The Journal of hand surgery
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Randomized Controlled Trial Clinical Trial
Exogenous hyaluronate as an adjunct in the prevention of adhesions after flexor tendon surgery: a controlled clinical trial.
Postoperative adhesions that restrict tendon gliding are a major cause of failure after tendon repair and grafting in zone II. Several experimental reports have claimed that exogenously administered sodium hyaluronate helps to prevent the formation of such adhesions. In a prospective double-blind, randomized, clinical study with open therapeutic control sodium hyaluronate or physiologic saline solution was injected into the tendon sheath after completion of tenorrhaphy or tendon grafting in 120 digits. Sodium hyaluronate had no statistically significant effect as evaluated on total active motion at follow-up.
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This study evaluates the effectiveness of continuous intravenous regional anesthesia for prolonged operations on the upper extremity. The factors evaluated include patient's sex and age, number of procedures performed, tourniquet on and off times, anesthetic doses, adjunctive drugs used, technical complications, and side effects. Seventy-two procedures were done on 34 patients. ⋯ There were two (6%) technical complications and two (6%) patients had side effects. Continuous intravenous regional anesthesia offers the prolonged anesthesia of brachial plexus block or general anesthesia and the safety, reliability, and ease of intravenous regional anesthesia. Continuous intravenous regional anesthesia should be considered an alternative choice of anesthetic method in upper extremity surgery.