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The Georgicks of Virgil, with an English Translation and Notes Virgil, John Martyn Ipsi in defossis specubus secura sub alta Otia agunt terra, congestaque robora, Pierius says it is confecto in the Roman manuscript. And Tacitus also says the Germans used to make caves to defend them from the severity of winter, .

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With outpatient surgery becoming increasingly common, why is that so unusual? Traditionally, hand and wrist surgeons have used an arm tourniquet to limit bleeding, but the pressure it causes is often so uncomfortable that medication is required to make it tolerable.

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But all that has changed, thanks to a flood of studies showing that epinephrine is safe, and a technique in which epinephrine blended with a local anesthetic eliminates the need for a tourniquet. Surgery on the hand or fingers can now be performed without an IV, sedatives, or preoperative testing.

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Wide-awake surgery is used for a range of operations, from the excision of a ganglion cyst or a carpal-tunnel release to more complex procedures. The new technique can also improve outcomes.

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A fully conscious patient can move their hand and fingers, enabling the surgeon to assess the results in real time. The surgeon can also communicate with the patient, soothing any nervousness. The only pain is the sting of the initial shot. Patient Care , Complex Cases.

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