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Messana F, Faccio D, Sonda R, Scortecci L, Tiengo C, Bassetto F. Wide-awake anesthesia in Dupuytren's contracture treated with collagenase. Hand Surg Rehabil 2020; 40:93-96. [PMID: 32961287 DOI: 10.1016/j.hansur.2020.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/30/2020] [Accepted: 09/08/2020] [Indexed: 11/19/2022]
Abstract
The injection of collagenase followed by cord manipulation is one of the most popular treatments for Dupuytren's contracture. This is traditionally performed under local anesthesia or regional nerve block potentially with sedation. Neither the treatment with collagenase, nor the wide-awake anesthesia are novel techniques for hand surgeons. Nevertheless, we report the first experience of cord manipulation using the wide-awake approach. In this prospective study, we compared the pain perception of patients who underwent wide-awake anesthesia versus traditional local anesthesia. We recorded the pain sensation on a visual analog scale (VAS) (0 to 10) during anesthetic injection, during cord manipulation and before discharge. Wide-awake anesthesia significantly reduced pain levels during anesthetic injection (p=0.003) and cord manipulation (p=0.0009). Pain levels did not differ significantly right before discharge in the two groups (p=0.54). Wide-awake anesthesia can be successfully applied to cord manipulation after collagenase injection in Dupuytren's contracture. This way, it is possible to improve the patient's subjective perspective of the procedure.
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Affiliation(s)
- F Messana
- Clinic of Plastic Surgery, University Hospital of Padua, Via Nicolò Giustiniani 2, Padua, PD 35128, Italy.
| | - D Faccio
- Clinic of Plastic Surgery, University Hospital of Padua, Via Nicolò Giustiniani 2, Padua, PD 35128, Italy
| | - R Sonda
- Clinic of Plastic Surgery, University Hospital of Padua, Via Nicolò Giustiniani 2, Padua, PD 35128, Italy
| | - L Scortecci
- Clinic of Plastic Surgery, University Hospital of Padua, Via Nicolò Giustiniani 2, Padua, PD 35128, Italy
| | - C Tiengo
- Clinic of Plastic Surgery, University Hospital of Padua, Via Nicolò Giustiniani 2, Padua, PD 35128, Italy
| | - F Bassetto
- Clinic of Plastic Surgery, University Hospital of Padua, Via Nicolò Giustiniani 2, Padua, PD 35128, Italy
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Facchin F, Messana F, Sonda R, Faccio D, Tiengo C, Bassetto F. COVID-19: Initial experience of hand surgeons in Northern Italy. Hand Surg Rehabil 2020; 39:332-333. [PMID: 32376511 PMCID: PMC7196548 DOI: 10.1016/j.hansur.2020.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 12/03/2022]
Affiliation(s)
- F Facchin
- Hand Surgery and Microsurgery Unit, University of Padova/Plastic and Reconstructive Surgery Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; Plastic and Reconstructive Surgery Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - F Messana
- Hand Surgery and Microsurgery Unit, University of Padova/Plastic and Reconstructive Surgery Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; Plastic and Reconstructive Surgery Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - R Sonda
- Hand Surgery and Microsurgery Unit, University of Padova/Plastic and Reconstructive Surgery Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; Plastic and Reconstructive Surgery Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - D Faccio
- Hand Surgery and Microsurgery Unit, University of Padova/Plastic and Reconstructive Surgery Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; Plastic and Reconstructive Surgery Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - C Tiengo
- Hand Surgery and Microsurgery Unit, University of Padova/Plastic and Reconstructive Surgery Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; Plastic and Reconstructive Surgery Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - F Bassetto
- Hand Surgery and Microsurgery Unit, University of Padova/Plastic and Reconstructive Surgery Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; Plastic and Reconstructive Surgery Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
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