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2022, Number 2

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Revista Cubana de Ortopedia y Traumatología 2022; 36 (2)

The rise and fall of the epinephrine myth in the hand

Sardenberg T, Varanda D, Rangel RC, Cortopassi AC

Language: Spanish
References: 82
Page: 1-13
PDF size: 337.54 Kb.


ABSTRACT

The possibility of operating patients with hand conditions under local anesthesia, with lidocaine and epinephrine, using WALANT technique caused a revolution in hand surgery, which made life easier for patients and lowered the costs of hospital services. Surgeons need to be aware of the possibilities and history of WALANT technique. The objective was to identify the origins of the rise and fall of the myth and dogma of the prohibition of adrenaline in anesthetic finger blocks. A critical analysis of the main texts of the articles and books on the use of epinephrine in finger anesthesia was carried out. The conception of the myth of banning the use of epinephrine in anesthetic finger blocks occurred due to misinterpretation of reports of necrosis occurring, which were not actually caused by epinephrine. That myth influenced the appearance of a dogma. The history of the use of epinephrine in anesthetic finger blocks demonstrates that superficial and misleading interpretations of clinical complications published as case reports can breed myth and dogma. Only science can prevent and destroy such medical myths and dogmas.


REFERENCES

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  2. Lalonde DH, Tang JB. Preface - how the wide awake tourniquet-free approach is changing hand surgery in most countries of the world. Hand Clin. 2019;35:12-13. DOI: https://doi.org/10.1016/j.hcl.2018.10.0012.

  3. Bunnell S. Reconstruction of the hand. Surgery of the hand. Philadelphia: JB Lippincott; 1944. p. 78-119.

  4. Fiallo YR, Morales AIA, Calderón RG, García OVR. Ventajas y limitaciones del uso del torniquete en ortopedia y traumatología. Rev Cuba Ortop Traumatol. 2021;35(1):e341. LILACS-Express | LILACS | ID: biblio-1289549

  5. Hustedt JW, Chung A, Bohl DD, Olmschied N, Edwards GA. Comparison of postoperative complications associated with anesthesic choice for surgery of the hand. J Hand Surg Am. 2017;42:18.e5. DOI: https://doi.org/10.1016/j.jhsa.2016.10.0075.

  6. Sardenberg T, Ribak S, Colenci R, Campos RB, Varanda D, Cortopassi AC. 488 hand surgeries with local anesthesia with epinephrine, without tourniquet, without sedation, and without anesthesiologist. Rev Bras Ort. 2018;53:281-6. DOI: https://doi.org/10.1016/j.rboe.2018.03.0116.

  7. Lalonde DH. Wide awake hand surgery. Boca Raton: CRC Press; 2016.

  8. Abbagnamo N. Dogma. Dicionário de filosofia. São Paulo: Martins Fonte; 1998. p. 292-3.

  9. Abbagnamo N. Mito. Dicionário de filosofia. São Paulo: Martins Fonte; 1998. p. 673-5.

  10. Schöpke R. Dogma/dogmatismo. Dicionário filosófico. São Paulo: Martins Fonte; 2010. p. 84.

  11. Schöpke R. Mito. Dicionário filosófico. São Paulo: Martins Fonte; 2010. p. 162-3.

  12. Bunnell S, Boyes JH. Principios de reconstrucción. Bunnell - Boyes Cirurgia de la mano. Buenos Aires: Intermédica; 1967. p. 119-47.

  13. Vandam LD. Anestesia para la cirurgía de la mano. En: Flynn JE, editor. Cirurgía de la mano. Barcelona: Ediciones Toray; 1977. p. 59-72.

  14. Vicent-Espinasse J, Goaziou FL. Anesthesia in surgery of the hand. En: Tubiana R, editor. The hand vol II. Philadelphia: Saunders; 1985. p. 18-30.

  15. Milford L. Surgical technique and aftercare. En: Crenshaw AH, editor. Campbell's operative orthopaedics. St. Louis, Washington, Toronto: Mosby; 1987. p. 111-37.

  16. Romamurthy S. Anesthesia. En: Green DP, editor. Operative hand surgery. New York: Churchill Livingstone; 1988. p. 27-60.

  17. Gerancher JC, Weller RS. Anesthesia for upper extremity surgery. En: Mathes SJ, Hentz VR, eds. Mathes plastic surgery. Philadelphia: Elsevier; 2006. p. 87-108.

  18. Fasciani AC, Carvalho EG. Anestesia para o tratamento dos traumatismos da mão. En: Pardini A, Freitas A, eds. Traumatismos da mão. Rio de Janeiro: Medbook; 2008. p.163-80.

  19. Denkler K. A comprehensive review of epinephrine in the finger: to do or not to do. Plast Reconstr Surg. 2001;108:114-24. DOI: https://doi.org/10.1097/00006534-200107000-0001719.

  20. Thomson CJ, Lalonde DH, Denkler KA, Feicht AJ. A critical look at the evidence for and against elective epinephrine use in the finger. Plast Reconstr Surg 2007;119:260-6. DOI: https://doi.org/10.1097/01.prs.0000237039.71227.1120.

  21. Laws B. Coca - Erythroxylum coca. 50 plantas que mudaram o rumo da história. Rio de Janeiro: Sextante; 2013. p. 70-5.

  22. Friedman M, Friedland GW. Crawford Long e a anestesia cirúrgica. As dez maiores descobertas da medicina. São Paulo: Companhia das Letras; 2000. p. 141-69.

  23. Parascandola J. Pioneers and milestones. J Allergy Clin Immunol. 2010;125:514-7. DOI: https://doi.org/10.1016/j.jaci.2009.11.04423.

  24. López-Valverde A, Vicente JD, Cutando A. The surgeons Halsted and Hall, cocaine and the discovery of dental anesthesia by nerve blocking. Br Dent J. 2011;211:485-7. DOI: https://doi.org/10.1038/sj.bdj.2011.96124.

  25. Stuber M, Nentwig W. How informative are case studies of spider bites in the medical literature? Toxicon. 2016;114:40-4. DOI: https://doi.org/10.1016/j.toxicon.2016.02.02325.

  26. Campbell J, Moyers B. O poder do mito. São Paulo: Palas Athena; 2009.

  27. Krunic AL, Wang LC, Soltani K, Weitzul S, Taylor RS. Digital anesthesia with epinephrine: an old myth revisited. J Am Acad Dermatol 2004;51:755-9. DOI: https://doi.org/10.1016/j.jaad.2004.05.02827.

  28. Fitzcharles-Bowe C, Denkler K, Lalonde D. Finger injection with high-dose (1:1,000) epinephrine: does it cause finger necrosis and should it be treated? Hand. 2007;2:5-11. DOI: https://doi.org/10.1007/s11552-006-9012-428.

  29. Braithwaite BD, Robinson GJ, Burge PD. Haemostasis during carpal tunnel release under local anesthesia: a controlled comparison of a tourniquet and adrenaline infiltration. J Hand Surg Br. 1993;18B:184-6. DOI: https://doi.org/10.1016/0266-7681(93)90103-M29.

  30. Sylaidis P, Logan A. Digital blocks with adrenaline - an old dogma refuted. J Hand Surg Eur. 1998;23:17-9. DOI: https://doi.org/10.1016/S0266-7681(98)80210-630.

  31. Wilhelmi B, Blackwell SJ, Miller JH, Mancoll JS, Dardano T, Tran A, et al. Do not use epinephrine in digital block: myth or truth? Plast Reconstr Surg. 2001;107:393-7. DOI: https://doi.org/10.1097/00006534-200102000-0001431.

  32. Andrades PR, Olguin FA, Calderón W. Digital blocks with or without epinephrine. Plast Reconstr Surg. 2003;111:1769-70. DOI: https://doi.org/10.1097/00006534-200304150-0004032.

  33. Lalonde D, Bell M, Benoit P, Sparkes G, Denkler K, Chang P. A multicenter prospective study of 3,110 consecutive cases of elective epinephrine use in the fingers and hand: the Dalhousie project clinical phase. J Hand Surg Am. 2005;30:1061-7. DOI: https://doi.org/10.1016/j.jhsa.2005.05.00633.

  34. Chowdhry S, Seidenstricker L, Cooney DS, Hazani R, Wilhelmi BJ. Do not use epinephrine in digital blocks: myth or truth? Part II. A retrospective review of 1111 cases. Plast Reconstr Surg. 2010;126:2031-4. DOI: https://doi.org/10.1097/PRS.0b013e3181f4448634.

  35. Nodwell T, Lalonde D. How long does it take phentolamine to reverse adrenaline-induced vasoconstriction in the finger and hand? A prospective randomized, blinded study: The Dalhousie project experimental phase. Can J Plast Surg. 2003;11:187-90. DOI: https://doi.org/10.1177/22925503030110040835.

  36. Pires Neto PJ, Ribak S, Sardenberg T. Wide awake hand surgery under local anesthesia no tourniquet in South America. Hand Clinic. 2019;35:51-8. DOI: https://doi.org/10.1016/j.hcl.2018.08.00536.

  37. Novaes Junior RAF, Costa BRJ, Carmo JMM. Uso de adrenalina com lidocaína em cirurgia da mão. Rev Bras Ortop. 2013;49:452-60. DOI: https://doi.org/10.1016/j.rboe.2014.09.00637.

  38. O'Neill N, Abdall-Razak A, Norton E, Kumar A, Shah H, Khatkar H, et al. Use of wide-awake local anaesthetic no tourniquet (WALANT) in upper limb and hand surgery: a systematic review protocol. Int J Surg Protoc. 2020;20:8-12. DOI: https://doi.org/10.1016/j.isjp.2020.03.00138.

  39. Wilczynski M. Pharmacology. En: Hammert WC, Calfee RP, Bozentka DJ, Boyer MI, eds. ASSH manual of hand surgery. Philadelphia: Wolters Kluwe, Lippincott Williams & Wilkins; 2010:35-43.

  40. Yang E. Anesthesia. En: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, Cohen MS, eds. Green's operative hand surgery. Philadelphia: Elsevier, 2017:1-16.

  41. Ribak S, Campos RB. WALANT em lesões agudas - casos de cirurgia da mão. In: Ribak S, Rezende MR, Pignataro MB, Santos JBG, Neder Filho AT, Costa AC, eds. Atualização em cirurgia da mão - traumatologia - Sociedade Brasileira de Cirurgia da Mão. Rio de Janeiro: DiLivros; 2021. p. 471-87.

  42. Lalonde DH. Conceptual origins, current practice, and views of wide awake hand surgery. J Hand Surg Eur. 2017;42:1-8. DOI: https://doi.org/10.1177/17531934177284271.

  43. Lalonde DH, Tang JB. Preface - how the wide awake tourniquet-free approach is changing hand surgery in most countries of the world. Hand Clin. 2019;35:12-13. DOI: https://doi.org/10.1016/j.hcl.2018.10.0012.

  44. Bunnell S. Reconstruction of the hand. Surgery of the hand. Philadelphia: JB Lippincott; 1944. p. 78-119.

  45. Fiallo YR, Morales AIA, Calderón RG, García OVR. Ventajas y limitaciones del uso del torniquete en ortopedia y traumatología. Rev Cuba Ortop Traumatol. 2021;35(1):e341. LILACS-Express | LILACS | ID: biblio-1289549

  46. Hustedt JW, Chung A, Bohl DD, Olmschied N, Edwards GA. Comparison of postoperative complications associated with anesthesic choice for surgery of the hand. J Hand Surg Am. 2017;42:18.e5. DOI: https://doi.org/10.1016/j.jhsa.2016.10.0075.

  47. Sardenberg T, Ribak S, Colenci R, Campos RB, Varanda D, Cortopassi AC. 488 hand surgeries with local anesthesia with epinephrine, without tourniquet, without sedation, and without anesthesiologist. Rev Bras Ort. 2018;53:281-6. DOI: https://doi.org/10.1016/j.rboe.2018.03.0116.

  48. Lalonde DH. Wide awake hand surgery. Boca Raton: CRC Press; 2016.

  49. Abbagnamo N. Dogma. Dicionário de filosofia. São Paulo: Martins Fonte; 1998. p. 292-3.

  50. Abbagnamo N. Mito. Dicionário de filosofia. São Paulo: Martins Fonte; 1998. p. 673-5.

  51. Schöpke R. Dogma/dogmatismo. Dicionário filosófico. São Paulo: Martins Fonte; 2010. p. 84.

  52. Schöpke R. Mito. Dicionário filosófico. São Paulo: Martins Fonte; 2010. p. 162-3.

  53. Bunnell S, Boyes JH. Principios de reconstrucción. Bunnell - Boyes Cirurgia de la mano. Buenos Aires: Intermédica; 1967. p. 119-47.

  54. Vandam LD. Anestesia para la cirurgía de la mano. En: Flynn JE, editor. Cirurgía de la mano. Barcelona: Ediciones Toray; 1977. p. 59-72.

  55. Vicent-Espinasse J, Goaziou FL. Anesthesia in surgery of the hand. En: Tubiana R, editor. The hand vol II. Philadelphia: Saunders; 1985. p. 18-30.

  56. Milford L. Surgical technique and aftercare. En: Crenshaw AH, editor. Campbell's operative orthopaedics. St. Louis, Washington, Toronto: Mosby; 1987. p. 111-37.

  57. Romamurthy S. Anesthesia. En: Green DP, editor. Operative hand surgery. New York: Churchill Livingstone; 1988. p. 27-60.

  58. Gerancher JC, Weller RS. Anesthesia for upper extremity surgery. En: Mathes SJ, Hentz VR, eds. Mathes plastic surgery. Philadelphia: Elsevier; 2006. p. 87-108.

  59. Fasciani AC, Carvalho EG. Anestesia para o tratamento dos traumatismos da mão. En: Pardini A, Freitas A, eds. Traumatismos da mão. Rio de Janeiro: Medbook; 2008. p.163-80.

  60. Denkler K. A comprehensive review of epinephrine in the finger: to do or not to do. Plast Reconstr Surg. 2001;108:114-24. DOI: https://doi.org/10.1097/00006534-200107000-0001719.

  61. Thomson CJ, Lalonde DH, Denkler KA, Feicht AJ. A critical look at the evidence for and against elective epinephrine use in the finger. Plast Reconstr Surg 2007;119:260-6. DOI: https://doi.org/10.1097/01.prs.0000237039.71227.1120.

  62. Laws B. Coca - Erythroxylum coca. 50 plantas que mudaram o rumo da história. Rio de Janeiro: Sextante; 2013. p. 70-5.

  63. Friedman M, Friedland GW. Crawford Long e a anestesia cirúrgica. As dez maiores descobertas da medicina. São Paulo: Companhia das Letras; 2000. p. 141-69.

  64. Parascandola J. Pioneers and milestones. J Allergy Clin Immunol. 2010;125:514-7. DOI: https://doi.org/10.1016/j.jaci.2009.11.04423.

  65. López-Valverde A, Vicente JD, Cutando A. The surgeons Halsted and Hall, cocaine and the discovery of dental anesthesia by nerve blocking. Br Dent J. 2011;211:485-7. DOI: https://doi.org/10.1038/sj.bdj.2011.96124.

  66. Stuber M, Nentwig W. How informative are case studies of spider bites in the medical literature? Toxicon. 2016;114:40-4. DOI: https://doi.org/10.1016/j.toxicon.2016.02.02325.

  67. Campbell J, Moyers B. O poder do mito. São Paulo: Palas Athena; 2009.

  68. Krunic AL, Wang LC, Soltani K, Weitzul S, Taylor RS. Digital anesthesia with epinephrine: an old myth revisited. J Am Acad Dermatol 2004;51:755-9. DOI: https://doi.org/10.1016/j.jaad.2004.05.02827.

  69. Fitzcharles-Bowe C, Denkler K, Lalonde D. Finger injection with high-dose (1:1,000) epinephrine: does it cause finger necrosis and should it be treated? Hand. 2007;2:5-11. DOI: https://doi.org/10.1007/s11552-006-9012-428.

  70. Braithwaite BD, Robinson GJ, Burge PD. Haemostasis during carpal tunnel release under local anesthesia: a controlled comparison of a tourniquet and adrenaline infiltration. J Hand Surg Br. 1993;18B:184-6. DOI: https://doi.org/10.1016/0266-7681(93)90103-M29.

  71. Sylaidis P, Logan A. Digital blocks with adrenaline - an old dogma refuted. J Hand Surg Eur. 1998;23:17-9. DOI: https://doi.org/10.1016/S0266-7681(98)80210-630.

  72. Wilhelmi B, Blackwell SJ, Miller JH, Mancoll JS, Dardano T, Tran A, et al. Do not use epinephrine in digital block: myth or truth? Plast Reconstr Surg. 2001;107:393-7. DOI: https://doi.org/10.1097/00006534-200102000-0001431.

  73. Andrades PR, Olguin FA, Calderón W. Digital blocks with or without epinephrine. Plast Reconstr Surg. 2003;111:1769-70. DOI: https://doi.org/10.1097/00006534-200304150-0004032.

  74. Lalonde D, Bell M, Benoit P, Sparkes G, Denkler K, Chang P. A multicenter prospective study of 3,110 consecutive cases of elective epinephrine use in the fingers and hand: the Dalhousie project clinical phase. J Hand Surg Am. 2005;30:1061-7. DOI: https://doi.org/10.1016/j.jhsa.2005.05.00633.

  75. Chowdhry S, Seidenstricker L, Cooney DS, Hazani R, Wilhelmi BJ. Do not use epinephrine in digital blocks: myth or truth? Part II. A retrospective review of 1111 cases. Plast Reconstr Surg. 2010;126:2031-4. DOI: https://doi.org/10.1097/PRS.0b013e3181f4448634.

  76. Nodwell T, Lalonde D. How long does it take phentolamine to reverse adrenaline-induced vasoconstriction in the finger and hand? A prospective randomized, blinded study: The Dalhousie project experimental phase. Can J Plast Surg. 2003;11:187-90. DOI: https://doi.org/10.1177/22925503030110040835.

  77. Pires Neto PJ, Ribak S, Sardenberg T. Wide awake hand surgery under local anesthesia no tourniquet in South America. Hand Clinic. 2019;35:51-8. DOI: https://doi.org/10.1016/j.hcl.2018.08.00536.

  78. Novaes Junior RAF, Costa BRJ, Carmo JMM. Uso de adrenalina com lidocaína em cirurgia da mão. Rev Bras Ortop. 2013;49:452-60. DOI: https://doi.org/10.1016/j.rboe.2014.09.00637.

  79. O'Neill N, Abdall-Razak A, Norton E, Kumar A, Shah H, Khatkar H, et al. Use of wide-awake local anaesthetic no tourniquet (WALANT) in upper limb and hand surgery: a systematic review protocol. Int J Surg Protoc. 2020;20:8-12. DOI: https://doi.org/10.1016/j.isjp.2020.03.00138.

  80. Wilczynski M. Pharmacology. En: Hammert WC, Calfee RP, Bozentka DJ, Boyer MI, eds. ASSH manual of hand surgery. Philadelphia: Wolters Kluwe, Lippincott Williams & Wilkins; 2010:35-43.

  81. Yang E. Anesthesia. En: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, Cohen MS, eds. Green's operative hand surgery. Philadelphia: Elsevier, 2017:1-16.

  82. Ribak S, Campos RB. WALANT em lesões agudas - casos de cirurgia da mão. In: Ribak S, Rezende MR, Pignataro MB, Santos JBG, Neder Filho AT, Costa AC, eds. Atualização em cirurgia da mão - traumatologia - Sociedade Brasileira de Cirurgia da Mão. Rio de Janeiro: DiLivros; 2021. p. 471-87.




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