Wrist Arthroscopy under Portal Site Local Anesthesia (PSLA) without Tourniquet

Abstract

).Wrist arthroscopy is typically performed under general or regional anesthesia with the aid of a tourniquet to maintain a bloodless field. Since the late 1970s, local anesthesia using intraarticular infiltration has been advocated for both diagnostic and therapeutic procedures in knee and ankle arthroscopy, with good results. AbstractPurpose: wrist arthroscopy is typically performed under general or regional anesthesia with the aid of a tourniquet to maintain a bloodless field. We have been using portal site local anesthesia (PSLA) for wrist arthroscopy without a tourniquet since 1998. The aim of the study was to assess the efficacy, safety, and complications of PSLA and whether this can be recommended for routine wrist arthroscopy. Method: We conducted a retrospective study, identifying 111 consecutive cases of wrist arthroscopies performed from

Complications after arthroscopic triangular fibrocartilage complex (TFCC) surgery

“…Radiofrequency ablation or shrinkage on the dorsal side has to be applied sparingly and should only be done under wet arthroscopy with adequate fluid outflow and ventilation. Performing arthroscopic surgery under portal site local anaesthesia with the patient wide awake and without the use of tourniquet further increases the safety, as assessment of active finger extension during and immediately after the surgery is possible (Ong et al., 2012), and is our routine practice.…”

Bare bones: Fundamentals of diagnostic wrist arthroscopy

“…Wrist arthroscopy is traditionally performed under general or regional anaesthesia, although more recently portal site local anaesthesia has also been described. 8,9 The use of local anaesthetic techniques, including WALANT (Wide Awake Local Anaesthesia No Tourniquet), whilst requiring a compliant patient, has the advantage of allowing for active dynamic assessment of the wrist throughout the procedure, which is particularly useful when assessing for carpal instability 10 or testing the integrity of the TFCC, 11 in addition to reducing the logistical burden of arthroscopy under general anaesthesia. 12 Once adequate anaesthesia has been achieved, clinical examination of the wrist should be performed for any mechanical instability that may have previously been too uncomfortable for the patient, and/or masked by guarding.…”