Overview

Wide-Awake Local Anesthesia vs. Regional/General Anesthesia for Flexor Tendon Repair

Status:
Not yet recruiting
Trial end date:
2033-11-01
Target enrollment:
0
Participant gender:
All
Summary
Wide-awake hand surgery with local anesthetic, no tourniquet and no sedation (WALANT) is increasingly utilized. Conventional anesthesia for hand surgery involves a patient with a block, unable to perform motor function in the arm, and with patient either intubated or sedated, unable to follow surgeon instructions intra-operatively. Flexor tendon repair with a wide awake and cooperative patient is routinely performed successfully at some centres. This method provides several potential benefits including being able to have the patient actively flex the digit and visualize the repair site to assess for any tendon gapping at the repair site, ensure adequate approximation, gliding and absence of triggering. There have not been any prospectively collected randomized controlled trials comparing wide awake vs. regional/general anesthesia in flexor tendon repair. The purpose of our study is to assess for differences in early outcomes including stiffness, patient satisfaction and early complications in wide-awake anesthesia when compared to general/regional anesthesia for flexor tendon repair in zones I and II. Our hypothesis is that there is a lower complication rate and better outcomes when using wide-awake flexor tendon repair.
Phase:
N/A
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
University of Western Ontario, Canada
Treatments:
Anesthetics
Anesthetics, Local
Epinephrine
Lidocaine
Ropivacaine
Criteria
Inclusion Criteria:

- over the age of 18

- acute single or multiple digit complete flexor tendon lacerations in zones I or II
presenting to attending physicians who agree to participate in the study.

Exclusion Criteria:

- gross wound contamination

- segmental tendon loss

- associated finger fractures

- sub-acute or chronic ruptures (ruptures > 6 weeks old)

- active or previous infection in the wound bed

- requirement of delayed repair

- complex or multisystem injuries

- multiple digit injuries

- significant joint injuries

- amputations (replants)

- mangled hand injuries.