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Epinefrina y cirugía de mano

Calista Stevens1, Kelly White1, Eve Cathcart1

  • 1University of Connecticut School of Medicine, Farmington, CT, USA.

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Resumen
Este resumen es generado por máquina.

El uso de epinefrina en cirugía de mano, incluida la técnica de Anestesia Local Despierta Sin Torniquete (WALANT), es seguro. Una revisión sistemática no encontró complicaciones de isquemia digital o necrosis en 14.735 pacientes.

Palabras clave:
EpinefrinaCirugía de manoIsquemiaLidocaínaWALANT

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Área de la Ciencia:

  • Cirugía de mano
  • Anestesiología
  • Cirugía Vascular

Sus antecedentes:

  • El creciente énfasis en la atención basada en el valor y la técnica de Anestesia Local Despierta Sin Torniquete (WALANT) aumentan el uso de epinefrina en cirugía de mano.
  • Los cirujanos expresan preocupaciones sobre el uso electivo de epinefrina en el dedo a pesar de su seguridad percibida.
  • Necesidad de datos basados en evidencia para informar a cirujanos y pacientes sobre la seguridad de la epinefrina en cirugía de mano.

Objetivo del estudio:

  • Revisar sistemáticamente la tasa de complicaciones isquémicas asociadas con el uso de epinefrina en cirugía de mano.
  • Evaluar la seguridad de la epinefrina en cirugía de mano, particularmente dentro de la técnica WALANT.
  • Proporcionar datos que respalden o refuten las preocupaciones sobre la isquemia digital por el uso de epinefrina.

Principales métodos:

  • Búsqueda sistemática de la base de datos Scopus (2005-2022).
  • Inclusión de 51 estudios con 14.735 pacientes sometidos a cirugía de mano con inyección de epinefrina (carpo y distal).
  • Exclusión de reportes de casos, revisiones, estudios en animales/cadáveres, estudios no en inglés o estudios que carezcan de datos de complicaciones; análisis agrupado de las tasas de complicaciones.

Principales resultados:

  • No se reportaron casos de isquemia digital o necrosis en 51 estudios.
  • Se incluyeron un total de 14.735 pacientes en la revisión sistemática.
  • El uso de epinefrina a concentraciones estándar no mostró asociación con complicaciones isquémicas.

Conclusiones:

  • El uso de epinefrina en cirugía de mano a concentraciones estándar es seguro y no se asocia con complicaciones isquémicas.
  • Los hallazgos respaldan el perfil de seguridad de la epinefrina, especialmente dentro de la técnica WALANT a concentraciones de 1:100.000.
  • Esta revisión sistemática proporciona evidencia sólida para el uso seguro de epinefrina en cirugía de mano.