What Is the Infection Rate of Carpal Tunnel Syndrome and Trigger Finger Release Performed Under Wide-Awake Anesthesia?

Rellán, Ignacio; Victorica, Pedro Bronenberg; Figueira, Surya Victoria Kohan Fortuna; Donndorff, Agustín; Carli, Pablo De; Boretto, Jorge G.

doi:10.1177/1558944721994262

Cited by 11 publications

(6 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a contemporary article, a retrospective study was conducted to evaluate post-operative complications and infection rates in a group of patients undergoing CTS surgical treatment [ 25 ]. Similar to our findings, there were no infections recorded after surgical treatment of CTS with the WALANT method.…”

Section: Discussionmentioning

confidence: 99%

Wide Awake Local Anesthesia No Tourniquet Surgery of Carpal Tunnel Syndrome: Patients’ Experience and Recall Bias in a Day-Care Setting

et al. 2023

View full text Add to dashboard Cite

Background and Objective: Wide-Awake Local Anesthesia No Tourniquet (WALANT) is a technique of local anesthesia commonly used in the surgical treatment of a wide variety of conditions affecting the upper extremity, including Carpal Tunnel Syndrome (CTS). The recent retrospective studies investigated patient experiences in a wide variety of hand disorder-related cases. The aim of our study is to evaluate patient satisfaction regarding open surgical treatment for CTS using the WALANT technique. Material and Methods: we enrolled 82 patients with CTS without medical record of surgical treatment for CTS. For WALANT, a hand surgeon used a combination of 1:200,000 epinephrine, 1% lidocaine, and 1 mL 8.4% sodium bicarbonate solution without tourniquet application and sedating the patient. All patients were treated in a day-care setting. For assessment of patient experience, Lalonde’s questionnaire was adapted. Participants completed survey twice: one month and six months after the surgical treatment was performed. Results: the median pre-operative pain score for all patients was 4 (range 0–8) after one month and 3 (range 1–8) after six months. The median intraoperative pain score for all patients was 1 (range 0–8) after one month and 1 (range 1–7) after six months. The median post-operative pain score for all patients was 3 (range 0–9) after one month and 1 (range 0–8) after six months. More than half (61% after one month and 73% after six months) of the patients responded by stating that their real experience of WALANT was better than their initial expectations. An absolute majority of patients (95% after one month and 90% after six months) would recommend WALANT treatment to their relatives. Conclusions: overall, patient satisfaction with treatment for CTS using WALANT is high. Furthermore, complications related to the performed treatment and persistent post-operative pain could be associated with more reliable patient recall of this healthcare intervention. A longer period of time between intervention and assessment of patient experience could possibly be a reason for recall bias.

show abstract

Section: Discussionmentioning

confidence: 99%

Wide Awake Local Anesthesia No Tourniquet Surgery of Carpal Tunnel Syndrome: Patients’ Experience and Recall Bias in a Day-Care Setting

et al. 2023

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…And while it is unlikely that the anesthesia method (WALANT vs TA groups) had a direct effect on the observed postoperative infection rates in our study, other investigators have suggested that the use of epinephrine in WALANT soft tissue surgery may result in an increased incidence of infection. 15,16 Adhesion formation and loss of mobility from repaired tendon bunching passing through pulleys remain common complications following flexor tendon repair. 1,2 Proponents of performing these repairs under WALANT believe that these complications can be avoided by observing active tendon excursion intraoperatively, showing that the repair does not bunch and trigger on pulleys.…”

Section: Retrospective Reviewedmentioning

confidence: 99%

Functional Outcomes of Flexor Tendon Repair in the Fingers: A Comparison of Wide-Awake Local Anesthesia No Tourniquet Versus Traditional Anesthesia

Townsend

Henry

Matzon

et al. 2022

Hand (New York, N,Y.)

View full text Add to dashboard Cite

Background: Flexor tendon lacerations in the fingers are challenging injuries that can be repaired using the wide-awake local anesthesia no tourniquet (WALANT) technique or under traditional anesthesia (TA). The purpose of our study was to compare the functional outcomes and complication rates of patients undergoing flexor tendon repair under WALANT versus TA. Methods: All patients who underwent a primary flexor tendon repair in zone I and II without tendon graft for closed avulsions or open lacerations between 2015 and 2019 were identified. Electronic medical records were reviewed to record and compare patient demographics, range of motion, functional outcomes, complications, and reoperations. Results: Sixty-five zone I (N = 21) or II (N = 44) flexor tendon repairs were included in the final analysis: 23 WALANT and 42 TA. There were no statistical differences in mean age, length of follow-up, proportion of injured digits, or zone of injury between the groups. The final Quick Disabilities of the Arm, Shoulder, and Hand score in the WALANT group was 17.2 (SD: 14.4) versus 23.3 (SD: 18.5) in the TA group. There were no statistical differences between the groups with any final range of motion (ROM) parameters, grip strength, or Visual Analog Scale pain scores at the final follow-up. The WALANT group was found to have a slightly higher reoperation rate (26.1% vs 7.1%; P = .034) than the TA group. Conclusions: This study represents one of the first clinical studies reporting outcomes of flexor tendon repairs performed under WALANT. Overall, we found no difference in rupture rates, ROM, and functional outcomes following zone I and II flexor tendon repairs when performed under WALANT versus TA.

show abstract

“…Many hand surgical procedures can be safely and effectively performed in a clinic-based procedure room using wide awake local anesthesia with no tourniquet (WALANT). Transitioning cases to a procedure room has many benefits, including decreased medical waste, decreased cost, shorter wait for a surgical procedure, high patient satisfaction, favorable complication rates, and the ability to make operating room time available for more complex or profitable procedures [54][55][56][57][58][59] . One would conclude that performing minor hand surgery in a procedure room should be the standard of care.…”

Section: Health-care Costmentioning

confidence: 99%

What’s New in Hand Surgery

Bohn

2024

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

show abstract

What Is the Infection Rate of Carpal Tunnel Syndrome and Trigger Finger Release Performed Under Wide-Awake Anesthesia?

Cited by 11 publications

References 59 publications

Wide Awake Local Anesthesia No Tourniquet Surgery of Carpal Tunnel Syndrome: Patients’ Experience and Recall Bias in a Day-Care Setting

Wide Awake Local Anesthesia No Tourniquet Surgery of Carpal Tunnel Syndrome: Patients’ Experience and Recall Bias in a Day-Care Setting

Functional Outcomes of Flexor Tendon Repair in the Fingers: A Comparison of Wide-Awake Local Anesthesia No Tourniquet Versus Traditional Anesthesia

What’s New in Hand Surgery

Contact Info

Product

Resources

About