Wide Awake Hand Surgery
نویسنده
چکیده
“Wide Awake Hand Surgery” is a small illustrated technical book written by Donald Lalonde, who is a professor at Dalhousie Medical School in New Brunswick, Canada. Dr. Lalonde has extensive expertise in hand surgery, with many years of experience using local anesthetics with epinephrine in surgery. This book is written in a simple, easy-to-understand manner; as the author states in the preface, it has recipes similar to those of a cookbook. The abundant illustrations and descriptions provide a sufficient general understanding of how to conduct anesthesia for hand surgery. The book buyer can register and can obtain an e-book and many video clips online. Each video clip includes procedures and communications between patients and Dr. Lalonde. Communication skills are also very useful for beginning hand surgeons. Epinephrine was discovered by Napoleon Cybulski in 1895, and was first used for ophthalmic surgery. So far, it has been believed that epinephrine should be avoided because of necrosis caused by vasoconstriction. It is logical expectation, but it has not been supported by practical evidence. Dr. Lalonde claimed that pervious expectations is wrong. He has investigated many previous reports on the use of epinephrine as a local anesthetic in hand surgery, and ultimately came to the following conclusion about its safety: Epinephrine does not lead to necrotic changes, and is beneficial for hand surgery because it provides a bloodless field without a tourniquet. Chapters 2 and 3 contain the BOOK REVIEW
منابع مشابه
Wide-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...
متن کاملTumescent Local Anesthesia for Hand Surgery: Improved Results, Cost Effectiveness, and Wide-Awake Patient Satisfaction
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...
متن کاملTransition to total one-stop wide-awake hand surgery service-audit: a retrospective review
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متن کاملDosage of local anesthesia in wide awake hand surgery.
O NE OF THE MORE NOTABLE recent changes in hand surgery is the method of delivery of the anesthesia. Similar to when they are having a dental procedure, patients who understand and are offered the wide awake alternative like the ideas of (1) no preoperative testing, (2) no tourniquet pain, (3) less time at the hospital to have the surgery, (4) the ability to speak to their surgeon during the su...
متن کاملHow the wide awake approach is changing hand surgery and therapy
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...
متن کاملWide-Awake Wrist Arthroscopy and Open TFCC Repair.
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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عنوان ژورنال:
دوره 44 شماره
صفحات -
تاریخ انتشار 2017