Awake Local Anesthesia Infiltration Compared to Regional Nerve Block for Hand Surgeries
Study Details
Study Description
Brief Summary
The study trying to fined out the best anaesthesia technique for hand flexor procedures which provide efficient anaesthesia while providing adequate surgical field exposure & less blood loss
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
The current study compared patients scheduled for hand surgical procedures using wide awake local anaesthetic infiltration to those receiving supra-clavicular brachial plexus block. the comparison including adequacy of pain control, blood loss, patient satisfaction, time & skills needed to provide aesthetic technique.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Wide Awake Local Anesthesia (WALANT) Study arm: (WALANT) patient received local anaesthesia infiltration at site of surgery for hand flexor tendons repair. |
Other: local anaesthesia infiltration
Infiltration of 150 mg of lidocaine solution per ray at site of surgical incision for flexor tendon repair in the palm, the 2 proximal & distal phalanges
|
| Active Comparator: Supra Clavicular- Brachial Plexus Block (SC-BPB) Control arm:(SC-BPB): ultrasound-guided injection of local aesthetics at supra-clavicular level where brachial plexus trunks are located this will provide anesthesia for the whole upper limb distal to shoulder joint. |
Other: brachial plexus block
ultrasound-guided infiltration of local aesthetics around brachial plexus trunks & divisions
|
Outcome Measures
Primary Outcome Measures
- Intra-operative pain score [duration of operation]
pain assessment during operation at the following moments: before the injection, during injections , during the incision , during gentle manipulation , during aggressive manipulation and during wound closure.
Secondary Outcome Measures
- anaesthesia induction time [duration of operation]
the time taken to provide anesthesia
- Blood loss [duration of operation]
calculated based upon the number and degree of soaking of swabs used in the operation and the amount in a suction container in the operation room.
- intra-operative preserved motor power intraoperative [duration of operation]
surgeon test the motor power after repair of the affected tendon
- operative time [duration of operation]
time from skin incision till last suture applied for wound closure
- patient satisfaction [12 hours post operative]
was measured and recorded using five-point Likert scale[25] (1 = very dissatisfied, 2 = dissatisfied, 3 = neutral, 4 = satisfied, and 5 = very satisfied) with checklist and a closed-ended question "If you were to undergo this surgery again, would you choose the same type of anaesthesia? YES or NO "
- postoperative pain scores [12 hours postoperatively]
numeric pain rating scale (NRS)A respondent selected a whole number (0- 10 integers) that best reflects the intensity of his pain, 0-10 was recorded by a blinded investigator at 2, 4, 6, 8, 10, 12 hours postoperatively, time of 1st call for postoperative analgesia was recorded, patients received 25 mg pethidine IV if the NRS pain exceeds 3, the dose was repeated on patient's demand with 2 hours minimal time interval between doses, total analgesic dose required in the 1st twelve hours postoperatively
Eligibility Criteria
Criteria
Inclusion Criteria:
- Participants were included if they were to be scheduled for Flexor tendon repair (Interventions involving flexor tendons of the wrist (Flexor Carpi Ulnaris (FCU), Flexor Carpi Radialis (FCR), and/or Palmaris Longus PL), fingers (flexor digitorum Profundus FDP and/or Flexor Digitorum Superficialis FDS) and thumb (Flexor Pollicis Longus FPL)), aged 18 years or over & of ASA physical status I or II.
Exclusion Criteria:
- Participants were excluded if they were (American society of Anaesthesia) ASA physical status III or IV, refusal of anaesthetic procedure or refuse to participation in the study, documented hypersensitivity to lidocaine, compromised peripheral circulation (Patients with previous vascular injury, vasculitis, Buerger's disease, and scleroderma), evidence of infection at injection site, patients with ischemic heart disease or psychiatric illness and patients with concomitant injuries that needed further operative procedure under general anesthesia or spinal anesthesia.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Ain Shams University Hospitals | Cairo | Egypt | 11591 |
Sponsors and Collaborators
- Ain Shams University
Investigators
- Principal Investigator: Salwa O. Mohammed, M.D., Assistant professor, Ain Shams University, Faculty of Medicine
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- MS 242/2022