Role of Wide Awake Local Anaesthesia in Soft Tissue Injury of Hand

¹Assistant Professor, Department of Emergency Medicine (AIIMS, Raipur), India

²Associate Professor, Department of Orthopedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India

³Senior Resident, Department of Emergency Medicine (AIIMS, New Delhi), India

⁴Professor and Head, Department of Emergency Medicine (AIIMS, New Delhi), India

⁵Professor (Surgery), Department of Emergency Medicine (AIIMS, New Delhi), India

⁶Professor (Medicine), Department of Emergency Medicine (AIIMS, New Delhi), India

⁷Department of Transfusion Medicine , AIIMS Raipur, India

Received Date: October 14, 2022

Published Date: October 31, 2022

*Corresponding Author: Shivam Patel, Assistant Professor, Department of Emergency Medicine (AIIMS, Raipur), India. Phone: 09810697593; Email: [email protected]

Citation: Patel S, et al. (2022). Role of Wide Awake Local Anaesthesia in Soft Tissue Injury of Hand. Mathews J Emergency Med. 7(2):46.

Copyrights: Patel S, et al. © (2022).

ABSTRACT

Study hypothesis: We conducted a quasi-experimental study which includes the data from 79 patients enrolled from March 2015 to November 2016. Injury repair was done under WALA. Visual analogue pain scale was calculated before, during and after repair. Blood loss was measured during repair. Follow up was done to look for functional disability and complications following treatment. SD and mean were calculated for visual pain analogue scale. p-value was calculated to look for the significance of this study. Results: Of the 79 patients enrolled in the study 76 were presented with clean lacerated wound while 3 were having associated tendon injuries. The mean pain score on VAS before repair was 4.6, during repair were 2.23 and after repair was 1.44. The average blood loss during repair (mean + SD) came out to be 4.95 + 2.44, with only 4 patients having a loss of > 10 ml. There was significant decrease in VAS score (p value <0.001), patients were discharged within a short interval of repair and on follow-up none of the cases were having complications. Conclusion: In this study, we found that in hand repair done under WALA there is significant decrease in pain scale. Also amount of bleeding was minimum. WALA may be safely used in digital and peripheral sites as it has no complications with recommended dose. The use of WALA may simplify the way of treatment in repairing hand injuries and may have a role in early disposition of patients in the crowded emergency department.

Keywords: Hand injury, Emergency department, Adrenaline, Lidocaine, Visual analogue scale, Quick DASH score, Mayo wrist score