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A-0024 Clinical evaluation of surgical management of hand pathologies under local anesthesia
Juanos Cabanas Jordi, Schuind Frederic, Jennart Harold, Zorman David, CHU Tivoli, La Louvière (Belgium); Erasme Hospital, Brussels (Belgium)
Thursday, June 14, 2018 · 8:43 a.m. · 07m 14s
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good the morning everyone i'm sure this one also i'm from belgium and i'll talk to you about clinical evaluation of
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hand surgery and the local initiatives yet so we haven't gotten the fan is users we
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can have in any other country in the world so we would like to try
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uh the what surgery uh because of the same reason would have a relative lack of finest
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assistant we want to decrease the time between operations and the only question is is that
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possible to do in belgium in a in an easy way we could have
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some problems with the surgeons considering it couldn't it can be difficult
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or or adventurous and we get we could have some problems with the patients
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that think uh it's more comfortable for them to have the sedation
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so we had the same expectations as anywhere else and we make a mail to
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sent extended between two departments of automatic surgery in as in the hospital in
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brussels with professor she intended into valley hospital in love yeah
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we had a questionnaire for surgeons uh uh with the
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difficulty of related to infiltration visualisation comport has failed
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as felt uh by the surgeon and the scale went from one to ten because you considered
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the zero leave a lot of difficulty doesn't exist for surgeon and uh if there was
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an expanding of the operation time i had a questionnaire for the patients about
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pain about anxiety about duration of us has television side effects and the the satisfaction
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so we had at the end up forty four patients stain it hasn't referring to valley uh we respected
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parity and we had six uh drums uh five of them never use wide awake surgery before
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uh we had forty seven iterations and it was well uh uh a
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couple general surgery a a trigger finger local flaps and so one
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so the result for the surgeon was that the intake iteration difficulty was very low
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at level one point two i i repeat the the lowest level is one
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the visualisation doing surgery was considered dude with a level up to the the patient into for but
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it was a one and clanging of surgery time just occurred in ten percent of cases
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for the patient base the uh five hours in the auto that's too much but
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uh most of the uh staying in the house that was before the surgery
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and uh we had technically just one side effects one case of knowledge yeah
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in terms of pain we see a rebound of pain after the surgery
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and uh uh well very uh a good values during the surgery
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it was very well control after the surgery with uh the energetic you gave in more than
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seventy percent of cases it was enough with a with a just a process demo
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and satisfaction at that point of view was about the ninety three percent of cases
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in terms of thanks eighty we see that uh the values are decreasing
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even after surgery when we see we have a rebound effect of
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in terms of pain we have no rebound of anxiety so uh probably that means that the pain was good control
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um we have the same uh satisfaction raise your as the uh
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we've seen before with the ninety five percent of patients satisfied
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let's keep it saying this so uh
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if we uh consider that at the beginning we were afraid that surgeons find
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it was difficult adventures we have to prove here that it's not
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difficult for them even for the first time between infiltration was easy so we can't even
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speak about the learning curve it's directly a very very easy for this uh surgeons
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in terms of visualisation we had we had four cases in which it was
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the more difficult you of them the incision was made after only
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ten minutes after the infiltration so that's not the uh technique described uh we have described in the literature
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and the two other cases it was just because of
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the diffusion of the product inside wound um
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so uh we can discuss about that a little bit later uh
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in any case the mean allegation time was to mean it so there's no big deal
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uh the can for for the patient has what a surgeon was really really very good and we did davis that you have indications
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um we can just tell the the duration is a little bit longer
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pat with the literature we but that's for practical reasons and we
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had technically uh no the side effects and zero complication so
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contrary to save method that was not the objective for this today but we can confirm that we had zero accidents
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patients and surgeons was satisfied reconfirmed that you have to wait
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twenty five to thirty minutes after infiltration and maybe even
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our correct these uh we're trying to use a little less quality of product
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uh for example for a week and then the surgery thank you ha
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hi
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thank you very much uh any questions
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in fact it's agenda question uh_huh it's income yeah uh yeah
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holland with uh no it's easy combined that's okay
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oh mine uh him operation show this such as c. d. s.
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and a track i think that twenty five minutes after all
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what is the advantage of long directly advantage just
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to wait thirty minutes and see that's
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the point well the advantages to come forth for the patient first
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of all because they they always feel uncomfortable with the
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only k. and the uh the twenty five minutes is not the last of time if you are organised you do
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the first infiltration like the beginning of the day and after that you do
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one case ends after you do more invitations for the next cases
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so you don't have to wait for each case twenty
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five minutes you can take that time while operating so there's no no problem with the with this to this technique
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thank you i think that's a good question ah but in reality there zero time wasted people
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look an angle thirty minutes how can you wait thirty minutes that's a waste of time
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so when i have the day of carpal tunnels i inject the first three or four carpal tunnels at the beginning
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and then by the time the first one is scott hi go do
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that because the nurse has that patient already reading in the room
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and then while she changes the room i go inject the fourth person
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and then by the time i've finished injecting the fourth person she has
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the second person in the room so me and one nurse
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can do three carpal tunnels very comfortably every hour so that's really
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the time it's not thirty minutes wasted there's no time wasted
Conference Program
A-0099 The creation of a Wide Awake Hand Surgery service in an NHS Trust in the UK. Challenges, cost savings and effectiveness
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June 14, 2018 · 8:23 a.m.
A-0099 Q&A
Constantinos Kritiotis, Manchester, UK
June 14, 2018 · 8:29 a.m.
A-0140 Benefits of the Implantation of a "Wide Awake Surgery" Circuit in Hand Surgery
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A-0719 Wide Awake Hand Surgery - Limits and Complications
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June 14, 2018 · 8:36 a.m.
262 views
A-0024 Clinical evaluation of surgical management of hand pathologies under local anesthesia
Juanos Cabanas Jordi, Schuind Frederic, Jennart Harold, Zorman David, CHU Tivoli, La Louvière (Belgium); Erasme Hospital, Brussels (Belgium)
June 14, 2018 · 8:43 a.m.
118 views
A-0043 Scope in Hand Surgery Using Surgeon Administered Local/Regional Anaesthesia (SALoRA)
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A-0853 The advantages of using WALANT anesthesia for hand and wrist fractures- personal experience
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A-0554 Wide awake flexor pollicis longus and digital nerve repairs on patients in the prone position
Thomas Apard 1, Yann Erwan Favennec 1, Gilles Candelier 1, Daniel Mckee 2, Donald H. Lalonde 2, 1 Center of Hand Surgery, Private Hospital of Saint Martin, Caen, France; 2 Plastic Surgery, Dalhousie University, Saint John, New Brunswick, Canada
June 14, 2018 · 9:06 a.m.
A-0075 Correlation between Extension-Block K-wire Insertion Angle and Postoperative Extension Loss in Mallet Finger Fracture
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June 14, 2018 · 9:13 a.m.
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June 14, 2018 · 9:20 a.m.
A-0114 Reconstruction of ulnar dislocation of the extensor tendon at the metacarpophalangeal joint
Masayoshi Ikeda 1,2, Yuka Kobayashi 2, Takehiko Takagi 2, Ikuo Saito 2,3, Takayuki Ishii 2, Daisuke Nakajima 2, Masahiko Watanabe 2, 1 Shonan Central Hospital, Fujisawa, Japan; 2 Tokai University School of Medicine, Isehara, Japan; 3 Isehara Kyodo Hospital, Isehara, Japan
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183 views
A-1022 Lumbrical plus or paradox finger extension syndrome - case report and review of the literature
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