WIDE-AWAKE HAND SURGERY Principles and Techniques

Wide-awake hand surgery is both safe and effective for a multitude of common hand surgical procedures. Wide-awake hand surgery provides the advantages of convenience and cost savings by avoiding preoperative testing and clearances and intraoperative anesthesia. The use of epinephrine as a vasoconstrictive agent is considered safe. Phentolamine can be used as a reversal agent in the event of an adverse reaction to epinephrine. Other agents, such as phenoxybenzamine and terbutaline, can also be utilized. Patients undergoing wide-awake hand surgery have improved satisfaction and decreased pain.