Comparison of Wide Awake Local Anaesthesia No Tourniquet Technique with Tourniquet Application under General Anesthesia in Carpal Tunnel Syndrome: A Retrospective Study

Kır, Mustafa; Bayraktar, Mehmet Kürşad; Gürbüz, Hakan

doi:10.4274/eamr.galenos.2018.68077

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…7,8 Specifically, the use of wide-awake, local anesthesia, with no tourniquet (WALANT) is a described technique shown to reduce postoperative pain, operating time, and cost when compared with traditional methods using sedation and tourniquets. 3,7,9,10,11 First described by Bezuhly et al 12 for an extensor indicis proprius-to-extensor pollicis longus tendon transfer, WALANT has since been applied to other surgical procedures, including CTR, with patients reporting similar overall satisfaction and Quick Disabilities of Arm, Shoulder, and Hand (qDASH) scores compared with anesthesia by way of sedation. 13,14,15 This approach is characterized by the use of larger volumes of local anesthetic with epinephrine delivered into the operative field and digits without the use of a tourniquet or formal sedation, regional, or general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

WALANT Technique versus Sedation for Endoscopic Carpal Tunnel Release

Wellington

Cusano

Ferreira

et al. 2021

Hand (New York, N,Y.)

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Background This study sought to investigate complication rates/perioperative metrics after endoscopic carpal tunnel release (eCTR) via wide-awake, local anesthesia, no tourniquet (WALANT) versus sedation or local anesthesia with a tourniquet. Methods Patients aged 18 years or older who underwent an eCTR between April 28, 2018, and December 31, 2019, by 1 of 2 fellowship-trained surgeons at our single institution were retrospectively reviewed. Patients were divided into 3 groups: monitored anesthesia care with tourniquet (MT), local anesthesia with tourniquet (LT), and WALANT. Results Inclusion criteria were met by 156 cases; 53 (34%) were performed under MT, 25 (16%) under LT, and 78 (50%) under WALANT. The MT group (46.1 ± 9.7) was statistically younger compared with LT (56.3 ± 14.1, P = .007) and WALANT groups (53.5 ± 15.8, P = .008), F(2, 153) = 6.465, P = .002. Wide-awake, local anesthesia, no tourniquet had decreased procedural times (10 minutes, SD: 2) compared with MT (11 minutes, SD: 2) and LT (11 minutes, SD: 2), F(2, 153) = 5.732, P = .004). Trends favored WALANT over MT and LT for average operating room time (20 minutes, SD: 3 vs 32 minutes, SD: 6 vs 23 minutes, SD: 3, respectively, F(2, 153) = 101.1, P < .001), postanesthesia care unit time (12 minutes, SD: 7 vs 1:12 minutes, SD: 26 vs 20 minutes, SD: 22, respectively, F(2, 153) =171.1, P < .001), and door-to-door time (1:37 minutes, SD: 21 vs 2:51 minutes, SD: 40 vs 1:46 minutes, SD: 33, respectively, F(2, 153) = 109.3, P < .001). There were no differences in complication rates. Conclusions Our data suggest favorable trends for patients undergoing eCTR via WALANT versus MT versus LT.

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Section: Introductionmentioning

confidence: 99%

WALANT Technique versus Sedation for Endoscopic Carpal Tunnel Release

Wellington

Cusano

Ferreira

et al. 2021

Hand (New York, N,Y.)

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Efficacy of Preemptive Analgesia on Tourniquet and Postoperative Pain Relief in Open Carpal Tunnel Release: A Prospective Randomized Control Trial

Vilai

Dhanachanvisith

Kongmalai

2023

The Journal of Hand Surgery

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Male Marfan mice are predisposed to high-fat diet-induced obesity, diabetes, and fatty liver

Tiedemann

Muthu

Reinhardt

et al. 2022

American Journal of Physiology-Cell Physiology

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Gene mutations in the extracellular matrix protein fibrillin-1 cause connective tissue disorders including Marfan syndrome (MFS) with clinical symptoms in the cardiovascular, skeletal, and ocular systems. MFS patients also exhibit alterations in adipose tissues, which in some individuals leads to lipodystrophy, whereas in others to obesity. We have recently demonstrated that fibrillin-1 regulates adipose tissue homeostasis. Here, we examined how fibrillin-1 abnormality affects metabolic adaptation to different diets. We used two MFS mouse models: Hypomorph Fbn1mgR/mgR mice and Fbn1C1041G/+ mice with a fibrillin-1 missense mutation. When Fbn1mgR/mgR mice were fed with high fat diet (HFD) for 12 weeks, male mice were heavier than littermate controls (LC), whereas female mice gained less weight compared to LC. Female Fbn1C1041G/+ mice on a HFD for 24 weeks were similarly protected from weight gain. Male Fbn1C1041G/+ mice on HFD demonstrated higher insulin levels, insulin intolerance, circulating levels of cholesterol and high-density lipoproteins. Moreover, male HFD-fed Fbn1C1041G/+ mice showed a higher liver weight and a fatty liver phenotype, which was reduced to LC levels after orchiectomy. Phosphorylation of protein kinase-like endoplasmic reticulum kinase (PERK) as well as the expression of sterol regulatory element-binding protein 1 (Srebp1) in livers of HFD-fed male Fbn1C1041G/+ mice were elevated. In conclusion, the data demonstrate that male mice of both MFS models are susceptible to HFD-induced obesity and diabetes. Moreover, male Fbn1C1041G/+ mice develop a fatty liver phenotype, likely mediated by a baseline increased endoplasmic reticulum stress. In contrast, female MFS mice were protected from the consequence of HFD.

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Comparison of Wide Awake Local Anaesthesia No Tourniquet Technique with Tourniquet Application under General Anesthesia in Carpal Tunnel Syndrome: A Retrospective Study

Cited by 3 publications

References 18 publications

WALANT Technique versus Sedation for Endoscopic Carpal Tunnel Release

WALANT Technique versus Sedation for Endoscopic Carpal Tunnel Release

Efficacy of Preemptive Analgesia on Tourniquet and Postoperative Pain Relief in Open Carpal Tunnel Release: A Prospective Randomized Control Trial

Male Marfan mice are predisposed to high-fat diet-induced obesity, diabetes, and fatty liver

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