Department of Plastic and Reconstructive Surgery, Dalhousie University, Saint John, New Brunswick, Canada.
J Am Acad Orthop Surg. 2013 Aug;21(8):443-7. doi: 10.5435/JAAOS-21-08-443.
Traditionally, surgeons were taught that local anesthesia containing epinephrine should not be injected into fingers. This idea has since been refuted in many basic and clinical scientific studies, and today, injection of lidocaine plus epinephrine is widely used for digital and hand anesthesia in Canada. The key advantages of the wide-awake technique include the creation of a bloodless field without the use of an arm tourniquet, which in turn reduces the need for conscious sedation. The use of local anesthesia permits active motion intraoperatively, which is particularly helpful in tenolysis, flexor tendon repairs, and setting the tension on tendon transfers. Additional benefits of wide-awake anesthesia include efficiencies and cost savings in outpatient surgical case flow due to the absence of conscious sedation.
传统上，外科医生被教导含有肾上腺素的局部麻醉剂不应注射到手指中。这个观点在许多基础和临床科学研究中已经被反驳，而如今，在加拿大，利多卡因加肾上腺素的注射被广泛用于手指和手部麻醉。清醒麻醉技术的主要优点包括无需使用止血带即可形成无血手术视野，从而减少对镇静的需求。局部麻醉的使用允许术中主动运动，这在松解术、屈肌腱修复和肌腱转移张力设置中特别有帮助。清醒麻醉的其他好处包括由于没有使用镇静，门诊手术流程中的效率和成本节约。
