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Wide awake local anesthesia no tourniquet in hand surgery: an analysis of adverse events and complications

   | 25. Apr. 2024


Introduction: Anesthesiologist’s assistance is considered an inseparable part of most surgical procedures, except for minor operations performed under local anesthesia. In hand surgery, most of the operations can be performed under regional (brachial plexus block) or local (infiltration) anesthesia. These procedures can be carried out by the surgeons themselves, which allows them to operate without the assistance of an anesthesiologist. The objective of this study was an analysis of the efficacy and safety of anesthesia to operations in hand surgery performed by surgeons, without the assistance of anesthesiologists.

Materials and Methods: This analysis was based on records of anesthesia protocols completed by the surgeons who performed the procedure and who operated on the patients. The following variables were considered: efficacy of anesthesia, adverse effects associated with anesthesia and complications.

Results: Over a 10-year period (2013–2022), a total of 16,583 procedures were performed, of which 5638 (34%) were carried out under anesthesia by surgeons, without the assistance of anesthesiologists. The efficacy of these procedures (local and brachial plexus blocks) was 98%. A total of 203 (3.6%) anesthesia-related events were noted, most of which were transient, requiring emergency intervention and without serious consequences. In only 12 cases (0.02%) adverse effects led to cancellation and postponement of the planned operation.

Conclusion: Anesthesia for operations in hand surgery performed by surgeons themselves and without the assistance of anesthesiologists is effective and safe and is associated with numerous benefits for patients, surgeons, and the budget of the medical care system.

Zeitrahmen der Veröffentlichung:
4 Hefte pro Jahr
Fachgebiete der Zeitschrift:
Medizin, Vorklinische Medizin, Grundlagenmedizin, andere, Klinische Medizin, Chirurgie, Öffentliches Gesundheitswesen