title: Wide Awake Hand Surgery.
abstract: Wide awake hand surgery employs local-only anesthesia with low-dose epinephrine to create a bloodless field without the use of an arm tourniquet. Despite traditional teaching, evidence-based medicine suggests epinephrine is safe for use in hand and digital anesthesia. Eliminating an arm tourniquet reduces the requirement for sedation and general anesthetic. This confers particular advantage in surgeries such as tendon repairs, tendon transfers, and soft tissue releases in which intraoperative active motion can used to optimize outcomes. The wide awake approach also confers significant benefit to patients, providers, and health care systems alike due to efficiencies and cost savings.
authors.forename: Matthew
authors.initials: M
authors.lastname: Cantlon
authors.forename: Steven
authors.initials: S
authors.lastname: Yang
mesh_terms: D000772:Anesthesia, Local / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D057668:Bloodless Medical and Surgical Procedures / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D004837:Epinephrine / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D006225:Hand / Q000098:blood supply* / Q000601:surgery*; D017048:Health Care Costs; D006801:Humans; D007267:Injections; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D012039:Regional Blood Flow; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D014851:Wakefulness
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D004837:Epinephrine