6,740 results match your criteria Hand Anesthesia


[Background and current use of adjuvants for regional anesthesia : From research to evidence-based patient treatment].

Anaesthesist 2019 Jan 15. Epub 2019 Jan 15.

Klinik für Anästhesiologie mit S. op. Intensivmedizin, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland.

The discovery of the local anaesthetic effect by blocking sodium ion channels was a milestone in anaesthesia but was soon limited by sometimes life-threatening toxic effects of the local anaesthetics. By developing novel local anaesthetics and also by adding so-called adjuvants, attempts have been made to limit these life-threatening events. This article focuses on the historic background and the current state of the use of these adjuvants for regional anaesthesia. Read More

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http://dx.doi.org/10.1007/s00101-018-0522-6DOI Listing
January 2019

A local anesthesia without tourniquet for distal fibula hardware removal after open reduction and internal fixation: the safe use of epinephrine in the foot. A randomized clinical study.

J Biol Regul Homeost Agents 2018 Nov-Dec;32(6 Suppl. 1):57-63

Intensive Unit Care, University of Pisa, Italy.

Hardware removal after surgical treatment fracture is one of the most common procedures in orthopaedic daily activity. A percentage from 14.5 to 21 of total removal involves the ankle joint. Read More

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January 2019

Predicting postoperative delirium and postoperative cognitive decline with combined intraoperative electroencephalogram monitoring and cerebral near-infrared spectroscopy in patients undergoing cardiac interventions.

J Clin Monit Comput 2019 Jan 11. Epub 2019 Jan 11.

Department of Acute Medicine, Section Cardiothoracic and Vascular Anesthesia, Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium.

Studies have associated electroencephalogram (EEG) suppression with postoperative delirium (POD) and postoperative cognitive decline (POCD). Otherwise, improving cerebral tissue oxygen saturation (rScO) seems beneficial. No study has evaluated the impact of EEG suppression and decreased rScO on the incidence of POD and POCD when the intraoperative management of patients is performed with a depth-of-anesthesia (DOA) monitor and a cerebral oximetry. Read More

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http://dx.doi.org/10.1007/s10877-019-00253-8DOI Listing
January 2019

Ethnic considerations in the upper lip bite test: the reliability and validity of the upper lip bite test in predicting difficult laryngoscopy in Koreans.

BMC Anesthesiol 2019 Jan 10;19(1). Epub 2019 Jan 10.

Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, South Korea.

Background: Several methods have been used to predict difficult tracheal intubation. Among recently suggested methods, the upper lip bite test (ULBT) could serve as a good predictor. Soft tissue and skeletal hard tissue profiles are affected by many factors including ethnicity. Read More

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https://bmcanesthesiol.biomedcentral.com/articles/10.1186/s1
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http://dx.doi.org/10.1186/s12871-018-0675-5DOI Listing
January 2019
1 Read

Suprascapular Nerve Blockade for Postoperative Pain Control After Arthroscopic Shoulder Surgery: A Systematic Review and Meta-analysis.

Orthop J Sports Med 2018 Dec 28;6(12):2325967118815859. Epub 2018 Dec 28.

Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.

Background: Regional nerve blocks are commonly used to manage postoperative pain after arthroscopic shoulder procedures. The interscalene brachial plexus block (ISB) is commonly used; however, because of the reported side effects of ISB, the use of a suprascapular nerve block (SSNB) has been described as an alternative strategy with fewer reported side effects.

Purpose: To examine the efficacy of SSNB for pain control after shoulder arthroscopy compared with ISB as well as anesthesia without a nerve block. Read More

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http://dx.doi.org/10.1177/2325967118815859DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311591PMC
December 2018
2 Reads

Downregulation of MicroRNA-33-5p Protected Bupivacaine-Induced Apoptosis in Murine Dorsal Root Ganglion Neurons Through GDNF.

Neurotox Res 2019 Jan 8. Epub 2019 Jan 8.

Department of Anesthesiology, Jining No.1 People's Hospital, Jining, 272011, Shandong Province, China.

In this work, we evaluated the functional role of microRNA-33-5p (miR-33-5p) in regulating bupivacaine (Bv)-induced neural apoptosis in dorsal root ganglion (DRG) cells. DRG was extracted from adult mice and treated with BV in vitro. A TUNEL assay was applied to assess neural apoptosis among DRG cells. Read More

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http://dx.doi.org/10.1007/s12640-018-9994-zDOI Listing
January 2019

Proximal migration of retained pencil lead along a flexor tendon in the hand: A case report.

Medicine (Baltimore) 2019 Jan;98(1):e13876

Rationale: The hand is the most common site for foreign body injuries. Pencil lead penetration mainly occurs in school-age children.We report a case of proximal migration of a retained pencil lead in the hand, emphasizing the importance of adequate imaging and prompt removal of the foreign body. Read More

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http://dx.doi.org/10.1097/MD.0000000000013876DOI Listing
January 2019
1 Read

Risk Factors for Surgical Site Infections After Orthopaedic Surgery in the Ambulatory Surgical Center Setting.

J Am Acad Orthop Surg 2018 Dec 31. Epub 2018 Dec 31.

From the Department of Orthopaedic Surgery, Washington University, St. Louis, MO (Dr. Brophy, Bansal, Rogalski, Rizzo, Weiner, and Dr. Goldfarb), and the Department of Anesthesia, Washington University, Barnes-Jewish West County Hospital, Creve Coeur, MO (Dr. Wolff).

Introduction: This study was designed to determine the incidence of surgical site infections (SSIs) after orthopaedic surgery in an ambulatory surgery center (ASC) and to identify patient and surgical risk factors associated with SSI.

Methods: Patients who underwent orthopaedic surgery at an ASC over a 6.5-year period were reviewed for evidence of SSI. Read More

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http://dx.doi.org/10.5435/JAAOS-D-17-00861DOI Listing
December 2018

The effect of playing video games on fiberoptic intubation skills.

Anaesth Crit Care Pain Med 2018 Dec 21. Epub 2018 Dec 21.

Hacettepe University, Faculty of Medicine, Department of Plastic Reconstructive and Aesthetic Surgery, Ankara, Turkey.

Introduction: The effect on hand-eye coordination and visuospatial skills made videogames popular for training in laparoscopic surgery. Although similar effects may be true for fiberoptic intubation (FOI), it has not been studied before. The aim of this study was to investigate the effect of playing videogames with gamepad on FOI skills. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S23525568183027
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http://dx.doi.org/10.1016/j.accpm.2018.11.012DOI Listing
December 2018
4 Reads

Percutaneous headless screws and wide-awake anesthesia to fix metacarpal and phalangeal fractures: outcomes of the first 56 cases.

J Biol Regul Homeost Agents 2018 Nov-Dec;32(6):1569-1572

AOU Careggi, Hand and Microsurgery Reconstruction Unit, Florence, Italy.

Phalangeal (P) and metacarpal (MC) fractures are very common injuries, with potentially disabling, residual impairment, deformities or stiffness. Conservative treatment represents the strategy of choice in most cases, but in unstable fractures and/or high-demanding patients, surgical fixation could be required. Ideally, the best treatment choice will be the intramedullary fixation systems, if possible without the implant protruding from the skin. Read More

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December 2018

Acute appendicitis complicating pregnancy: a 33 case series, diagnosis and management, features, maternal and neonatal outcomes.

Pan Afr Med J 2018 16;30:212. Epub 2018 Jul 16.

Department of General and Digestive Surgery Farhat Hached Universitary Hospital, Sousse, Tunisia.

The occurrence of acute appendicitis during pregnancy may pose diagnostic and therapeutic difficulties. In fact pregnancy can make the clinical diagnosis delicate and the use of morphological examinations is still subject to controversy. The debates concerning the ideal surgical approach during pregnancy continue. Read More

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http://dx.doi.org/10.11604/pamj.2018.30.212.14515DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294971PMC
January 2019
1 Read

Sleep safe in clean hands: Improving hand hygiene compliance in the operating room through education and increased access to hand hygiene products.

Am J Infect Control 2018 Dec 12. Epub 2018 Dec 12.

Duke University School of Nursing, Durham, NC.

Background: Hand hygiene compliance is low among anesthesia providers in the operating room, which places patients at risk of preventable infections. The goal of this project was to improve hand hygiene compliance by educating anesthesia providers on the World Health Organization's 5 indications for hand hygiene, and increasing access to hand hygiene products in the operating room.

Methods: Observations of hand hygiene in the operating room took place in 3 phases: preimplementation, postimplementation, and 60 days postimplementation. Read More

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http://dx.doi.org/10.1016/j.ajic.2018.10.021DOI Listing
December 2018

Strategies for Targeted Delivery to the Peripheral Nerve.

Front Neurosci 2018 27;12:887. Epub 2018 Nov 27.

Audie L. Murphy VA Hospital, San Antonio, TX, United States.

Delivery of compounds to the peripheral nervous system has the potential to be used as a treatment for a broad range of conditions and applications, including neuropathic pain, regional anesthesia, traumatic nerve injury, and inherited and inflammatory neuropathies. However, efficient delivery of therapeutic doses can be difficult to achieve due to peripheral neuroanatomy and the restrictiveness of the blood-nerve barrier. Depending on the underlying integrity of the blood-nerve barrier in the application at hand, several strategies can be employed to navigate the peripheral nerve architecture and facilitate targeted delivery to the peripheral nerve. Read More

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https://www.frontiersin.org/article/10.3389/fnins.2018.00887
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http://dx.doi.org/10.3389/fnins.2018.00887DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277764PMC
November 2018
1 Read

Comparison of Wide-Awake Local Anesthesia No Tourniquet With General Anesthesia With Tourniquet for Volar Plating of Distal Radius Fracture.

Orthopedics 2018 Dec 11:1-6. Epub 2018 Dec 11.

Wide-awake local anesthesia no tourniquet (WALANT) is used for various hand surgeries, but there are no reports of its use for distal radius fractures. The authors compared perioperative variables and clinical outcomes for volar plating for distal radius fractures with WALANT vs general anesthesia with tourniquet. This retrospective study included 47 patients who presented with distal radius fractures between January 2015 and February 2017. Read More

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http://dx.doi.org/10.3928/01477447-20181206-01DOI Listing
December 2018

Ginseng metabolite protopanaxadiol interferes with lipid metabolism and induces endoplasmic reticulum stress and p53 activation to promote cancer cell death.

Phytother Res 2018 Dec 9. Epub 2018 Dec 9.

The Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois, USA.

Protopanaxadiol (PPD), a ginseng metabolite generated by the gut bacteria, was shown to induce colorectal cancer cell death and enhance the anticancer effect of chemotherapeutic agent 5-FU. However, the mechanism by which PPD promotes cancer cell death is not clear. In this manuscript, we showed that PPD activated p53 and endoplasmic reticulum (ER) stress and induced expression of BH3-only proteins Puma and Noxa to promote cell death. Read More

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http://dx.doi.org/10.1002/ptr.6249DOI Listing
December 2018

A retrospective evaluation of the risk of bias in perioperative temperature metrics.

J Clin Monit Comput 2018 Dec 8. Epub 2018 Dec 8.

Department of Anesthesiology, Vanderbilt University Medical Center, 1211 21st Avenue South, MAB 422F, Nashville, TN, 37212, USA.

The prevention and treatment of hypothermia is an important part of routine anesthesia care. Avoidance of perioperative hypothermia was introduced as a quality metric in 2010. We sought to assess the integrity of the perioperative hypothermia metric in routine care at a single large center. Read More

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http://link.springer.com/10.1007/s10877-018-0233-1
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http://dx.doi.org/10.1007/s10877-018-0233-1DOI Listing
December 2018
5 Reads

Incidence and Associated Factors of Chronic Pain After Caesarean Section: A Systematic Review.

J Obstet Gynaecol Can 2018 Oct 24. Epub 2018 Oct 24.

Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

The number of CS procedures has increased dramatically both in developed and developing countries in recent decades. CS has been associated with chronic pain. A vicious impediment on quality of life may occur among women who experience chronic post-CS pain (CPCSP). Read More

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http://dx.doi.org/10.1016/j.jogc.2018.04.006DOI Listing
October 2018

Patient-reported outcomes associated with different restorative techniques in pediatric dentistry: A systematic review and MTC meta-analysis.

PLoS One 2018 6;13(12):e0208437. Epub 2018 Dec 6.

Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil.

Background: Despite the increasing number of studies evaluating patient reported outcome measures (PROs), there is no clearness regarding which restorative treatment offers major benefits based on the pediatric patient perspective.

Aim: To compare different restorative techniques in pediatric dentistry regarding patient-reported outcomes.

Design: Literature searching was carried out on prospective studies indexed in PubMed, Scopus and OpenGrey. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0208437PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6283634PMC
December 2018
9 Reads

Optimizing hepatectomy for hepatocellular carcinoma in Asia-patient selection and special considerations.

Transl Gastroenterol Hepatol 2018 8;3:75. Epub 2018 Oct 8.

Department of Surgery, The University of Hong Kong, Hong Kong, China.

Hepatocellular carcinoma (HCC) is a common affliction in Asia. The treatment of HCC depends on the tumor status as well as the underlying liver function. Resection is the cornerstone of surgical management of HCC. Read More

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http://dx.doi.org/10.21037/tgh.2018.09.09DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232050PMC
October 2018

A Pilot Project Using Eye-Tracking Technology to Design a Standardised Anaesthesia Workspace.

Turk J Anaesthesiol Reanim 2018 Dec 1;46(6):411-415. Epub 2018 Dec 1.

Department of Anaesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA; Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.

Objective: Maximising safe handoff procedures ensures patient safety. Anaesthesiology practices have primarily focused on developing better communication tools. However, these tools tend to ignore the physical layout of the anaesthesia workspace itself. Read More

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http://jtaics.org/jvi.aspx?pdir=tard&plng=eng&un=TAR
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http://dx.doi.org/10.5152/TJAR.2018.67934DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6223869PMC
December 2018
1 Read

Surgical management of laparoscopic cholecystectomy (LC) related major bile duct injuries; predictors of short-and long-term outcomes in a tertiary Egyptian center- a retrospective cohort study.

Ann Med Surg (Lond) 2018 Dec 16;36:219-230. Epub 2018 Nov 16.

Radioligy, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt.

Objectives: Laparoscopic cholecystectomy - associated bile duct injury is a clinical problem with bad outcome. The study aimed to analyze the outcome of surgical management of these injuries.

Patients And Methods: We retrospectively analyzed 69 patients underwent surgical management of laparoscopic cholecystectomy related major bile duct injuries in the period from the beginning of 2013 to the beginning of 2018. Read More

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http://dx.doi.org/10.1016/j.amsu.2018.11.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6251332PMC
December 2018
1 Read

Clinical Care Redesign to Improve Value in Carpal Tunnel Syndrome: A Before-and-After Implementation Study.

J Hand Surg Am 2019 Jan 28;44(1):1-8. Epub 2018 Nov 28.

Department of Orthopedics, VOICES Health Policy Research Center, Stanford University, Redwood City, CA; One Medical, San Francisco, CA.

Purpose: Carpal tunnel surgery is one of the most common procedures completed on the upper limb in the United States. There is currently no evidence-based high-value clinical care pathway to inform the management of carpal tunnel syndrome (CTS). We created an evidence-based care pathway and implemented a quality improvement initiative to evaluate its effect on patient time, quality, and cost in a tertiary care ambulatory surgery center. Read More

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http://dx.doi.org/10.1016/j.jhsa.2018.09.013DOI Listing
January 2019
1 Read

Carpal Tunnel Syndrome: Retrospective Analysis of 60 Consecutive Cases of Ambulatory Surgical Treatment With Local Anesthesia.

Hand (N Y) 2018 Dec 2:1558944718813721. Epub 2018 Dec 2.

3 Centro Universitário Serra dos Órgãos, Teresópolis, Brazil.

Background: The purpose of this study was to evaluate the safety and efficacy of ambulatory open surgical treatment for carpal tunnel syndrome with local anesthesia and without tourniquet ischemia, sedation by an anesthesiologist, or hospitalization.

Methods: A retrospective analysis of 60 consecutive cases performed during 1 year was conducted, excluding other compressive or noncompressive neuropathies. The criteria for treatment efficacy were improvements in symptoms and recurrence rates, and the safety criterion was the presence of complications. Read More

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http://dx.doi.org/10.1177/1558944718813721DOI Listing
December 2018
1 Read

[Finger necrosis following arterial cannulation - a case report].

Laeknabladid 2018 Dec;104(12):551-553

Department of Surgery, Faculty of Medicine, Faculty of Nursing, University of Iceland.

Arterial cannulation is a common procedure in critically ill patients, as it facilitates continuous monitoring of blood pressure, titration of inotropes, vasopressors and fluids and is also used for blood sampling. Serious complications from arterial lines are very rare, permanent ischemic damage occurs in less than 0,1% of patients. We report the case of a 60-year-old woman in septic shock caused by a perforated duodenal ulcer which was treated with emergent laparoscopic repair. Read More

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http://dx.doi.org/10.17992/lbl.2018.12.208DOI Listing
December 2018
2 Reads

Peripheral Nerve Blocks for Hand Procedures.

N Engl J Med 2018 11;379(22):2181-2

IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy

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http://dx.doi.org/10.1056/NEJMc1813329DOI Listing
November 2018
5 Reads

Peripheral Nerve Blocks for Hand Procedures.

N Engl J Med 2018 11;379(22):2182

Stanford University School of Medicine, Stanford, CA

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http://www.nejm.org/doi/10.1056/NEJMc1813329
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http://dx.doi.org/10.1056/NEJMc1813329DOI Listing
November 2018
5 Reads

Disabled-1 is down-regulated in clinical breast cancer and regulates cell apoptosis through NF-κB/Bcl-2/caspase-9.

J Cell Mol Med 2018 Nov 28. Epub 2018 Nov 28.

Department of Hand Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.

Disabled-1 (Dab1) is best known as an adaptor protein regulating neuron migration and lamination during development. However, the exact function of Dab1 in breast cancer is unknown. In this study, we examined the expression of Dab1 in 38 breast cancer paraffin sections, as well as 60 paired frozen breast cancer and their adjacent tissues. Read More

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http://dx.doi.org/10.1111/jcmm.14047DOI Listing
November 2018

TRAUMATIC CORNEAL LACERATION IN NORTHWESTERN NIGERIA.

J West Afr Coll Surg 2017 Oct-Dec;7(4):72-84

Department of Ophthalmology, University of Ilorin Teaching Hospital, Ilorin, Nigeria.

Background: Corneal laceration is a partial or full thickness corneal injury resulting from direct or indirect ocular trauma. Cornea laceration generally leads to the development of corneal opacity which is a significant cause of blindness worldwide, particularly in developing countries where facility for corneal transplant is not readily available. Clinical outcomes depend on causes, the part of cornea involved, and availability of skilled human resource and presence of corneal transplant services. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6237321PMC
November 2018
4 Reads

A technique to identify the axillary nerve and its cutaneous branch for triceps nerve-to-deltoid nerve transfer. A case report.

Int J Surg Case Rep 2018 17;53:351-353. Epub 2018 Nov 17.

Department of Anesthesia, King Saud University Riyadh, Saudi Arabia. Electronic address:

Introduction: Triceps nerve-to-deltoid nerve transfer requires the identification of the axillary nerve in the quadrilateral space. This may be difficult especially for residents-in-training. The senior author is a Professor of Hand Surgery at a teaching institution and has devised a new technique of identification of the axillary nerve and its cutaneous branch using surface land-marks and on-table ultrasonography. Read More

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http://dx.doi.org/10.1016/j.ijscr.2018.11.023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6260380PMC
November 2018

Local Anesthesia Without Tourniquet in Hand and Forearm Surgery: My Story of Using and Promoting it.

Authors:
Jin Bo Tang

Hand Clin 2019 Feb;35(1):xv-xx

Department of Hand Surgery, The Hand Surgery Research Center, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China. Electronic address:

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http://dx.doi.org/10.1016/j.hcl.2018.10.002DOI Listing
February 2019

Extending Applications of Local Anesthesia Without Tourniquet to Flap Harvest and Transfer in the Hand.

Hand Clin 2019 Feb;35(1):97-102

Department of Hand Surgery, The Hand Surgery Research Center, Affiliated Hospital of Nantong University, 20 West Temple Road, Nantong 226001, Jiangsu, China.

The authors' experience demonstrates that wide-awake flap surgery in the hand is safe. The authors used this approach in 4 commonly used flaps in the hand in 27 patients: the extended Segmuller flap, the homo-digital reverse digital artery flap, the dorsal metacarpal artery perforator flap, and the Atasoy advancement flap. Wide-awake flap surgery works very well and safely achieved excellent anesthetic and vasoconstrictive effects in the authors' cases. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07490712183010
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http://dx.doi.org/10.1016/j.hcl.2018.08.009DOI Listing
February 2019
5 Reads

Wide Awake Surgery as an Opportunity to Enhance Clinical Research.

Hand Clin 2019 Feb;35(1):93-96

Department of Orthopedic Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address:

Wide Awake surgery under Local Anesthesia with No Tourniquet (WALANT) has revolutionized clinical hand surgery, improving clinical outcomes and reducing postoperative pain and morbidity. It can also be used to deepen scientific knowledge, because the unsedated patient, with sensation intact and without the adverse effects of tourniquet neurapraxia or paralysis, can follow commands and actively move the limb after tendon and nerve surgery. These movements can be correlated with fingertip force, tendon tension, nerve conduction and amplitude, and muscle sarcomere length measurements to develop new insights into the effectiveness of many different tendon and nerve procedures in the hand. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07490712183010
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http://dx.doi.org/10.1016/j.hcl.2018.08.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6260941PMC
February 2019
5 Reads

Wide-Awake Wrist and Small Joints Arthroscopy of the Hand.

Hand Clin 2019 Feb;35(1):85-92

Upper Limb Unit, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, Lancashire WN6 9EP, UK.

The minimally invasive nature of wrist and small joint arthroscopy renders it particularly suitable for the application of the wide-awake local anesthesia no tourniquet (WALANT) technique. The application of WALANT wrist and small joint arthroscopy has given surgeons the ability to visualize both static and dynamic movements of a joint, to show the pathology and discuss with the patient, and to visualize a patient's repaired structures. This reinforces confidence in surgeons and encourages patients to comply with postoperative rehabilitation. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07490712183010
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http://dx.doi.org/10.1016/j.hcl.2018.08.010DOI Listing
February 2019
7 Reads

Wide-Awake Hand Surgery in Two Centers in China: Experience in Nantong and Tianjin with 12,000 patients.

Hand Clin 2019 Feb;35(1):7-12

Department of Hand Surgery, Tianjin Hospital, 406 Jiefang Nan Road, Hexi District, Tianjin 300211, China.

This article summarizes the application of local anesthesia no tourniquet in 2 hand surgery centers in China, Nantong and Tianjin, where more than 12,000 patients were operated on with the new approach. This approach achieves excellent anesthetic and vasoconstrictive effects. In Nantong, surgeons performed fracture fixation, soft tissue tumor excision, and flap transfer in the hand with this approach. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.08.011DOI Listing
February 2019
5 Reads

Wide Awake Tendon Transfers in Leprosy Patients in India.

Hand Clin 2019 Feb;35(1):67-84

Division of Plastic Surgery, Dalhousie University, Dalhousie Medicine New Brunswick, Suite C204, 600 Main Street, Saint John, New Brunswick E2K 1J5, Canada.

Dr Akbar Khan began using the wide awake local anesthesia no tourniquet (WALANT) technique for leprosy tendon transfers in the summer of 2015 at the Damien Foundation Hospital in Nellore, India. This article summarizes his first 18 months of experience and describes 5 of his operations. He found that WALANT provides effective anesthesia with good visibility for leprosy tendon transfers. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07490712183011
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http://dx.doi.org/10.1016/j.hcl.2018.09.001DOI Listing
February 2019
7 Reads

Lessons Learned in the Authors' First Years of Wide-Awake Hand Surgery at the W Hospital in Korea.

Hand Clin 2019 Feb;35(1):59-66

W Institute for Hand & Reconstructive Microsurgery, W General Hospital, 1632 Dalgubeol-daero, Dalseo-Gu, Daegu 42642, Korea.

Wide-awake local anesthesia no tourniquet (WALANT) is a promising development for surgeons and patients through improved operation outcomes in hand and wrist surgery. The authors have mostly used WALANT for flexor and extensor tendon repair, tenolysis, and tendon transfer. Its application at W Hospital in korea has bolstered surgeon confidence in tendon repair integrity, gliding ability, and transfer tension via direct observation and patient feedback. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.08.006DOI Listing
February 2019
1 Read

Wide Awake Hand Surgery Under Local Anesthesia No Tourniquet in South America.

Hand Clin 2019 Feb;35(1):51-58

Departament of Surgery and Orthopedics, Botucatu Medical School, São Paulo State University, UNESP, Av. Professor Mario Rubens Montenegro s/n, Botucatu, São Paulo 18 618-687, Brazil.

The authors report the introduction and development of wide awake hand surgery under local anesthesia no tourniquet (WALANT) in South America, specifically in Brazil, where thousands of cases have already been performed with this technique. This was largely stimulated by Dr Lalonde's first visit to Brazil in 2012. The authors began with smaller procedures such as trigger fingers and carpal tunnels, which were easily implemented. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07490712183010
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http://dx.doi.org/10.1016/j.hcl.2018.08.005DOI Listing
February 2019
6 Reads

Practice in Wide-Awake Hand Surgery: Differences Between United Kingdom and Cyprus.

Hand Clin 2019 Feb;35(1):43-50

Manchester Hand Centre, Salford Royal NHS Foundation Trust, Manchester, UK; Orthopaedic Department, Salford Royal Hospital, Stott Lane, Salford M6 8HD, UK.

The implementation of the wide-awake local anesthetic no tourniquet (WALANT) approach to surgical procedures in Cyprus has led to significant cost savings. In the United Kingdom, the implementation of WALANT has led to shorter waiting times for hand surgical procedures, cost savings for the National Health Service, and high patient satisfaction rates. In both countries, patient education is a prerequisite for WALANT surgery. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.08.007DOI Listing
February 2019
7 Reads

Wide Awake Secondary Tendon Reconstruction.

Hand Clin 2019 Feb;35(1):35-41

Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, 770 Welch Road, Suite 400, Palo Alto, CA 94304, USA.

The wide awake anesthesia technique is a useful tool in secondary tendon reconstruction. With active participation of the patient, the tendon repair can be adjusted appropriately to prevent repairs that are too tight or too loose. Areas of tendon scarring or triggering can be identified and released. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07490712183010
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http://dx.doi.org/10.1016/j.hcl.2018.08.004DOI Listing
February 2019
4 Reads

Impact of Wide-Awake Local Anesthesia No Tourniquet on Departmental Settings, Cost, Patient and Surgeon Satisfaction, and Beyond.

Hand Clin 2019 Feb;35(1):29-34

Chirurgie Lindenpark, Surgical Day Case Center, Lindenstrasse 23, Kloten 8302, Switzerland.

This article reviews the impact of wide-awake hand surgery without tourniquet on departmental settings and savings on patients' medical cost, and efficiency of fellowship training and practice of junior hand surgeons in 3 units in 3 countries. The medical cost of the commonly performed procedures is decreased remarkably with this approach in the 3 units. Hand surgery fellowship training and practice of junior surgeons are benefited from this approach in 2 units in Turkey and Switzerland. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.08.012DOI Listing
February 2019
8 Reads

The Canadian Model for Instituting Wide-Awake Hand Surgery in Our Hospitals.

Hand Clin 2019 Feb;35(1):21-27

Department of Plastic and Reconstructive Surgery, Dalhousie University, Suite C204, 600 Main Street, Saint John, New Brunswick E2K1J5, Canada.

Clinic-based hand surgery performed under local anesthetic has been steadily increasingly performed in Canada for 50 years. The drive for its development stems from the Canadian health care system's finite funding structure and resources. Benefits have extended far beyond cost and garbage reduction. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07490712183009
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http://dx.doi.org/10.1016/j.hcl.2018.08.001DOI Listing
February 2019
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The Current and Possible Future Role of Wide-Awake Local Anesthesia No Tourniquet Hand Surgery in Military Health Care Delivery.

Hand Clin 2019 Feb;35(1):13-19

Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address:

Wide-awake hand surgery is versatile and can be performed in a variety of settings for various pathologies. The benefits associated with wide-awake local anesthesia no tourniquet hand surgery can be extremely beneficial in the military health care system. Military medicine focuses on supporting soldiers in areas of combat, providing humanitarian care to local nationals, and to delivering health care to active duty soldiers and veterans in the domestic setting. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07490712183010
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http://dx.doi.org/10.1016/j.hcl.2018.08.008DOI Listing
February 2019
5 Reads

Latest Advances in Wide Awake Hand Surgery.

Authors:
Donald H Lalonde

Hand Clin 2019 Feb;35(1):1-6

Division of Plastic Surgery, Dalhousie University, Dalhousie Medicine New Brunswick, Suite C204, 600 Main Street, Saint John, New Brunswick E2K 1J5, Canada. Electronic address:

Injection of tumescent local anesthesia should no longer be painful. WALANT anesthesia, strong sutures, a slightly bulky repair, intraoperative testing of active movement, and judicious venting of the A2 and A4 pulleys improve results in flexor tendon repair. WALANT K wire finger fracture reduction permits intraoperative testing of K wire stability with active movement to facilitate early protected movement at 3 to 5 days after surgery. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.08.002DOI Listing
February 2019
3 Reads

Intravenous Regional Anesthesia Using a Forearm Tourniquet: A Safe and Effective Technique for Outpatient Hand Procedures.

Hand (N Y) 2018 Nov 21:1558944718812190. Epub 2018 Nov 21.

1 Department of Orthopaedic Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.

Background: Bier block provides anesthesia of an entire extremity distal to the tourniquet without necessitating direct injection at the surgical site. This avoids obscuring anatomy with local anesthetic and anesthetizes a wide area, allowing for multiple procedures and incisions. We hypothesize that a low-volume Bier block with forearm tourniquet, rather than a traditional brachial tourniquet, is a safe, well-tolerated, and effective anesthesia technique. Read More

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http://dx.doi.org/10.1177/1558944718812190DOI Listing
November 2018
9 Reads

Mechanical ventilation management during cardiothoracic surgery: an open challenge.

Ann Transl Med 2018 Oct;6(19):380

Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Mechanical ventilation during surgery is a highly complex procedure, particularly in cardiothoracic surgery, where patients need to undergo substantial hemodynamic management, involving large fluid exchanges and pharmacological manipulation of vascular resistance, as well as direct manipulation of the lungs themselves. Cardiothoracic surgery is burdened by a high rate of postoperative pulmonary complication (PPC), comorbidity, and mortality. Recent trials have examined various techniques to preserve lung function, although consensus on best practice has yet to be reached. Read More

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http://dx.doi.org/10.21037/atm.2018.06.08DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212361PMC
October 2018
8 Reads

Effect of Reneurorrhaphy of Distal Coaptation on Nerve Regeneration After Nerve Grafting: Animal Experimental Study.

World Neurosurg 2018 Nov 15. Epub 2018 Nov 15.

Department of Hand Surgery, China Japan Union Hospital, Jilin University, Changchun, PR China. Electronic address:

Background: Previous studies have shown that reneurorrhaphy of a distal coaptation at an appropriate time after nerve grafting can upregulate neurotrophins in rat spinal cord neurons. The objective of the present study was to evaluate the effect this procedure has on peripheral nerve regeneration.

Methods: Fifteen Wistar rats were randomly assigned to sham-surgery, control, or experimental (transection and rerepair of the distal coaptation of the grafting nerve) groups. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.11.049DOI Listing
November 2018

Development and validation of an android-based application for anaesthesia neuromuscular monitoring.

J Clin Monit Comput 2018 Nov 16. Epub 2018 Nov 16.

Dienst Anesthesiologie en Perioperatieve Geneeskunde, Universitair Ziekenhuis Brussel, Brussels, Belgium.

Quantitative neuromuscular block (NMB) assessment is an internationally recognised necessity in anesthesia care whenever neuromuscular blocking agents are administered. Despite this, the incidence of residual neuromuscular block and its associated major respiratory morbidity and mortality remain unacceptably high considering its preventable nature. Recent surveys show that quantitative NMB assessment is not consistently employed by anesthesiologists. Read More

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http://dx.doi.org/10.1007/s10877-018-0224-2DOI Listing
November 2018

EO technique provides better mask seal than the EC clamp technique during single handed mask holding by novices in anaesthetised and paralysed patients.

Indian J Anaesth 2018 Oct;62(10):780-785

Department of Anaesthetics and Critical Care, Royal Adelaide Hospital, North Terrace, Adelaide, Australia.

Background And Aims: Bag mask ventilation (BMV) allows for oxygenation and ventilation of patients until a definitive airway is secured and when definitive airway is difficult/impossible. This study hypothesised that the EO (thumb and index finger form a O shape around the mask) technique of mask holding provides better mask seal with the novices compared to the classic EC clamp technique (thumb and index finger form a C shape around the mask).

Methods: Sixty patients participated in this double blinded, prospective, crossover study. Read More

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http://www.ijaweb.org/text.asp?2018/62/10/780/242880
Publisher Site
http://dx.doi.org/10.4103/ija.IJA_228_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6190409PMC
October 2018
4 Reads

Neural Correlation between Evoked Tactile Sensation and Central Activities in the Somatosensory Cortex.

Conf Proc IEEE Eng Med Biol Soc 2018 Jul;2018:2296-2299

Evoked tactile sensation (ETS) is induced with stimulation of areas in the projected finger map (PFM) in the stump skin of forearm amputees. The aim of the present study is to further explore the neural correlation of the ETS with central activities in the somatosensory cortex (SI). Two forearm amputees were recruited to participate in this study. Read More

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https://ieeexplore.ieee.org/document/8512779/
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http://dx.doi.org/10.1109/EMBC.2018.8512779DOI Listing
July 2018
8 Reads

Development of a Load-Cell Based Palpation Sensor Suitable for Ophthalmic Anesthesia Training.

Conf Proc IEEE Eng Med Biol Soc 2018 Jul;2018:929-932

Palpation is the process of using one's hand to perform a physical examination. Ophthalmic anaesthetists palpate the orbital bone around the eye, to locate anatomical markers to help them guide the needle safely for regional needle block into the orbital cavity. The anaesthetists are provided very little training on palpation procedure due to the lack of a suitable training system. Read More

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http://dx.doi.org/10.1109/EMBC.2018.8512364DOI Listing
July 2018
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