How the wide awake approach is changing hand surgery and therapy
نویسنده
چکیده
The wide-awake approach to flexor tendon repair has decreased our rupture and tenolysis rates, and permitted us to get consistently good results in cooperative patients. We no longer perform flexor tendon repair with the tourniquet, sedation and muscle paralysis of general or block (Bier or axillary) anesthesia. Injection of only lidocaine with epinephrine wherever incisions will be made in the finger and hand permits comfortable tourniquet-free awake patients cooperate with active finger full flexion and extension testing during the surgery. 5 main reasons that I never want to do a flexor tendon repair asleep or with a motor block ever again
منابع مشابه
How the wide awake approach is changing hand surgery and hand therapy: inaugural AAHS sponsored lecture at the ASHT meeting, San Diego, 2012.
The wide awake approach to hand surgery means that the patient is unsedated for up to 95% of all hand surgery procedures. For the patient, the experience is reduced to the equivalent of a visit to the dentist where no preoperative tests are required, only lidocaine with epinephrine is injected, and where they get up and go directly home after the procedure.1 This is made possible by the recent ...
متن کاملWide-awake flexor tendon repair.
The wide-awake approach to hand surgery is performed with no sedation and no tourniquet. Only locally injected tumescent lidocaine and epinephrine are used for anesthesia and hemostasis. The confirmation that epinephrine hemostasis in the finger is safe1–5 has permitted the use of this technique, which has now become widespread in Canada. With exceptions that include hand surgery in small child...
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This is a review article of the wide-awake approach to hand surgery. More than 95% of all hand surgery can now be performed without a tourniquet. Epinephrine is injected with lidocaine for hemostasis and anesthesia instead of a tourniquet and sedation. This is sedation-free surgery, much like a visit to a dental office. The myth of danger of using epinephrine in the finger is reviewed. The wide...
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This article provides video and narration to describe the technical details of how to inject local anesthesia and perform the extensor indicis proprius to extensor pollicis longus tendon transfer in patients with wide-awake local anesthesia and no tourniquet. Lidocaine for anesthesia and epinephrine for hemostasis are the only 2 medications given to the patient. Sedation and the tourniquet are ...
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The wide-awake approach to hand surgery entails the use of local infiltration anesthesia using lidocaine with epinephrine and no tourniquet. The technique provides practitioners with an option to perform advanced hand surgical care in an ambulatory setting, without the need for general or regional anesthetics. We present our results using wide-awake approach in wrist surgery, both open and arth...
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