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清醒局部麻醉用于近端肱骨骨折:一例报告

Wide-Awake Local Anesthesia for a Proximal Humerus Fracture: A Case Report.

作者信息

Shepard Samuel, Aluvaala Eliud Seme, Bamberger H Brent

机构信息

Department of Orthopaedics, Kettering Health Grandview Medical Center, Dayton, Ohio.

Department of Surgery, Machakos Level 5 Hospital, Machakos Town, Kenya.

出版信息

J Orthop Case Rep. 2024 Apr;14(4):115-119. doi: 10.13107/jocr.2024.v14.i04.4380.

Abstract

INTRODUCTION

Over the past two decades, wide-awake local anesthesia no-tourniquet (WALANT) surgery has gained substantial popularity, challenging conventional assumptions regarding the safety of epinephrine. This report investigates the unprecedented expansion of the wide-awake local anesthesia technique beyond hand surgeries. It meticulously documents its successful application in a peri-implant proximal humerus fracture, presenting a fresh perspective on its safety and viability for managing intricate orthopedic injuries.

CASE REPORT

The subject of this study is a 61-year-old HIV-positive male with a history of recurrent falls, seeking treatment for a peri-implant proximal humerus fracture. Electing the wide-awake local anesthesia option due to financial constraints, the patient underwent a successful surgery. The technique employed involved precise administration of local anesthetic, facilitating fracture reduction, and plate replacement. Notably, the emphasis was placed on active patient participation during intraoperative assessment.

CONCLUSION

This report extends the recognized utility of WALANT surgery beyond hand surgeries, demonstrating its versatility and potential transformative impact on health-care delivery. The study underscores the pivotal role played by wide-awake local anesthesia surgery in addressing challenges related to health-care accessibility. It presents a promising avenue for future orthopedic interventions and positions itself as a safe and viable option for patients in underserved areas globally.

摘要

引言

在过去二十年中,清醒局部麻醉无止血带(WALANT)手术广受欢迎,挑战了关于肾上腺素安全性的传统观念。本报告调查了清醒局部麻醉技术在手部手术之外前所未有的扩展。它详细记录了其在肱骨近端植入物周围骨折中的成功应用,为其在处理复杂骨科损伤方面的安全性和可行性提供了新视角。

病例报告

本研究对象是一名61岁的HIV阳性男性,有反复跌倒史,因肱骨近端植入物周围骨折寻求治疗。由于经济限制,患者选择了清醒局部麻醉方案,手术成功。所采用的技术包括精确注射局部麻醉剂,以利于骨折复位和钢板置换。值得注意的是,术中评估强调患者的积极参与。

结论

本报告将WALANT手术的公认效用扩展到了手部手术之外,展示了其多功能性以及对医疗服务提供的潜在变革性影响。该研究强调了清醒局部麻醉手术在应对与医疗可及性相关挑战方面所起的关键作用。它为未来的骨科干预提供了一条有前景的途径,并将自身定位为全球服务不足地区患者安全可行的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b61a/11043985/ee8b358832b5/JOCR-14-115-g001.jpg

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