New Frontiers in Wide-Awake Surgery

被引:0
|
作者
Lalonde, Donald H. [1 ,6 ]
Gruber, Meegan M. [2 ]
Ahmad, Amir A. [3 ]
Langer, Martin F. [4 ]
Sepehripour, Sarvnaz [5 ]
机构
[1] Dalhousie Univ, Plast Surg, St John, NB, Canada
[2] Univ Clin Muenster, Gruber Plast Surg, Munster, Germany
[3] Univ Clin Muenster, Prince Court Med Ctr, Munster, Germany
[4] Univ Clin Muenster, Clin Trauma Hand & Reconstruct Surg, Munster, Germany
[5] Birmingham Womens & Childrens Natl Hlth Serv Fdn T, Birmingham, England
[6] Dalhousie Univ, Div Plast Surg, 600 Main St,Suite C204, St John, NB E2K 1J5, Canada
关键词
ANESTHESIA NO TOURNIQUET; LOCAL-ANESTHESIA; WALANT TECHNIQUE; HAND SURGERY; HERNIA REPAIR; PARAUMBILICAL HERNIA; GENERAL-ANESTHESIA; FRACTURE FIXATION; INTERNAL-FIXATION; DIGITAL BLOCKS;
D O I
10.1097/PRS.0000000000011414
中图分类号
R61 [外科手术学];
学科分类号
摘要
Learning Objectives:After studying this article, the participant should be able to: 1. Explain the most important benefits of wide-awake surgery to patients. 2. Tumesce large parts of the body with minimal pain local anesthesia injection technique to eliminate the need for sedation for many operations. 3. Apply tourniquet-free surgery to upper and lower limb operations to avoid the sedation required to tolerate tourniquet pain. 4. Move many procedures out of the main operating room to minor procedure rooms with no increase in infection rates to decrease unnecessary cost and solid waste in surgery.Summary:Three disruptive innovations are changing the landscape of surgery: (1) minimally painful injection of large-volume, low-concentration tumescent local anesthesia eliminates the need for sedation for many procedures over the entire body; (2) epinephrine vasoconstriction in tumescent local anesthesia is a good alternative to the tourniquet and proximal nerve blocks in extremity surgery (sedation for tourniquet pain is no longer required for many procedures); and (3) evidence-based sterility and the elimination of sedation enable many larger procedures to move out of the main operating room into minor procedure rooms with no increase in infection rates. This continuing medical education article explores some of the new frontiers in which these changes affect surgery all over the body.
引用
收藏
页码:1212e / 1223e
页数:12
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