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Pediatric Wide-Awake Local Anesthesia No-Tourniquet Hand Surgery: A Practical Approach

Kailash Kapadia1, Sejal Shah1, Michael Gabriel Galvez2

  • 1Department of Surgery, Plastic and Reconstructive Surgery Division, Rutgers New Jersey Medical School, New Brunswick, NJ.

Journal of Hand Surgery Global Online
|November 24, 2022
PubMed

Keywords:
Congenital hand differencesPediatric hand fracturesPediatric hand surgeryWALANTWide awake

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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