Patient Concerns About Wide-Awake Local Anesthesia No Tourniquet (WALANT) Hand Surgery

Morris, Marie; Rolf, Elizabeth; Tarkunde, Yash R.; Dy, Christopher J.; Wall, Lindley B.

doi:10.1016/j.jhsa.2021.08.026

Cited by 22 publications

(14 citation statements)

References 21 publications

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“…Through Figures 2 to 4, we present a visual depiction of the steps involved in the WALANT surgery performed on one of our patients. It allows surgeons to carry out surgical procedures using only lidocaine and adrenaline by associating bicarbonate and saline at different dilutions depending on the duration of the procedure and the surgical indication (fracture vs. wound) [6,[8][9][10] .…”

Section: Resultsmentioning

confidence: 99%

“…The WALANT technique represents several advantages for the patient and for the surgeon, these have been grouped in the following table [8] : The patient can communicate with the surgeon during the procedure.…”

Section: Resultsmentioning

confidence: 99%

“…As with any other medical procedure, the use of WALANT has certain limitations and contraindications, which are summarized in the table below [8] : The practical applications of this technique are multiple. In tendon repairs, this technique has the advantage of allowing the surgeon to test the success of his sutures in cooperation with the patient by active flexion-extension movements.…”

Section: • the Safest Sedation Is No Sedationmentioning

confidence: 99%

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One-Year Prospective Study Evaluating the Role of the WALANT Technique in Managing Upper Limb Trauma in the Emergency Room

Barchah

Rahou

Achkoun

et al. 2023

ijirms

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Background: WALANT (Wide Awake Locale Anesthesia No Tourniquet) is a technique recently developed by Lalonde. It has allowed surgeons to perform more procedures with a remarkable time grain and to reduce the cost. The objective of our study is to evaluate the interest of this technique in the management of upper limb trauma in the emergency room. Results: The study included 36 patients, 14 fractures and 22 wounds. The average waiting time in the emergency room was 82.9 minutes, the average time between anesthesia and incision was 37 minutes, and the average duration of the procedure was 37 minutes. Three patients whose procedure was prolonged required additional anesthetic, and no patient required sedation or general anesthesia. None of the patients required the use of a tourniquet. No complications were reported in these patients. 92% of patients were satisfied. Discussion: WALANT makes it possible to perform surgical procedures using only lidocaine and adrenaline in combination with bicarbonate and saline. The long-standing dogma about the involvement of adrenaline in ischemic necrosis of the fingers has been reconsidered by several authors. Several advantages have been reported in the various publications. This concerns the patient, the surgeon and the health care system. Thus, it allows to improve the result in tendon repairs and to verify the stability of the osteosynthesis intraoperatively. Conclusion: WALANT presented a solution to the shortage of medical staff during the COVID-19 pandemic by reducing the risk of contagiousness through the reduction of the number of staff in the OR and shortening the hospital stay.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: • the Safest Sedation Is No Sedationmentioning

confidence: 99%

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One-Year Prospective Study Evaluating the Role of the WALANT Technique in Managing Upper Limb Trauma in the Emergency Room

Barchah

Rahou

Achkoun

et al. 2023

ijirms

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“…As Morris et al showed, WALANT offers a solution for patients who are fearful of general anesthesia and its side effects. With regard to WALANT specifically, patients were most concerned with hearing or seeing the procedure as it was being performed and the possibility of feeling pain intraoperatively [67]. Furthermore, Lee et al found that anxiety was higher among WALANT patients when compared with patients who were given local anesthesia with a tourniquet, although there was no change in overall satisfaction [68].…”

Section: Patient Satisfaction and Perspectivementioning

confidence: 99%

“…First, it is essential that patients are comfortable with the idea of remaining awake during surgery. As discussed, there are multiple concerns and anxieties that may interfere with the safe execution of CTR under WALANT [67]. It is critical for surgeons to appropriately manage expectations in patients prior to WALANT procedures, as patients with certain comorbidities or low thresholds of anxiety may be better suited to alternative anesthesia methods.…”

Section: Contraindications To Walantmentioning

confidence: 99%

Optimization of Carpal Tunnel Syndrome Using WALANT Method

Segal

Debasitis

Koehler

2022

JCM

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As surgical management of carpal tunnel release (CTR) becomes ever more common, extensive research has emerged to optimize the contextualization of this procedure. In particular, CTR under the wide-awake, local-anesthesia, no-tourniquet (WALANT) technique has emerged as a cost-effective, safe, and straightforward option for the millions who undergo this procedure worldwide. CTR under WALANT is associated with considerable cost savings and workflow efficiencies; it can be safely and effectively executed in an outpatient clinic under field sterility with less use of resources and production of waste, and it has consistently demonstrated standard or better post-operative pain control and satisfaction among patients. In this review of the literature, we describe the current findings on CTR using the WALANT technique.

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