Name:
Local Anaesthetic Injection Technique for Pain Free Carpal Tunnel Decompression Surgery
Description:
Local Anaesthetic Injection Technique for Pain Free Carpal Tunnel Decompression Surgery
Thumbnail URL:
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Duration:
T00H03M45S
Embed URL:
https://stream.cadmore.media/player/c8700046-a7c0-4964-9dfe-be4d2854e650
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/c8700046-a7c0-4964-9dfe-be4d2854e650/Local Anaesthetic Injection Technique for Pain Free Carpal .mp4?sv=2019-02-02&sr=c&sig=Oi%2BITgv74VQMfUmMcA%2FL1OFkjGCflEMafpETgw%2FS26g%3D&st=2024-11-23T12%3A07%3A58Z&se=2024-11-23T14%3A12%3A58Z&sp=r
Upload Date:
2024-05-31T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
Today, I'm going to demonstrate the technique of putting local anesthetic when you are doing carpal tunnel decompression under local anesthesia. It is an operation which can easily be done under local anesthesia without causing any pain to the patient. And I've done more than 500 cases without causing any pain to the patient. There are two techniques of infiltrating local anesthetic in carpal tunnel decompression.
One is the Gale technique in which you put the local anesthetic under the skin. And the other technique is Altissimi a technique in which you put it up, put the local anesthetic into the carpal tunnel by infiltrating the local anesthetic and inserting the needle at an angle of 45 degree, which I will demonstrate in a second. I use a modified technique in which I use both these techniques.
I put fibrements under the skin and four fiberments under the carpal tunnel and 2m 1 to 2m in the fracture network alone. So I will demonstrate this technique in a second. So I've drawn around 10 to 12 Mils of 1% bitlocaine with adrenaline. As I'm planning to do this procedure without the tourniquet, I'm now going to demonstrate you the technique. So so now patient is lying supine with the hand on the hand table and all you can see your line of incision in line of the third web space.
So I start infiltrating just under the skin. Alcazar and you just get a few seconds and be very slow and try to use the smallest possible needle. So I use a very thin needle so that it doesn't cause much pain. So I'm just going under the skin and as I'm infiltrating, I'm taking my needle deeper and deeper. So I inject around 3 to 5, depending what this hand is very small, so I'm just going to inject three ml.
If it's a big hand, I usually inject five ml so you can see the blanching of the skin, which means the local anesthetic has gone through to the skin. This is the Gale's technique. Now, if you take this needle at a 45 degree, but I don't use 45 degree because I think it's too vertical. So I just go at around 30 degree and pass my needle and you will just feel a give way.
The technique describes is that you feel you hit the superflexor tendon and then you back out your needle and then infiltrate. However, with experience, I have learned that you can actually feel the give away of the carpal tunnel. So I am pretty confident that my needle is gone through the carpal tunnel. And if you'll see, this is flowing without any problem. So I will inject another 3 to 5 mls depending upon the hand.
And you can see the blanching is getting prominent and this is one of the giveaway signs that you are in the right spot. So normally when you inject you can see the blanching getting there. So I live two ML which I am going to inject on the flexor muscle. You can see some amount has already gone in the flexor, so with the same hole, go back and inject in the flex red column so that when you release it you can see it's getting prominent when you release the extra column, because this is the time when you most of the patients will report pain.
But if you inject this two ml, in my experience you will never experience the patient having any pain. So this is the one safe way of putting a local anesthetic in the carpal tunnel. I'm sure this video will hopefully help you when you're doing this procedure. Do like and share this video. And subscribe to our YouTube channel. Thank you.
