&lt;p&gt;Open cubital and carpal tunnel release using wide-awake technique: reduction of postoperative pain&lt;/p&gt;

Kang, Seung Wan; Park, Hye Mi; Park, Ji Kang; Jeong, Ho-Seung; Kwon, Jung Hye; Go, Ban Suk; Min, Kyoung Tae

doi:10.2147/jpr.s210366

Cited by 30 publications

(26 citation statements)

References 16 publications

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“…For minor hand surgeries, Ki Lee et al 53 reported a significantly longer duration of anesthetic effect, lower injection pain, and lower postoperative pain scores until the first day after surgery for WALANT patients versus those who received conventional anesthesia. Huang et al 54 found that WALANT patients with distal radius fractures experienced less postoperative pain than general anesthesia patients, whereas Kang et al 55 found that using WALANT for cubital and carpal tunnel surgery was superior for pain. These findings suggest effective analgesia can be achieved safely without the additional side effects of traditional anesthetic regimens.…”

Section: Discussionmentioning

confidence: 99%

Wide-awake Local Anesthesia with No Tourniquet: An Updated Review

Kurtzman

Etcheson

Koehler

2021

Plastic and Reconstructive Surgery - Global Open

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Background: The wide-awake local anesthesia with no tourniquet (WALANT) technique has become popularized for various hand/upper extremity procedures. Before surgery, patients receive local anesthetic, consisting of lidocaine with epinephrine, and remain awake for the entire procedure. The purpose of this review was to investigate the advantages, diverse application, outcomes, cost benefits, use in challenging environments, patient considerations, and contraindications associated with WALANT. Methods: A comprehensive review of the literature on the WALANT technique was conducted. Search terms included: WALANT, wide-awake surgery, no tourniquet, local anesthesia, hand, wrist, cost, and safety. Results: The WALANT technique has proven to be successful for common procedures such as flexor tendon repair, tendon transfer, trigger finger releases, Depuytren disease, and simple bony procedures. Recently, the use of WALANT has expanded to more extensive soft-tissue repair, fracture management, and bony manipulation. Advantages include negating preoperative evaluation and testing for anesthesia clearance, eliminating risk of monitored anesthesia care, removal of anesthesia providers and ancillary staff, significant cost savings, and less waste produced. Intraoperative evaluations can be performed through active patient participation, and postoperative recovery and monitoring time are reduced. WALANT is associated with high patient satisfaction rates and low infection rates. Conclusions: The WALANT technique has proven to be valuable to both patients and providers, optimizing patient satisfaction and providing substantial healthcare savings. As its application continues to grow, current literature suggests positive outcomes.

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Section: Discussionmentioning

confidence: 99%

Wide-awake Local Anesthesia with No Tourniquet: An Updated Review

Kurtzman

Etcheson

Koehler

2021

Plastic and Reconstructive Surgery - Global Open

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“…Recent studies have demonstrated that moving common hand procedures from the main operating room (OR) to a minor procedure room provides benefits in waste reduction, cost-efficiency, time savings, and risk attenuation without compromising patient safety and satisfaction. 1 -10 In the setting of a small procedure room or clinic, the full OR sterile procedure can be consolidated to “minor field sterility.” This practice involves fewer disposable items, which results in a reduction of excess OR waste and costs. 11 Additionally, these procedure rooms require less preparation than the main OR, resulting in decreased turnover and wait times.…”

Section: Introductionmentioning

confidence: 99%

WALANT Hand and Upper Extremity Procedures Performed With Minor Field Sterility Are Associated With Low Infection Rates

et al. 2021

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Background: The use of minor field sterility in hand/upper extremity cases has been shown to improve workflow efficiency while maintaining patient safety. As this finding has been limited to specific procedures, we investigated the safety of performing a wide array of hand/upper extremity procedures outside the main operating room using minimal field sterility with Wide-Awake Local Anaesthesia No Tourniquet (WALANT) anaesthesia by evaluating superficial and deep infection rates across a diverse series of cases. Methods: This study was a case series conducted between October 2017 and June 2020. Of all, 217 patients underwent hand/upper extremity procedures performed in a minor procedure room via WALANT technique with field sterility. Primary outcome measures include superficial and deep surgical site infections within 14 days post-surgery. Results: Of all, 217 patients were included in this study; 265 consecutive hand/upper extremity operations were performed by a single surgeon, with notable case diversity. The majority of patients (n = 215, 99.1%) did not report or present with signs of infection before or after their operation. We report 0% 14-day and 0.37% 30-day surgical site infection rates for such hand/upper extremity procedures performed in a minor procedure room with field sterility. Conclusion: Hand/upper extremity procedures performed via WALANT technique with field sterility in a minor procedure room are associated with low surgical site infection rates. These rates are comparable to surgical site infection rates for similar surgeries performed in main operating rooms with standard sterilization procedures. Thus, the implementation of this technique may allow for improved workflow efficiency and reduced waste, all while maintaining patient safety.

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“…Chapman et al similarly saw no difference in post-operative consumption of opioids between WALANT and general anesthesia patients, concluding that age and gender were more predictive of opioid consumption than anesthesia type [61]. Kang et al did, however, observe that there was less need for supplemental opioid injections in the wide-awake group than in the general anesthesia group (12% versus 35%, respectively), showing that there is a strong possibility that WALANT could be beneficial in reducing the need for opioids [62]. Additionally, Dar et al demonstrated that WALANT patients who were not prescribed opioids following surgery experienced lower pain scores at 14 days post-operation than patients who underwent similar procedures under MAC [63].…”

Section: Opioid Usementioning

confidence: 95%

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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<p>Open cubital and carpal tunnel release using wide-awake technique: reduction of postoperative pain</p>

Cited by 30 publications

References 16 publications

Wide-awake Local Anesthesia with No Tourniquet: An Updated Review

Wide-awake Local Anesthesia with No Tourniquet: An Updated Review

WALANT Hand and Upper Extremity Procedures Performed With Minor Field Sterility Are Associated With Low Infection Rates

Optimization of Carpal Tunnel Syndrome Using WALANT Method

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