doi:Reed KL, Malamed SF, Fonner AM. From classic big-chocolate to strawberry-milkshake. Newsletter
J Am Acad Orthop Surg. Plast Reconstr Surg 119:260–266 CrossRefPubMedZurück zum Zitat Mckee DE, Lalonde DH, Thoma A et al (2015) Achieving the optimal epinephrine effect in wide awake hand surgery using local anesthesia without a tourniquet. Clin Hemorheol Microcirc 55:241–253 PubMedZurück zum Zitat Sylaidis P, Logan A (1998) Digital blocks with adrenaline. Reference Manager
Diese Methode, von Lalonde „Wide Awake Approach“, also „Zugang bei völlig wachem Patienten“ genannt, birgt erhebliche Vorteile für Patient und Arzt: • Die Operation wird in örtlicher Betäubung durchgeführt, d.h. das Narkoseverfahren ist für den Patienten, der völlig wach bleibt, körperlich nicht belastend und äußerst schonend Postoperative Schmerzmitteleinnahme.Von 38 Patienten empfanden 32 den Eingriff als nicht belastend, 6 als etwas belastend. Der Plastische Chirurg wurde 2009 zum Vorstand des American Board of Plastic Surgery gewählt. And oh, we love to give advice on coffee and life. We fuel independent cafes, offices and coffee enthusiasts in Brussels and beyond. In our experience with wide awake hand surgery over 15 years, we have not encountered a patient who was confirmed to have a local anaesthetic allergy.The least allergenic local anaesthesia would be an alternate amide such as prilocaine; use it without adrenaline and use a single-use vial (with no preservative).If there are any doubts, postpone the surgery and refer to an allergy specialist.Vasopressors, such as low-dose adrenaline, for instance, at 1:200,000, are commonly used in wide awake hand surgery to provide constriction of blood vessels and hence minimise bleeding by activating alpha-1 adrenergic receptors. Name must be less than 100 characters Arch Plast Surg 41:312–316 CrossRefPubMedPubMedCentralZurück zum Zitat Thomson CJ, Lalonde DH, Denkler KA et al (2007) A critical look at the evidence for and against elective epinephrine use in the finger.
Rev Infirm. Zurück zum Zitat Lalonde D (2016) Wide awake hand surgery.
If there is any doubt that a patient may have a local anaesthetic allergy, he should be referred to an allergy specialist for evaluation and surgery should not be performed.Rather than having a true allergy, patients are more likely to faint or to react to adrenaline (either their own adrenaline or that administered—adrenaline is a beta-1 adrenergic agonist). The Robbins TH. CME Nachteile 4 WirkzeitpunktmitblutungsfreiemOperationsgebietbeträgtmindestens30min[1,20]. The Wide-Awake Approach to Dupuytren's contracture involves fasciectomy under local anesthetic with epinephrine and no tourniquet.
Entwickelt wurde der ‘Wide-Awake-Ansatz’ von dem Kanadier Dr. Donald Lalonde. USD 89.00 2016 Dec;119(12):986-992. doi: 10.1007/s00113-016-0248-3. Handchir Mikrochir Plast Chir 45:271–274 CrossRefPubMedZurück zum Zitat Schnabl SM, Unglaub F, Leitz Z et al (2013) Skin perfusion and pain evaluation with different local anaesthetics in a double blind randomized study following digital nerve block anaesthesia. 1981;63(5):357–8.Wakai A, Winter DC, Street JT, Redmond PH.
In addition to minimising bleeding in the operative field, low-dose adrenaline delays anaesthetic absorption, enabling pain-free surgery for more complex procedures. Zurück zum Zitat Löw S, Herold D, Eingartner C (2013) The “wide-awake approach” – efficiency and patient safety in carpal tunnel releases. Our Probatino is churning out small fresh batches every day. Unable to load your collection due to an error
Ann R Coll Surg Engl 72:408–409 PubMedPubMedCentralZurück zum Zitat Koegst WH, Wölfle O, Thoele K et al (2011) The “Wide Awake Approach” in hand surgery: a comfortable anaesthesia method without a tourniquet. We help you serve the best coffee in town. Ann Emerg Med 56:270–274 CrossRefPubMedZurück zum Zitat Nodwell T, Lalonde D (2003) How long does it take phentolamine to reverse adrenaline-induced vasoconstriction in the finger and hand? Papers
2007 Apr 15;119(5):1507-12. doi: 10.1097/01.prs.0000256071.00235.d0.Unfallchirurg.
This service is more advanced with JavaScript availableWide awake hand surgery is performed under local anaesthesia with low-dose adrenaline without (the risks of) general anaesthesia, regional anaesthesia, sedation or tourniquets, is applicable to the majority of hand surgery procedures and is especially suited to soft tissue conditions including Dupuytren’s contracture (Bismil et al., World wide awake hand surgery consensus statement.
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