Our Summary

This research paper is about a technique the researchers developed for wrist surgery, also known as arthroscopy. They used a local anesthetic called lidocaine, combined with epinephrine, and injected it into specific areas in the wrist. After this, they filled the wrist joint with saline solution and made a small cut in the skin for the surgery. Unlike traditional surgery, the patient is fully awake and not under any general or regional anesthesia. There is also no need for a tourniquet. This method was found to be comfortable for 88% of the 111 patients involved in the study, with no complications. This suggests that for certain patients, it’s a safe and comfortable way to perform wrist surgery.

FAQs

  1. What is the technique of portal site local anaesthesia (PSLA) for wrist arthroscopy?
  2. What is the success rate of PSLA in achieving patient comfort?
  3. Is the patient sedated or under general or regional anesthesia during a PSLA procedure?

Doctor’s Tip

A doctor might tell a patient that wrist arthroscopy can be performed using a technique called portal site local anesthesia (PSLA), where lidocaine is injected at various portal sites to provide comfort during the procedure. This technique has been shown to be safe and effective in majority of patients. Additionally, the patient may not need to be sedated or undergo general anesthesia, and a tourniquet may not be necessary. It is important to follow the doctor’s instructions before and after the procedure to ensure a successful outcome.

Suitable For

Patients who are typically recommended for wrist arthroscopy include those with wrist pain, swelling, stiffness, or instability that has not responded to conservative treatments such as rest, physical therapy, or medications. Patients with conditions such as ligament tears, cartilage injuries, wrist arthritis, ganglion cysts, or wrist fractures may benefit from wrist arthroscopy to diagnose and treat their condition. Additionally, patients who require minimally invasive surgery for wrist conditions may also be recommended for wrist arthroscopy.

Timeline

Before wrist arthroscopy:

  • The patient is informed about the procedure and given instructions on how to prepare for it.
  • The patient may undergo pre-operative tests and evaluations to ensure they are a suitable candidate for the procedure.
  • On the day of the procedure, the patient arrives at the clinic or hospital and is taken to the operating room.
  • The patient is positioned on the operating table and the wrist area is cleaned and prepped for the procedure.
  • Local anaesthesia is administered through portal sites using a 25G needle to numb the area.

After wrist arthroscopy:

  • The patient may experience some discomfort or pain in the wrist area as the anaesthesia wears off.
  • The patient is monitored for any signs of complications or adverse reactions to the procedure.
  • The patient is given post-operative instructions on how to care for the wrist, including pain management and wound care.
  • Follow-up appointments may be scheduled to check on the healing process and monitor any potential complications.
  • The patient may gradually resume normal activities and physical therapy to aid in recovery and rehabilitation.

What to Ask Your Doctor

  1. What is wrist arthroscopy and why is it being recommended for me?
  2. What are the potential risks and complications associated with wrist arthroscopy?
  3. How will the procedure be performed and what can I expect during and after the surgery?
  4. Will I need to undergo general anesthesia or will a local anesthesia be used?
  5. How long is the recovery period after wrist arthroscopy and what restrictions or limitations will I have?
  6. What are the potential benefits of wrist arthroscopy for my specific condition?
  7. Are there any alternative treatments or procedures that I should consider before undergoing wrist arthroscopy?
  8. How experienced are you in performing wrist arthroscopy procedures?
  9. What is the success rate of wrist arthroscopy in patients with similar conditions to mine?
  10. Is there anything specific I should do to prepare for the wrist arthroscopy procedure?

Reference

Authors: Koo SJJ, Ho PC. Journal: Hand Clin. 2017 Nov;33(4):585-591. doi: 10.1016/j.hcl.2017.06.001. PMID: 28991571