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      Plating of an isolated fracture of shaft of ulna under local anaesthesia and periosteal nerve block

      case-report
      Author(s): a , b , *
      Publication date (Electronic):
      Journal: Trauma Case Reports
      Publisher: Elsevier
      Keywords: Plating of ulna, Periosteal block, WALANT

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          Abstract

          Isolated fractures of shaft of ulna are common. Plate fixation with anatomic reduction is thought to produce the best functional results in closed or open fractures. Surgery can be done under general and various types of regional anaesthesia. We report a case of fracture shaft of ulna treated by plating under a combination of WALANT (wide awake, local anaesthesia, no tourniquet) using tumescent anaesthesia and periosteal nerve block as a day care procedure.

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          Optimal time delay between epinephrine injection and incision to minimize bleeding.

          Daniel E McKee, Donald Lalonde, Achilleas Thoma … (2013)
          The time until maximal cutaneous vasoconstriction after injection of lidocaine with epinephrine is often given in textbooks and multiple choice examinations as 7 to 10 minutes. However, in our experience, there is significantly less cutaneous bleeding if one waits considerably longer than 7 to 10 minutes after injection of local anesthesia with epinephrine for most procedures on human skin.
          Article 0 comments Cited 42 times – based on 0 reviews     Review now
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            Lidocaine and epinephrine levels in tumescent technique liposuction.

            G Guzman, R D Burk, L Vasconez (1996)
            The safety of lidocaine dosing in the tumescent technique has been well documented, but there is little evidence regarding the safety of combining tumescent lidocaine infiltration with subcutaneous lidocaine infiltration required in other aesthetic surgery. The safety of lidocaine and epinephrine dosing was investigated in 10 patients undergoing tumescent technique liposuction alone and in 10 patients undergoing tumescent liposuction with concurrent facial and aesthetic breast surgery by determining serum lidocaine and epinephrine levels at 3, 12, and 23 hours following infiltration of the tumescent solution and the subcutaneous lidocaine. The mean lidocaine dose of all patients was 22.3 mg/kg. All patients demonstrated safe lidocaine levels at all intervals, with the highest levels occurring in patients who received intravenous lidocaine at the induction of anesthesia. The peak epinephrine levels occurred at the 3-hour blood draw and were approximately four times physiologic. No patient demonstrated any subjective or objective signs of lidocaine or epinephrine toxicity.
            Article 0 comments Cited 19 times – based on 0 reviews     Review now
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              Wide awake technique versus local anesthesia with tourniquet application for minor orthopedic hand surgery: a prospective clinical trial.

              Sompob Ruxasagulwong, Jirachart Kraisarin, Kanit Sananpanich (2015)
              Most minor hand operations can be performed with local anesthesia and tourniquet. Some literature supports this concept based on the believe that the "patient can tolerate it". Nowadays, the wide-awake technique with epinephrine- contained lidocaine is safe. This technique does not need a tourniquet because epinephrine provides local vasoconstriction.
              Article 0 comments Cited 10 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Mohammad Arshad Ikram
                Journal
                Journal ID (nlm-ta): Trauma Case Rep
                Journal ID (iso-abbrev): Trauma Case Rep
                Title: Trauma Case Reports
                Publisher: Elsevier
                ISSN (Electronic): 2352-6440
                Publication date PMC-release: 31 October 2017
                Publication date Collection: December 2017
                Publication date (Electronic): 31 October 2017
                Volume: 12
                Pages: 40-44
                Affiliations
                [a ]Orthopaedic Department, International Medical University & University of Kuala Lumpur & Medical Center, Malaysia
                [b ]Orthopaedic Department, International Medical University, Clinical Campus, Seremban, 70300, Malaysia
                Author notes
                [* ]Corresponding author. mohammadarshad@ 123456imu.edu.my
                Article
                Publisher ID: S2352-6440(17)30061-4
                DOI: 10.1016/j.tcr.2017.10.016
                PMC ID: 5887097
                PubMed ID: 29644283
                SO-VID: 265ecac5-686c-43a6-a059-95995c9b2e23
                Copyright © © 2017 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date accepted : 25 October 2017
                Categories
                Subject: Article

                Keywords: plating of ulna,periosteal block,walant
                Data availability:
                Keywords: plating of ulna, periosteal block, walant

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