Anesthésie pour la chirurgie de la main

Saché, Frédéric Le; Campard, Sébastien; Raingeval, Xavier; Ellies, Emilie; Fouchecour, Etiennette de; Douiri, Hatem; Bloc, Sébastien

doi:10.1016/j.anrea.2019.11.001

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…The solution was injected slowly, intradermally, and then into the dermis [1]. A delay of 30 minutes between the injection and the incision was recommended, which was necessary to reach the anesthetic peak [3]. The anesthesia time in WALANT was up to 10 hours in the fingers [13].…”

Section: The Anesthesia Techniquementioning

confidence: 99%

“…Lidocaine has an anesthetic effect, and epinephrine acts as a hemostatic effect [2]. In sub-Saharan Africa, surgical treatment of traumatic hand injuries is still performed under general anesthesia, sometimes under regional anesthesia (axillary, distal trunk, radial, ulnar forearm, median forearm area's anesthesia) but rarely under local anesthesia [3]. The use of general or regional anesthesia can sometimes cause anesthetic accidents [4] [5].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the Local Epinephrine Anesthesia without Tourniquet in the Surgical Treatment of Hand Injuries in Adults: About 27 Cases in Sub-Saharan Africa

Feigoudozoui¹,

Parteina²,

Soumaro³

et al. 2023

OJO

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Background: In sub-Saharan Africa, surgery for hand injuries is usually performed under axillary or general anesthesia. This is often not without consequences. The Wide Awake Local Anesthesia No Tourniquet (WALANT) is, therefore, an anesthetic asset in the surgical treatment of hand injuries. This study aims to share an experience on this technique's effectiveness and to spark interest among African authors and practitioners. Method: This prospective study focuses on 27 surgeries of hand injuries carried out with WALANT. The study spanned over nine months (November 2021-August 2022) and included 19 men and eight women with a mean age of 35.4 years (extremes: 19 and 54). There were five (18%) flexor tendon ruptures, three of which were in zone 2, eleven (41%) metacarpal fractures, four of which were open, seven (26%) phalangeal fractures, two of which were open, and four (15%) finger springs. The operated lesions were assessed at a minimum of three months. The pain was assessed using the Visual Analog Scale. The QuickDASH score was evaluated for each patient at the end of the follow-up period. Results: Intra-operatively, the mean value of the Visual Analog Scale was 1/10, with extreme values of 1/10 and 3/10. Of the five cases of flexor tendon ruptures, three were located in zone 2 and two in zone 3. The metacarpal fractures were divided into seven closed diaphyseal fractures and four extra-articular metaphyseal fractures. Four of the seven phalangeal fractures were oblique diaphyseal, and three were transverse diaphyseal. The treatment of the protruding fingers followed the conventional technique.

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Section: The Anesthesia Techniquementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of the Local Epinephrine Anesthesia without Tourniquet in the Surgical Treatment of Hand Injuries in Adults: About 27 Cases in Sub-Saharan Africa

Feigoudozoui¹,

Parteina²,

Soumaro³

et al. 2023

OJO

View full text Add to dashboard Cite

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The wide-awake local anesthesia no tourniquet (WALANT) technique in thumb injuries: a systematic review

do Rosario Saraiva,

Vázquez,

Ortiz-Huerta

et al. 2024

Eur J Trauma Emerg Surg

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Human hands have a complex anatomical structure. The thumb, being an integral part of the hand, has an essential function in gripping. In this sense, thumb fractures account for 4% of all hand fractures (it may occur in association with fractures of the trapezium). The majority of hand fractures should be treated non-surgically and surgeons must avoid unnecessary surgery. Historically, hand surgery has used a combination of local/regional/general anaesthesia and a tourniquet. This study aims to carry out a systematic review to determine whether the WALANT technique is an advantageous alternative to conventional anaesthesia for surgical procedures on thumb injuries, in terms of patient function and pain. Method: We conducted a search in the following databases: Pubmed/Medline, EBSCOhost, Web of Science, Scopus, ScienceDirect and Google Scholar, using the equation "WALANT" OR "Wide Awake Local Anesthesia No Tourniquet" AND "thumb pathology". Results: In five of the 584 articles included, two studied trapeziometacarpal osteoarthritis, one De Quervain's disease and the remaining two flexor injuries. WALANT showed good results in active movements, but with similar levels of pain between anaesthetics. Patients were more anxious during general anaesthesia, plus the fact that they were fasting and suspending medication. Conclusion: WALANT is a convenient and favourable option in several studies. It has been demonstrated the benefits in terms of return to function and pain.

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Retrospective evaluation of WALANT in emergency hand surgery in the Bordeaux university hospital

Luciani

Delgove

Pelissier

2022

Hand Surgery and Rehabilitation

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Anesthésie pour la chirurgie de la main

Cited by 4 publications

References 28 publications

Evaluation of the Local Epinephrine Anesthesia without Tourniquet in the Surgical Treatment of Hand Injuries in Adults: About 27 Cases in Sub-Saharan Africa

Evaluation of the Local Epinephrine Anesthesia without Tourniquet in the Surgical Treatment of Hand Injuries in Adults: About 27 Cases in Sub-Saharan Africa

The wide-awake local anesthesia no tourniquet (WALANT) technique in thumb injuries: a systematic review

Retrospective evaluation of WALANT in emergency hand surgery in the Bordeaux university hospital

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