gms | German Medical Science

Objectives: The objective of the study is to confirm the efficiency and safety of using lidocaine:epinephrine solution in local anesthesia performed in Hand Surgery and to statistically analyse several factors taken into consideration. Also, we encourage the use of Wallant technique in Hand Surgery based on our achieved experience.

Method: The study is based on 100 patients, 55 men and 45 women, whose hand surgeries were performedunder local anesthesia. We used Wallant technique on 47 cases of carpal tunnel syndrome, 33 cases of Dupuytren's disease and 20trigger finger cases. The used anesthetic solution was 1% lidocaine: epinephrine in a concentration of 1:100 000. We studied the necessary anesthetic volume, waiting time for the onset of the anesthesia effect, operated hand, intraoperative bleeding, record of digital necrosis and other complications, surgeon and patient comfort during surgery, period of hospitalisation. Regression (ANOVA) showed that the duration of hospitalisation is positive, moderate and directly correlated to the volume of anesthetic used for patients with carpal tunnel syndrome. The correlation coefficient is 0.52, statistically significant with a p value<0.01 (Significance F=0.002). Applying regression in ANOVA, correlating the used anesthetic volume to the entire group with the time to onset of anesthesia, the value of correlation coefficient is 0.43, indicating a moderate correlation, but highly statistically significant for p<<0.00001.

Results: In all cases, the anesthetic solution created optimal conditions to perform a proper surgical intervention, similar to those obtained by using the tourniquet, in similar volumes to those indicated in the literature. The waiting time for the onset of the anesthesia effect was between 8 to 15 minutes. In none of the cases, it was not necessary to use neither the tourniquet, bipolar forceps, nor sedatives. No complication, such as ischemia or digital necrosis, was recorded.

Conclusion: Using lidocaine-epinephrine solution (1:100 000 concentration) as local anesthesia in Hand Surgery (Wallant technique) is safe and efficient, avoiding the risks implied by the use of tourniquet, sedatives and dealing with a cooperative patient throughout the surgery. Also, the aspects of reducind time and costs of hopitalisation are not to be neglected.