488 hand surgeries with local anesthesia with epinephrine, without a tourniquet, without sedation, and without an anesthesiologist

Objectives

Evaluate the incidence of digital infarction and tissue necrosis using local anesthesia with 1% lidocaine and 1:100,000 epinephrine in wrist, hand, and fingers surgeries, without a tourniquet, without sedation, and without an anesthesiologist.

Methods

Patients with wrist, hand, and fingers disorders prospectively underwent surgery under local anesthesia with 1% lidocaine and 1:100,000 epinephrine. The primary outcomes evaluated were the presence of digital infarction and tissue loss due to necrosis. As secondary outcomes, the need for the use of sedatives, tourniquet, anesthesiologist assistance, or surgery suspension were evaluated.

Results

Fifty-three wrists, 307 hands, and 128 fingers were anesthetized with lidocaine and epinephrine without any complications related to epinephrine. There was no patient that presented with any of the primary or secondary outcomes.

Conclusions

Wrist, hand, and fingers surgeries can be safely performed with local anesthesia with 1% lidocaine and 1:100,000 epinephrine, without sedation, without a tourniquet, and without an anesthesiologist.