title: Digital replantations under local anaesthesia.
abstract: We performed 10 digital replantations under local anaesthesia. Nine were single digit replantations and one case had a digital replantation together with another digit revascularisation. Criteria for patient selection for the local anaesthetic procedure included healthy young individuals, solitary hand injury, ability to understand the procedure and a stable emotional makeup. A combination of 10 ml of lidocaine 1% and 10 ml of bupivacaine 0.5% was used for volar metacarpal block and a dorsal ring block to the base of the digit. The patient was simultaneously sedated with 10 mg diazepam intramuscularly. Standard intraoperative monitoring of blood pressure, continuous electrocardiogram and pulse oximeter were carried out. The average duration of surgery was 3 hours. There was complete pain relief intraoperatively and good postoperative sensory block for an additional 7 to 15 hours. The technical execution of microsurgery was not compromised. All replantations were successful with no complication encountered from the use of local anaesthesia.
authors.affiliation: Department of Orthopaedic Surgery, National University of Singapore, Singapore.
authors.forename: A K
authors.initials: AK
authors.lastname: Kour
authors.forename: M H
authors.initials: MH
authors.lastname: Phone
authors.forename: J
authors.initials: J
authors.lastname: Chia
authors.forename: R W
authors.initials: RW
authors.lastname: Pho
mesh_terms: D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D000772:Anesthesia, Local; D002045:Bupivacaine; D016292:Procedural Sedation; D003975:Diazepam; D005240:Feasibility Studies; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012092:Replantation / Q000379:methods*; D013933:Thumb / Q000293:injuries*; D016896:Treatment Outcome
chemical_list: D008012:Lidocaine; D003975:Diazepam; D002045:Bupivacaine