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Anesthesia in a hand surgery unit

E Vatashsky, H B Aronson, M R Wexler

    The Journal of Hand Surgery
    |September 1, 1980
    PubMed
    Summary
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    Two regional anesthesia techniques offer safe and effective pain management for hand surgery. Subcutaneous ring anesthesia is ideal for lower wrist procedures, while intravenous regional anesthesia suits extensive upper limb surgeries.

    Area of Science:

    • Anesthesiology
    • Hand Surgery
    • Regional Anesthesia

    Background:

    • Effective pain management is crucial in hand surgery.
    • Regional anesthesia offers an alternative to general anesthesia.

    Purpose of the Study:

    • To describe impressions of two regional anesthetic techniques in 670 hand surgery cases.
    • To evaluate the efficacy and safety of different regional anesthesia methods.

    Main Methods:

    • Subcutaneous ring anesthesia with local nerve block/infiltrative anesthesia (Lignocaine) for operations at or below the wrist.
    • Intravenous regional anesthesia with Bupivacaine for more extensive upper limb surgery.

    Main Results:

    • Subcutaneous ring anesthesia was satisfactory, effective, simple, and safe, allowing motor function assessment.

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  • Intravenous regional anesthesia was effective but carried toxicity risks if tourniquet management was poor.
  • Diazepam administration prior to tourniquet release minimized toxicity risks.

    • Conclusions:

    • Subcutaneous ring anesthesia is a suitable technique for distal upper limb surgeries.
    • Intravenous regional anesthesia is effective for extensive surgeries but requires careful tourniquet management.
    • Diazepam can mitigate potential toxicity associated with intravenous regional anesthesia.