title: Pain management strategies in hand surgery.
abstract: Modern anesthetic agents have allowed for the rapid expansion of ambulatory surgery, particularly in hand surgery. The choice between general anesthesia, peripheral regional blocks, regional intravenous anesthesia (Bier block), local block with sedation, and the recently popularized wide-awake hand surgery depends on several variables, including the type and duration of the procedure and patient characteristics, coexisting conditions, location, and expected length of the procedure. This article discusses the various perioperative and postoperative analgesic options to optimize the hand surgical patients' experience.
authors.affiliation: Rothman Institute at Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA. Electronic address: ketonis@gmail.com.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Ketonis
authors.affiliation: Rothman Institute at Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA.
authors.forename: Asif M
authors.initials: AM
authors.lastname: Ilyas
authors.affiliation: Rothman Institute at Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA.
authors.forename: Frederic
authors.initials: F
authors.lastname: Liss
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D000768:Anesthesia, General / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage; D016292:Procedural Sedation / Q000379:methods; D005260:Female; D006225:Hand / Q000503:physiopathology / Q000601:surgery*; D006230:Hand Injuries / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D009407:Nerve Block / Q000379:methods*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000503:physiopathology; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D019990:Perioperative Care / Q000379:methods*; D018570:Risk Assessment
chemical_list: D000779:Anesthetics, Local
keywords: Ambulatory hand surgery; Combination analgesics; Exparel; Nerve block; Wide-awake surgery