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The rise of wide awake hand surgery - Contribution from Turkey
- Source :
- Hand and Microsurgery, Vol 7, Iss 3, Pp 125-134 (2018)
- Publication Year :
- 2018
- Publisher :
- ScopeMed, 2018.
-
Abstract
- Objectives: Recently, many surgeons started to prefer wide awake local anesthesia no tourniquet (WALANT) approach to provide an almost bloodless field for the vast majority of hand surgery procedures. We aimed to present our two-year experience with WALANT technique. Methods: A wide variety of 682 hand surgery operations in 626 patients were performed with WALANT technique. For infiltrative local anesthesia, the mixture of 1% lidocaine, 1:100.000 epinephrine and 8.4% bicarbonate was prepared. The need for intraoperative sedation and intraoperative patient cooperation were evaluated. Patients' fingers were observed in case of postoperative circulatory compromise. A simple cost-effectivity analysis for the anesthesia types was performed. Results: Mean age of the patients was 43.7. None of the patients needed intraoperative sedation, and patients obeyed to orders of surgeon throughout the procedure. The postoperative circulatory compromise was observed in two fingers; one finger resolved spontaneously and the other rescued with phentolamine. WALANT technique was more cost-effective than Bier block or general anesthesia. Conclusion: The WALANT technique seems like a great innovation to perform a wide variety of hand surgery cases. Increased patient comfort without a tourniquet, cost-effectivity, no preoperative tests, no risks of general anesthesia, no need to stay in the hospital overnight, and intraoperative active motion assessment facility are important advantages. [Hand Microsurg 2018; 7(3.000): 125-134]
- Subjects :
- 030222 orthopedics
Tourniquet
medicine.medical_specialty
Lidocaine
business.industry
Sedation
Wide awake hand surgery
lcsh:Surgery
Hand surgery
WALANT
lcsh:RD1-811
030230 surgery
Patient Cooperation
03 medical and health sciences
Active motion
0302 clinical medicine
Anesthesia
medicine
Local anesthesia
epinephrine
medicine.symptom
business
tourniquet
medicine.drug
Patient comfort
Subjects
Details
- ISSN :
- 24587834
- Volume :
- 7
- Database :
- OpenAIRE
- Journal :
- Hand and Microsurgery
- Accession number :
- edsair.doi.dedup.....96ef673461b05cf548ca013cbd0c0fc8