Jan Lalonde's research while affiliated with Dalhousie University and other places

Publications (10)

Article
Introduction: There is very little information in the literature evaluating the natural history of adult trigger fingers and their rate of spontaneous resolution over time. Methods: A consecutive case series of patients with trigger finger was generated. For each patient, we recorded whether the patient's disease resolved from either no treatmen...
Article
The objective of the present study was to determine whether it is possible to consistently and reliably teach medical students and resident learners how to administer local anesthetics in an almost painless manner. Using the published technique, 25 consecutive medical students and residents were taught how to inject local anesthetics for carpal tun...
Article
The objective of the present study was to determine whether it is possible to consistently and reliably teach medical students and resident learners how to administer local anesthetics in an almost painless manner. Using the published technique, 25 consecutive medical students and residents were taught how to inject local anesthetics for carpal tun...
Article
Orbital floor fractures can result in diplopia, enophthalmos, hypoglobus and infraorbital dysthesia. Currently, the most common treatment for orbital floor fractures is immediate surgical intervention. However, there are a number of well-documented cases of unoperated orbital floor fractures in the literature, culminating in diplopia or enophthalmo...
Article
Unlabelled: The use of local anesthesia with epinephrine and no tourniquet/no sedation is becoming an excellent alternative for hand surgeries. This wide-awake approach is the most commonly used method of anesthesia for carpal tunnel release in Canada. The purpose of this paper is to provide a video detailing this technique for trapeziectomy for t...
Article
Orbital floor fractures can result in diplopia, enophthalmos, hypoglobus and infraorbital dysthesia. Currently, the most common treatment for orbital floor fractures is immediate surgical intervention. However, there are a number of well-documented cases of unoperated orbital floor fractures in the literature, culminating in diplopia or enophthalmo...
Article
Full-text available
Over 70% of Canadian carpal tunnel syndrome (CTS) operations are performed outside of the main operating room (OR) with field sterility and surgeon-administered pure local anesthesia [LeBlanc et al., Hand 2(4):173-8, 14]. Is main OR sterility necessary to avoid infection for this operation? This study evaluates the infection rate in carpal tunnel r...
Conference Paper
Purpose: More than 70% of Canadian carpal tunnel operations are now performed outside of the main operating room with field sterility (1). Main OR sterility comes with a fourfold cost in money, and generates considerably more garbage (see figure 1). Is main OR sterility really necessary to avoid infection? This study evaluates the infection rate in...
Article
Full-text available
Wide-awake flexor tendon repair in tourniquet-free unsedated patients permits intraoperative Total Active Movement examination (iTAMe) of the freshly repaired flexor tendon. This technique has permitted the intraoperative observation of tendon repair gapping induced by active movement when the core suture is tied too loosely. The gap can be repaire...

Citations

... The improvement with time observed in the sham group can be explained by the natural course of TF. McKee et al 26 reported that TF spontaneously resolved in over half of 343 patients without any intervention after a mean period of 8 months from the initial consultation, implying that inflammation may be the major cause of TF symptoms. In addition, because this trial included only patients with grade II TF according to the Quinnell classification, the symptoms of TF may be caused by inflammation inside the tendon sheath rather than mechanical locking that occurs during tendon gliding. ...
... Lalonde has revolutionized wide awake, in-office surgery with injection techniques that minimize discomfort and maximize efficacy. [80][81][82][83][84][85][86] Local infiltration analgesia not only allow for painless awake office procedures, but also minimize postoperative pain. 87 A meta-analysis found that local anesthetic injected before incision decreases pain and decreases postoperative analgesic consumption and time to first rescue pain medication dose. ...
... However, in Western countries, other etiologies are more likely to cause these lesions. Thus, sports accidents were ranked first according to Tang et al. [14] in Canada and Piombino et al. [15] in Italia. For Open Journal of Stomatology Senese et al. in Belgium [16], assaults were in the majority. ...
... Various studies suggested that the technique of anesthetic injection is an important factor in the amount of pain during injection. Hence, appropriate training for using less painful techniques can reliably limit the pain of local anesthetic injection (17)(18)(19). ...
... Lalonde and Wong 1 stated that additional anesthesia may be avoided using a large amount of local anesthetic; nevertheless, it is necessary to inject at least 40 mL of the local anesthetic, depending on the surgical procedure. 1,5 The domestic package insert recommends the use of at most 200 mg (20 mL, 1% solution) of lidocaine at a time. Thus, 40 mL of lidocaine should not be injected at a time. ...
... With this trend, it is important to consider how the procedure room differs from the traditional operating room. First, the use of field sterility instead of main-operating-room sterility has allowed for considerable cost and waste reductions, without impacting upon the likelihood of surgical site infections ( Figure 1) [29][30][31]. Instead of needing the full standard set-up for main-operating-room sterility (which includes head covers, neck-to-knee sterile surgeon gowns, shoe covers, laminar airflow, and full-patient-body sterile draping), CTR can safely be performed in a clinic's procedure room with nothing more than a mask, sterile gloves, and single drape. Importantly, where CTR is performed in such settings, the absence of costly, specialized ventilation systems such as laminar air filtration or high-efficiency particulate air filters has not been linked to worse outcomes. ...
... 3,5,9 Surgeons have embraced the fully awake approach for their surgery of the hand, which defined as hand surgery without sedation and the use of tourniquet. [10][11][12][13][14] It incorporates the addition of relatively small concentration of epinephrine to local anesthetics in a tumescent solution. The most common concentration being used is 1:100,000 that has been reported to be safe and effective. ...
... WALANT has been used in hand surgeries (3,4) as well as procedures involving foot and ankle (1,2). This anaesthetic technique has fewer risks and side effects compared to conventional sedation or general anaesthesia technique. ...