Intraoperative Active Motion Confirmation During Wide-Awake Local Anesthesia No Tourniquet Surgery

Takehiko Takagi

doi:10.1016/j.jhsg.2022.05.007

Intraoperative Active Motion Confirmation During Wide-Awake Local Anesthesia No Tourniquet Surgery

J Hand Surg Glob Online. 2022 Aug 19;4(6):437-441. doi: 10.1016/j.jhsg.2022.05.007. eCollection 2022 Nov.

Author

Takehiko Takagi¹

Affiliation

¹ Division of Orthopaedic Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan.

Abstract

As a recent advance in the field of hand surgery, the wide-awake local anesthesia no tourniquet surgical technique-performed using an epinephrine-containing local anesthetic without a tourniquet while the patient is awake-has attracted attention. The wide-awake local anesthesia no tourniquet technique has been indicated for surgeries such as trigger release, soft tissue tumor excision, surgery for Dupuytren contracture, thumb carpometacarpal arthroplasty, or any other tendon, nerve, or ligament surgeries, requiring intraoperative active motion confirmation. Herein, the surgical procedures performed with the wide-awake local anesthesia no tourniquet technique have been described; moreover, the indications and precautions of this technique have been reconsidered.

Keywords: Suture suspension arthroplasty; Thumb CMC arthroplasty; Ulnar collateral ligament injury of the thumb MCP joint; Wide-awake hand surgery; de Quervain tenosynovitis.