Wide local anaethesia without a tourniquet in extensor tendons repair of the hand in the awake patient-a prospective study

Abstract

اMore and more surgeons are leaning towards shifting from general to local anesthesia whenever possible. The main purpose behind such trend is to avoid the unnecessary risks and contraindications of general anesthesia, provided that local anesthesia will efficiently do the job.Local anesthesia is used for many surgical procedures in the hand and wrist with the limitation of a bloody field and inadequate visibility. Therefore, to prevent the blood loss a tourniquet must be used to obtain a bloodless field; but since tourniquets also present a nuisance to patients, a new technique has come to light using epinephrine instead. Epinephrine is injected with local anesthetics for hemostasis and anaesthesia instead of a tourniquet and sedation. This method is referred to as Tumescent local anesthesia or WALANT (Wide-Awake Local Anesthesia No Tourniquet).The aim of this study was to assess the effectiveness as well as confirm the safety of using the Wide Awake Local Anaesthesia No Tourniquet method in repair of extensor tendon injuries of the hand and wrist.