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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 Läs online Författare: Hagert, Elisabet ; Lalonde, Donald H Språk: Swe Antal referenser: 20 Dokumenttyp: Översikt UI-nummer: 15037862

Tidskrift

Läkartidningen 2015;112(6)208-10 ISSN 0023-7205 E-ISSN 1652-7518 KIBs bestånd av denna tidskrift Denna tidskrift är expertgranskad (Peer-Reviewed)

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.