly

Because in theatre and on the ward, they will use a probe on the finger to measure oxygen levels. The light can't take a reading through dark nail varnish or fake nails. In most cases though, you can just sit the probe on the side of the finger so its touching skin- and not the nail.

Most pre-op paperwork will tell you to remove false nails and varnish. I never worked in theatre, but 1 ward I was worked on years ago kept a bottle of acetone to remove varnish.

@ellyo the probe can be put on the finger going side to side rather than front to back. The finger probes can go on toes too. We also have clips that go on an ear (or lip/nostril). Certain colours of nail are more problematic than others and long fingernails (natural or falsies) can be a pain just because the finger probe won’t fit properly. At the end of the day though, there are other ways to measure a heart rate and oxygenation and sats monitors are generally a bit rubbish - we’re all trained to use our clinical skills to know if they’re actually giving useful info or whether we need to use other equipment to monitor things. HTH.

Thanks all. I wasn’t sure if a pulse oximeter would be used for an op with local anaesthetic. I’ll soak them off to be on the safe side.

@Greybeardy yes but the hospital will ask for it to be removed. Makes life easier and why would you intentionally ignore their requests?

Surely not for a local anaesthetic? I've certainly never had to take mine off for implant changes, steroid injections with LA added, or mole removals.

I'd like to think if you needed to it would be standard advice in your letter.

Why would you for local anesthetic?

I had surgery a couple of years ago and didn't have to remove my acrylic nails. It's fine.

If you are only having local for your surgery you should be ok, they can put a pulse/oximeter in one of your toes if needed.

@Greybeardy funnily enough this makes me think of Invisible Women and the "default male" thinking - maybe this particular instrument was designed by men for use on men, or something as basic and every day as nail polish or slightly longer fingernails on a large proportion of the adult population would be built into the design?!

Just a thought 😆

It's fine, until it isn't.....

I used to work in surgery and sometimes it was really difficult to get a reading from someone even without fake nails. Yes, we did side finger, toes, ears and even inside the nose (yucky probe...... 🤢). I wouldn't want to put that kind of hindrance on my own treatment.

Get the gel nails after the surgery 😉

I had to remove polish from my fingers for surgery a couple of years back but was fine to leave it on my toes.

You do not need to soak them off

We can place a pulse oximetry on the ear lobe for a patient with false nails

This is a very old fashioned practice .. preferably bare nails so we can see the colour of the nail bed to measure capillary refill but it is really not worth ruining your expensive manicure

I love how an anaesthetist comments with a perfectly reasonable sensible answer and someone slates them as clearly they know more about peri-operative care and the physics behind pulse oximetry, I admire that audacity, I really do. Looking at you @PigsInBlanketyBlankets

Hope your procedure goes well, OP.

They do often use some sort of pulse monitoring in eye surgery regardless of the mode of anaesthesia because there are some things specifically to do with the surgery that can make the pulse drop quite low (easily fixed, but only if you’re actually watching out for it). Local anaesthetic for eye surgery can also mean just eye drops, which are low risk in terms of side effects, or injections. Injecting local around the eye definitely needs cardiac monitoring.

@PigsInBlanketyBlanketshonestly you can do whatever you want - if you’re not bothered about your nails then take them off, if it’s a right old faff/vital part of your identity/an emergency then don’t worry about it. As an anaesthetist I don’t think I’ve ever asked someone to remove their nail varnish just for the purpose of sats monitoring because it really isn’t that important - it’s just a rather old fashioned thing that’s hard to get rid of.

@BattleofBeamfleot I’m not sure we can claim any sort of gender discrimination when we do have a perfectly adequate alternative (the ear probe) that works very well on people (of any gender) with long nails/coloured nails/quadruple amputees. In fact, I have a feeling ears may have been used before fingers way back in the past. Of interest though to people trying to eliminate discrimination in healthcare, sats probes are recognised to work less reliably in people with dark skin tones.

I had eye surgery Wednesday and today with acrylics on and they weren't concerned just made a note

Also I had anaesthetic drops, local in my eye via injection and had the finger clip thing during the procedure, the normal position. It was for implantable collamer lense which I'm told is similar to cataracts surgery