Dosage of Local Anesthesia in Wide Awake Hand Surgery

Lalonde, Donald H.; Wong, Alison

doi:10.1016/j.jhsa.2013.07.017

Cited by 152 publications

(139 citation statements)

References 7 publications

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“…Studies on the effects of epinephrine use in local anesthesia in hand surgery have been also conducted by Chowdhry (2010), Muck (2010) and Mann (2012) (7)(8)(9). Lalonde established in 2013 the dosage of 1% lidocaine with 1:100,000 epinephrine for the typical surgical procedures, recommending the use of 20 cc for CTS, 4 cc for trigger finger, 15 cc for each digital ray affected by DD, 40 cc for Bennet fracture and metacarpal fractures (10). Taking into account these recommendations, in our study we used volumes of anesthetic solution of 8.5 mL to 15 mL per digital ray affected by DD, 8 mL to 20 mL for CTS, and 3 mL to 6 mL for trigger finger.…”

Section: Discussionmentioning

confidence: 99%

Use of WALLANT technique in hand surgery, safe and advantageous. Personal experience

Perţea¹,

Poroch²,

Grosu³

et al. 2018

J Clin Invest Surg.

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To cite this article: Pertea M, Poroch V, Grosu OM, Manole A, Velenciuc N, Lunca S. AbstractObjectives. To confirm the efficiency of using local anesthesia with lidocaine and epinephrine in hand surgery.Materials and methods. 75 patients in whom we used local anesthesia with 1% lidocaine and epinephrine in solution 1: 100 000. We evaluated the amount of used anesthetic, the time to onset of anesthesia, intraoperative bleeding, the duration of intervention and hospitalization, immediate postoperative complications.Results. It has been no case of digital necrosis or other vascular complications and no intraoperative bleeding. The amount of the used anesthetic varied. In no case it was necessary to use of phentolamine as an antidote to the effects of adrenaline.Conclusions. Wide awake local anesthesia no tourniquet technique is safe, having many advantages: it is not necessary to use the tourniquet with or without intravenous sedation, the surgeon and patient comfort is maximum, there is no risk of digital necrosis, hospitalization time is short and the costs are minimal.

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Section: Discussionmentioning

confidence: 99%

Use of WALLANT technique in hand surgery, safe and advantageous. Personal experience

Perţea¹,

Poroch²,

Grosu³

et al. 2018

J Clin Invest Surg.

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show abstract

“…In fact, Lalonde et al 34 claims that this approach can be used for up to 95% of all hand surgery procedures. In a recent article in the Journal of Hand Surgery 35 , he describes the ideal dosage and location for placement of the injection for various procedures and serves as a good resource and guide for hand surgeons. Further advantages of WAHS, include significant savings in cost and since no anesthesia is administered it eliminates pre-assessment visits, and pre-operative investigations [36][37][38][39] .…”

Section: Wide Awake Surgerymentioning

confidence: 99%

Pain Management Strategies in Hand Surgery

Ketonis

Ilyas

Liss

2015

Orthopedic Clinics of North America

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“…1–4 As a result, the tourniquet has been replaced with finger and hand injection of epinephrine and lidocaine for hemostasis by many practitioners for many procedures. 5–7 The dosage and location of local anesthetic infiltration for tourniquet-free common hand surgery operations has been published 8 (Table 1). “Wide-awake local anesthesia no tourniquet” (WALANT) technique has been published widely for carpal tunnel surgery, 9 flexor tendon repair, 10 tendon transfer, 11 Dupuytren’s contracture, 12 and trapeziectomy.…”

Section: The Removal Of the Need For The Tourniquet Sedation And Prmentioning

confidence: 99%