Dags att begrava adrenalinmyten! Säkert bruk av adrenalinbedövning inom handkirurgi och ortopedi
Engelsk titel: Time to bury the adrenaline myth! Safe use of adrenaline anesthesia in hand surgery and orthopedics
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Författare:
Hagert, Elisabet
;
Lalonde, Donald H
Email: Hagert@handfoot.se
Språk: Swe
Antal referenser: 20
Dokumenttyp:
Översikt
UI-nummer: 15037862
Sammanfattning
The epinephrine myth originated in the 1940s, when acidic (pH 1) procaine-epinephrine was injected into fingers, causing finger
necrosis. Today, level 1 evidence exists for the safe use of epinephrine in fingers. The ability to use lidocaine-epinephrine in hand
surgery and orthopedics eliminates the need for a tourniquet, or »bloodless field«. Surgery using Wide Awake, Lidocaine-epinephrine
Anesthesia, No Tourniquet (WALANT) reduces patient discomfort, facilitates patient participation in surgery, improves safe outcomes
following reconstructions and greatly reduces the cost of medical care. Furthermore, patients regarded as high-risk can be safely
treated without risk of cardiac or pulmonary side effects. In this manuscript, the background of the epinephrine myth is described, as
well as recommended use of WALANT in hand surgery and orthopedics.