Evaluación de la aplicabilidad de la técnica LANT (Local Anesthesia No Tourniquet) en la osteosíntesis de fracturas del radio distal (FRD)

Ana Scott-Tennent De Rivas; Carla Albert Minguell; Laura Prats Gispert; Amer Mustafa Gondolbeu; Marta Bonjorn Martí; Pau Forcada Calvet

doi:10.1055/s-0044-1793922

Revista Iberoamericana de Cirugía de la Mano, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2024; 52(02): e93-e106
DOI: 10.1055/s-0044-1793922

Artículo Original | Original Article

Evaluation of the applicability of the LANT (Local Anesthesia No Tourniquet) technique in the osteosynthesis of distal radius fractures (DRF)

Artikel in mehreren Sprachen: español | English

Ana Scott-Tennent De Rivas

¹Hospital Arnau de Vilanova, Lleida, España

²Hospital Santa Maria, Lleida, España

,

Carla Albert Minguell

³Hospital Arnau de Vilanova, Lleida, España

,

Laura Prats Gispert

¹Hospital Arnau de Vilanova, Lleida, España

²Hospital Santa Maria, Lleida, España

⁴Departamento de Anatomía y Embriología, Universitat de Lleida (UdL), Lleida, España

,

Amer Mustafa Gondolbeu

¹Hospital Arnau de Vilanova, Lleida, España

²Hospital Santa Maria, Lleida, España

⁴Departamento de Anatomía y Embriología, Universitat de Lleida (UdL), Lleida, España

⁵Laboratorio de Macro y Microdisección y Anatomía Quirúrgica, Departamento de Anatomía Humana, Universitat de Barcelona (UB), Barcelona, España

,

Marta Bonjorn Martí

¹Hospital Arnau de Vilanova, Lleida, España

²Hospital Santa Maria, Lleida, España

⁴Departamento de Anatomía y Embriología, Universitat de Lleida (UdL), Lleida, España

,

Pau Forcada Calvet

¹Hospital Arnau de Vilanova, Lleida, España

²Hospital Santa Maria, Lleida, España

⁴Departamento de Anatomía y Embriología, Universitat de Lleida (UdL), Lleida, España

⁵Laboratorio de Macro y Microdisección y Anatomía Quirúrgica, Departamento de Anatomía Humana, Universitat de Barcelona (UB), Barcelona, España

› Institutsangaben

Abstract

To evaluate the applicability of the LANT (Local Anesthesia No Tourniquet) technique in the osteosynthesis of distal radius fractures (DRF), a randomized clinical trial was designed that compared the short-term results between patients treated with local anesthesia without ischemia (LANT) and those operated on with locoregional anesthesia (RA) and ischemia cuff. The main variables of the study were pain, swelling, and patient satisfaction. Bleeding from the surgical wound, mobility, technical difficulty perceived by the surgeon, anesthetic insufficiency, and complications were also analyzed.

Between December 2020 and 2021, 27 patients were included. Those treated with LANT had less pain between days 10 and 15 after surgery, as well as less bleeding during the immediate postoperative period. 22 of the 27 patients in the study required sedation, and 67% of the LANT group needed additional doses of local anesthesia. We conclude that LANT is a viable technique for DRF osteosynthesis and may offer certain benefits by avoiding the use of the ischemia cuff in selected cases. However, the authors of the study recommend adding local anesthesia around the distal radioulnar joint (DRUJ) to improve pain management during reduction maneuvers and emphasize that collaboration with an anesthesiologist was essential during their study.

Level of evidence 1/Therapeutic II.

Keywords

distal radius fractures - Wide Awake Local Anesthesia No Tourniquet (WALANT) - tourniquet - locoregional anesthesia - osteosynthesis

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Referenzen

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