Anaesthetic management of bilateral hand transplantation: A case series
Background: Bilateral hand transplantation is a rare surgery being considered for patients with bilateral upper limb loss. The procedure, though not lifesaving, is a life-altering procedure with inherent risks. Aims and Objectives: The anaesthetic management of these patients is technically challe...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Hamdan Medical Journal |
| Subjects: | |
| Online Access: | http://www.hamdanjournal.org/article.asp?issn=2227-2437;year=2023;volume=16;issue=2;spage=106;epage=110;aulast=Joseph |
| _version_ | 1797775242381230080 |
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| author | Nandhini Joseph Niranjan Kumar Sasikumar Sunil Rajan Pulak Tosh Jerry Paul Lakshmi Kumar |
| author_facet | Nandhini Joseph Niranjan Kumar Sasikumar Sunil Rajan Pulak Tosh Jerry Paul Lakshmi Kumar |
| author_sort | Nandhini Joseph |
| collection | DOAJ |
| description | Background: Bilateral hand transplantation is a rare surgery being considered for patients with bilateral upper limb loss. The procedure, though not lifesaving, is a life-altering procedure with inherent risks. Aims and Objectives: The anaesthetic management of these patients is technically challenging, with huge fluid shifts, blood loss, haemodynamic instability and hypothermia. We aimed to find out the major perioperative concerns and their management strategies during bilateral hand transplantation surgery by retrospectively analysing the anaesthetic management of six such cases. Materials and Methods: A retrospective study of the anaesthetic management of six patients who underwent bilateral hand transplants in our institute, and their post-operative outcomes is described. Results: All cases were performed under general anaesthesia with supplemental brachial plexus block. The major intraoperative concerns were immunosuppression, massive blood loss and fluid replacement, haemodynamic instability, reperfusion injury and hypothermia. Vasopressors were used in four out of the six patients with no major effect on the graft survival outcome. These patients have been followed up for a time period varying from 6 months to 3 years and have been successfully rehabilitated back to normal life. Conclusion: Bilateral hand transplants can be safely performed under general anaesthesia with supplemental brachial plexus block. The anaesthetic management of these patients is challenging and requires a structured approach with good facilities for perioperative management. |
| first_indexed | 2024-03-12T22:32:55Z |
| format | Article |
| id | doaj.art-ca6cb9a201a340fd9700a0739bf3d19f |
| institution | Directory Open Access Journal |
| issn | 2227-2437 2227-247X |
| language | English |
| last_indexed | 2024-03-12T22:32:55Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Hamdan Medical Journal |
| spelling | doaj.art-ca6cb9a201a340fd9700a0739bf3d19f2023-07-21T14:44:41ZengWolters Kluwer Medknow PublicationsHamdan Medical Journal2227-24372227-247X2023-01-0116210611010.4103/hmj.hmj_98_22Anaesthetic management of bilateral hand transplantation: A case seriesNandhini JosephNiranjan Kumar SasikumarSunil RajanPulak ToshJerry PaulLakshmi KumarBackground: Bilateral hand transplantation is a rare surgery being considered for patients with bilateral upper limb loss. The procedure, though not lifesaving, is a life-altering procedure with inherent risks. Aims and Objectives: The anaesthetic management of these patients is technically challenging, with huge fluid shifts, blood loss, haemodynamic instability and hypothermia. We aimed to find out the major perioperative concerns and their management strategies during bilateral hand transplantation surgery by retrospectively analysing the anaesthetic management of six such cases. Materials and Methods: A retrospective study of the anaesthetic management of six patients who underwent bilateral hand transplants in our institute, and their post-operative outcomes is described. Results: All cases were performed under general anaesthesia with supplemental brachial plexus block. The major intraoperative concerns were immunosuppression, massive blood loss and fluid replacement, haemodynamic instability, reperfusion injury and hypothermia. Vasopressors were used in four out of the six patients with no major effect on the graft survival outcome. These patients have been followed up for a time period varying from 6 months to 3 years and have been successfully rehabilitated back to normal life. Conclusion: Bilateral hand transplants can be safely performed under general anaesthesia with supplemental brachial plexus block. The anaesthetic management of these patients is challenging and requires a structured approach with good facilities for perioperative management.http://www.hamdanjournal.org/article.asp?issn=2227-2437;year=2023;volume=16;issue=2;spage=106;epage=110;aulast=Josephcomposite tissue allotransplantationgraft survivalhand transplantationvascularised composite allotransplantation |
| spellingShingle | Nandhini Joseph Niranjan Kumar Sasikumar Sunil Rajan Pulak Tosh Jerry Paul Lakshmi Kumar Anaesthetic management of bilateral hand transplantation: A case series Hamdan Medical Journal composite tissue allotransplantation graft survival hand transplantation vascularised composite allotransplantation |
| title | Anaesthetic management of bilateral hand transplantation: A case series |
| title_full | Anaesthetic management of bilateral hand transplantation: A case series |
| title_fullStr | Anaesthetic management of bilateral hand transplantation: A case series |
| title_full_unstemmed | Anaesthetic management of bilateral hand transplantation: A case series |
| title_short | Anaesthetic management of bilateral hand transplantation: A case series |
| title_sort | anaesthetic management of bilateral hand transplantation a case series |
| topic | composite tissue allotransplantation graft survival hand transplantation vascularised composite allotransplantation |
| url | http://www.hamdanjournal.org/article.asp?issn=2227-2437;year=2023;volume=16;issue=2;spage=106;epage=110;aulast=Joseph |
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