Discussion: Do Not Use Epinephrine in Digital Blocks: Myth or Truth? Part II. A Retrospective Review of 1111 Cases

Lalonde, Donald H.; Lalonde, Jan

doi:10.1097/prs.0b013e3181f52549

Cited by 22 publications

(7 citation statements)

References 14 publications

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“…In Canada, more than 90% of operations to release the carpus are now performed under local anesthesia without sedation. 17 Good results can be obtained, provided that the anesthetic and surgical techniques are used correctly. The local anesthetic in the skin is given time to act before any new skin puncture is made using a needle, and as little tissue as possible is pushed away in areas that have not been anesthetized.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of surgical treatment of carpal tunnel syndrome using local anesthesia

Barros

Júnior

Roncaglio

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo evaluate the results and complications from surgical treatment of carpal tunnel syndrome by means of an open route, using a local anesthesia technique comprising use of a solution of lidocaine, epinephrine and sodium bicarbonate.Material and methodsThis was a cohort study conducted through evaluating the medical files of 16 patients who underwent open surgery to treat carpal tunnel syndrome, with use of local anesthesia consisting of 20 mL of 1% lidocaine, adrenaline at 1:100,000 and 2 mL of sodium bicarbonate. The DASH scores before the operation and six months after the operation were evaluated. Comparisons were made regarding the intensity of pain at the time of applying the anesthetic and during the surgical procedure, and in relation to other types of procedure.ResultsThe DASH score improved from 65.17 to 16.53 six months after the operation (p < 0.01). In relation to the anesthesia, 75% of the patients reported that this technique was better than or the same as venous puncture and 81% reported that it was better than a dental procedure. Intraoperative pain occurred in two cases. There were no occurrences of ischemia.ConclusionUse of local anesthesia for surgically treating carpal tunnel syndrome is effective for performing the procedure and for the final result.

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Section: Discussionmentioning

confidence: 99%

Evaluation of surgical treatment of carpal tunnel syndrome using local anesthesia

Barros

Júnior

Roncaglio

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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“…Numerous studies have proven the safety of epinephrine with concentrations ranging from 1:80,000 to 1:400,000 in a tumescent solution when used for various upper extremity surgeries [ 9 , 10 , 11 , 12 , 13 , 14 ]. Our team [ 15 , 16 ] has reported the use of a 1:1,000,000 (one-per-million) epinephrine tumescent formula.…”

Section: Introductionmentioning

confidence: 99%

Retrospective Analysis of the One-per-Million Tumescent Technique in Post-Burn Hand Deformity Surgeries

Prasetyono

Koswara

2015

Arch Plast Surg

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BackgroundThe use of a tourniquet in hand surgery is generally accepted as necessary to create a clear visualization of the operative field. This study aims to determine the effectiveness of one-per-million tumescent solution (1:1,000,000 epinephrine concentration) in creating a bloodless operative field in post-burn hand deformity surgeries performed without a tourniquet.MethodsThis retrospective observational study was conducted on a series of 12 patients with post-burn hand deformities who underwent surgery between February 2013 and January 2014. A total of 29 operative fields were recorded. The one-per-million tumescent solution was used for hemostatis instead of a tourniquet. The clarity of the operative field, volume of solution injected, duration of surgery, scar thickness and density, and functional outcomes at least three months after the surgery were observed. The relationship of scar thickness and density with the clarity of the operative field was analyzed with the chi-square test.ResultsOf the 29 operative fields in which the one-per-million tumescent technique was used, 48.2% were totally bloodless, 44.8% had minimal bleeding, and 6.9% had an acceptable level of bleeding. Both scar thickness and density were shown to have a significant relationship with operative field clarity (P<0.05).ConclusionsThe one-per-million tumescent technique is effective in facilitating post-burn hand deformity surgeries involving meticulous, multiple, and lengthy procedures by creating a relatively clear operative field without the use of a tourniquet. Although scar thickness and density are associated with the clarity of the operative field, this technique can be considered safe and effective in creating a clear operative field.

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“…[1][2][3][4][5] There are very few instances of office-based hand surgery in a pediatric population present in the literature. 6,7 Polydactyly of the hand is one of the most common congenital hand malformations, with multiple treatment options available for various presentations of type B postaxial polydactyly (Fig.…”

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confidence: 96%

Office-Based Post–Axial Polydactyly Excision in Neonates, Infants, and Children

Carpenter

Cuellar

Friel

2016

Plastic and Reconstructive Surgery

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Discussion: Do Not Use Epinephrine in Digital Blocks: Myth or Truth? Part II. A Retrospective Review of 1111 Cases

Cited by 22 publications

References 14 publications

Evaluation of surgical treatment of carpal tunnel syndrome using local anesthesia

Evaluation of surgical treatment of carpal tunnel syndrome using local anesthesia

Retrospective Analysis of the One-per-Million Tumescent Technique in Post-Burn Hand Deformity Surgeries

Office-Based Post–Axial Polydactyly Excision in Neonates, Infants, and Children

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