488 hand surgeries with local anesthesia with epinephrine, without a tourniquet, without sedation, and without an anesthesiologist

Abstract

ObjectivesEvaluate the incidence of digital infarction and tissue necrosis using local anesthesia with 1% lidocaine and 1:100,000 epinephrine in wrist, hand, and fingers surgeries, without a tourniquet, without sedation, and without an anesthesiologist.MethodsPatients with wrist, hand, and fingers disorders prospectively underwent surgery under local anesthesia with 1% lidocaine and 1:100,000 epinephrine. The primary outcomes evaluated were the presence of digital infarction and tissue loss due to necrosis. As secondary outcomes, the need for the use of sedatives, tourniquet, anesthesiologist assistance, or surgery suspension were evaluated.ResultsFifty-three wrists, 307 hands, and 128 fingers were anesthetized with lidocaine and epinephrine without any complications related to epinephrine. There was no patient that presented with any of the primary or secondary outcomes.ConclusionsWrist, hand, and fingers surgeries can be safely performed with local anesthesia with 1% lidocaine and 1:100,000 epinephrine, without sedation, without a tourniquet, and without an anesthesiologist.

Anais Do Iv Congresso Nacional De Residências Em Saúde (On-Line) - Iv Conres: Resumos Simples E Expandidos

“…Golyakhovks e Franzel também destacam a técnica para extração do fio, enfatizando a remoção cuidadosa para evitar sangramentos, que pode ser gerenciado ambulatorialmente. Sardenberg et al (2018) reportaram alta satisfação em cirurgias da mão realizadas com anestesia local contendo epinefrina, sem sedação ou assistência anestésica, reforçando a segurança da anestesia local mesmo em mãos de cirurgiões menos experientes.…”

Diagnóstico e tratamento do dedo de gatilho no Brasil - Estudo transversal

“…33 Um estudo brasileiro avaliou o uso de anestesia local com lidocaína e epinefrina nas cirurgias do punho, mão e dedos, sem torniquete, sem sedação e sem anestesista, e não relatou nenhuma complicação relacionada à epinefrina. 34 O tratamento cirúrgico do dedo de gatilho tem uma taxa de sucesso relatada de até 97%. 3,22 A cirurgia percutânea apresentou sucesso de 60 a 90% para 43,0% dos respondedores, sendo a complicação mais comum a recidiva do engatilhamento.…”

Hand surgery without tourniquet as a model for the development of surgical service innovation for competitive advantage-based service readiness

“…Clinical studies initiated at Cipto Mangunkusumo Hospital, Jakarta, demonstrated advancements, with international research publications supporting the technique's efficacy. [21][22][23][24][25][26] The presentation also highlighted challenges faced in the global plastic surgery community regarding using epinephrine in certain surgeries, emphasizing the safety measures adopted in Jakarta, where awareness gained through experimental research contributed to clinical success. 27 The surgical innovation of hand surgery without a tourniquet has proven effective, offering advantages in safety, efficiency, and good and excellent patient experience across various hand surgeries.…”