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Study aim
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The study hypothesis is that Wide awake local anaesthesia no tourniquet technique (WALANT) and forearm BIER block are safe, inexpensive and suitable alternative to the conventional anesthesia techniques for hand surgeries.
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Design
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Two arm parallel group randomised trial design of 86 patients, enrolled between june 2018 and september 2018
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Settings and conduct
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This study will be performed on 86 ASA class I-III patients between the ages of 20--65 years who undergoing hand and wrist surgeries. After obtaining of an informed consent, patients will be allocated to two groups by stratified random sampling.
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Participants/Inclusion and exclusion criteria
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Inclusion Criteria:20--65 years old patients undergoing hand surgeries
Exclusion Criteria:psychologic patients, addiction, history of allergy to local anesthethcs, epilepsy, history of peripheral vascular disease, coagulopathy, pregnancy, open wound in operation site
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Intervention groups
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. In the WALANT group, 20 ml solution including lidocaine 1% and einephrine( 5Mg/ml ) and sodium bicarbonate (50mg/2ml) will be injected into operation site. Injection will be done by a 27_gauge needle. In the bier block group(IRIV), a 22G cannula will be secured on the dorsum of the operative hand. The single cuff tourniquet will be then placed around the forearm and inflated to a pressure of 100 mmHg above the patient’s systolic blood pressure and minimum of 250 mmHg. IRIV will be achieved with 25 lidocaine 0.5 % plus fentanyl 50 Mg. The sensory block will be evaluated with pinprick testing every 30 s until the start of surgery.
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Main outcome variables
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Determination of WALANT effects on analgesia, complications, patient satisfaction, surgery site bleeding, need to additional IV sedation and analgesics and comparison them with forearm BIER block group.