The role of adrenaline added to local anesthesia solution in hand surgery

Abstract

Objective:

The aim of this study is to evaluate the role of adding adrenaline to local anesthesia on hand vascular perfusion. With this method we can dispense tourniquet usage, allowing most surgeries to be performed on the hand with local anesthesia.

Materials and Methods:

This is a study of series of cases. 24 patients underwent upper-limb surgery in the Unit of plastic Surgery at Al-Mowassat University Hospital in Damascus during the year 2021. We planned the surgery to be performed with local anesthesia. We used a technique included the injection of a solution containing mainly lidocaine with adrenaline with precise proportions in the surgical field

Results:

We evaluated the results based on the perfusion of the wounds in the hand and fingers and on the patient satisfaction, as well as the proportion of cases that needed general anesthesia, and the economic feasibility of the technique.

There was a need to general anesthesia in one case due to the need to harvest a tendon graft.  This method has led to the dispensing of the need to occupy the recovery room, anesthesiologists and discharge patients immediately after surgery.

Summary:

 Although this method is practiced from decades still some surgeons need to be shown that the addition of adrenaline with local anesthetic is safe for vascular perfusion and economically effective due to the dispensing of most general anesthetic requirements plus its reinforcement effect to anesthesia and analgesia.