Continuous local anaesthesia for post-operative mobilization of injured digits.
We have studied the effects of sustained local anaesthesia on postoperative mobilization of the injured hand. Small epidural catheters were placed adjacent to the peripheral nerves providing sensation to the involved part of the hand under direct vision in the distal forearm. Repeated doses of 0.5% bupivacaine were then administered during mobilization therapy to relieve pain. Fourteen out of 24 digits (60%) recorded 30 degrees or more increases in active range of motion after bupivacaine injection. The cases that failed to improve had suffered severe injuries. Complications were few and were easily managed as the catheters were distal, superficial and accessible. This is an effective, specific and safe method of providing sustained postoperative analgesia for mobilization.
Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore. yppeng@hotmail.com
Y P
YP
Peng
C
C
Seow
C K
CK
Low
W Y C
WY
Chew
R W H
RW
Pho
D000293:Adolescent; D000328:Adult; D000772:Anesthesia, Local / Q000295:instrumentation*; D000779:Anesthetics, Local; D002045:Bupivacaine; D002408:Catheters, Indwelling; D004434:Early Ambulation / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000187:drug effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D026741:Physical Therapy Modalities; D011183:Postoperative Complications / Q000534:rehabilitation*; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000187:drug effects
D000779:Anesthetics, Local; D002045:Bupivacaine