Transient tourniquets and electrocauterization in surgeries for metacarpal fractures under local anesthesia with epinephrine

Purpose This study aimed to investigate whether electrocauterization and a transient tourniquet enhanced the efficiency of local anesthesia with epinephrine in surgery for metacarpal fractures. Materials and methods In total, 44 consecutive cases of metacarpal fractures with an estimated operative time of more than 30 min were enrolled. Local anesthesia with epinephrine, electrocauterization, and a transient tourniquet technique were performed. Data on the effect of the anesthesia, bleeding in the surgical field (both after inflating and deflating the tourniquet), the time at which the patient felt uncomfortable with the tourniquet, inspection of the surgical outcome, and other surgical variables were collected and evaluated. Results None of the patients felt any pain in the surgical field during the surgical period. The mean time at which the patients felt uncomfortable due to the tourniquet was approximately 16 min. The mean tourniquet release time was approximately 29 min. There was little to no bleeding in the surgical field during the surgical period. The anatomical structures, such as nerves, tendons, and vessels, could be easily distinguished and dissected. The outcome of the repair and reconstruction could be examined with instructed movement. Postoperative inspections showed no symptoms of inflammation. Conclusions Local anesthesia with epinephrine, electrocauterization, and a transient tourniquet in major hand surgery can save time and allow the patient to remain awake, which satisfies both doctors and patients.