Tags

Type your tag names separated by a space and hit enter

Perceived comfort during minor hand surgeries with wide awake local anaesthesia no tourniquet (WALANT) versus local anaesthesia (LA)/tourniquet.
J Orthop Surg (Hong Kong). 2017 Sep-Dec; 25(3):2309499017739499.JO

Abstract

PURPOSE

Minor hand surgeries can be done under field sterility in procedure rooms. Surgeons are still sceptical about the usage of wide awake local anaesthesia no tourniquet (WALANT) technique. They perceive that patients can tolerate tourniquet for a brief period while they perform minor surgeries under local anaesthesia (LA). We compared the perceived comfort experienced by patients during minor hand surgeries with WALANT and LA/tourniquet. We investigated the difference in preoperative preparation time, operating time and blood loss between the two groups.

METHODS

Between July and October 2016, a total of 72 patients were diagnosed with carpal tunnel syndrome, trigger finger or ganglion, at the University Malaya Medical Centre. Forty patients consented to participate in this study and were randomized into WALANT and LA/tourniquet groups. Anaesthesia was administered accordingly and tourniquet was applied. The time taken for preoperative preparation and surgery was recorded. Each surgeon estimated the blood loss. The perceived comfort level of each patient was quantified using a visual analogue score (VAS). Data were analysed using SPSS.

RESULTS

The mean VAS for the WALANT group was 2.33 ± 1.94, whereas it was 4.72 ± 3.05 for the LA/tourniquet group, and the difference was statistically significant (p < 0.05). The mean time for preoperative preparation in WALANT group was 19.17 ± 12.61 min and LA/tourniquet group was 7.05 ± 3.44 min. The difference between these groups was statistically significant (p < 0.01). There was no significant difference in operating time and blood loss.

CONCLUSION

WALANT technique was associated with better patient comfort. Tourniquet was the main reason for discomfort during surgeries. WALANT is an alternative in minor hand surgeries for a bloodless surgical field without the discomfort of tourniquet application.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Faculty of Medicine, National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), University of Malaya, Kuala Lumpur, Malaysia.Department of Orthopaedic Surgery, Faculty of Medicine, National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), University of Malaya, Kuala Lumpur, Malaysia.Department of Orthopaedic Surgery, Faculty of Medicine, National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), University of Malaya, Kuala Lumpur, Malaysia.Department of Orthopaedic Surgery, Faculty of Medicine, National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), University of Malaya, Kuala Lumpur, Malaysia.Department of Orthopaedic Surgery, Faculty of Medicine, National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), University of Malaya, Kuala Lumpur, Malaysia.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

29141522

Citation

Gunasagaran, Jayaletchumi, et al. "Perceived Comfort During Minor Hand Surgeries With Wide Awake Local Anaesthesia No Tourniquet (WALANT) Versus Local Anaesthesia (LA)/tourniquet." Journal of Orthopaedic Surgery (Hong Kong), vol. 25, no. 3, 2017, p. 2309499017739499.
Gunasagaran J, Sean ES, Shivdas S, et al. Perceived comfort during minor hand surgeries with wide awake local anaesthesia no tourniquet (WALANT) versus local anaesthesia (LA)/tourniquet. J Orthop Surg (Hong Kong). 2017;25(3):2309499017739499.
Gunasagaran, J., Sean, E. S., Shivdas, S., Amir, S., & Ahmad, T. S. (2017). Perceived comfort during minor hand surgeries with wide awake local anaesthesia no tourniquet (WALANT) versus local anaesthesia (LA)/tourniquet. Journal of Orthopaedic Surgery (Hong Kong), 25(3), 2309499017739499. https://doi.org/10.1177/2309499017739499
Gunasagaran J, et al. Perceived Comfort During Minor Hand Surgeries With Wide Awake Local Anaesthesia No Tourniquet (WALANT) Versus Local Anaesthesia (LA)/tourniquet. J Orthop Surg (Hong Kong). 2017 Sep-Dec;25(3):2309499017739499. PubMed PMID: 29141522.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perceived comfort during minor hand surgeries with wide awake local anaesthesia no tourniquet (WALANT) versus local anaesthesia (LA)/tourniquet. AU - Gunasagaran,Jayaletchumi, AU - Sean,Ee Soon, AU - Shivdas,Sachin, AU - Amir,Shams, AU - Ahmad,Tunku Sara, PY - 2017/11/17/entrez PY - 2017/11/17/pubmed PY - 2018/5/31/medline KW - WALANT KW - minor surgery KW - satisfaction KW - tourniquet KW - wide awake SP - 2309499017739499 EP - 2309499017739499 JF - Journal of orthopaedic surgery (Hong Kong) JO - J Orthop Surg (Hong Kong) VL - 25 IS - 3 N2 - PURPOSE: Minor hand surgeries can be done under field sterility in procedure rooms. Surgeons are still sceptical about the usage of wide awake local anaesthesia no tourniquet (WALANT) technique. They perceive that patients can tolerate tourniquet for a brief period while they perform minor surgeries under local anaesthesia (LA). We compared the perceived comfort experienced by patients during minor hand surgeries with WALANT and LA/tourniquet. We investigated the difference in preoperative preparation time, operating time and blood loss between the two groups. METHODS: Between July and October 2016, a total of 72 patients were diagnosed with carpal tunnel syndrome, trigger finger or ganglion, at the University Malaya Medical Centre. Forty patients consented to participate in this study and were randomized into WALANT and LA/tourniquet groups. Anaesthesia was administered accordingly and tourniquet was applied. The time taken for preoperative preparation and surgery was recorded. Each surgeon estimated the blood loss. The perceived comfort level of each patient was quantified using a visual analogue score (VAS). Data were analysed using SPSS. RESULTS: The mean VAS for the WALANT group was 2.33 ± 1.94, whereas it was 4.72 ± 3.05 for the LA/tourniquet group, and the difference was statistically significant (p < 0.05). The mean time for preoperative preparation in WALANT group was 19.17 ± 12.61 min and LA/tourniquet group was 7.05 ± 3.44 min. The difference between these groups was statistically significant (p < 0.01). There was no significant difference in operating time and blood loss. CONCLUSION: WALANT technique was associated with better patient comfort. Tourniquet was the main reason for discomfort during surgeries. WALANT is an alternative in minor hand surgeries for a bloodless surgical field without the discomfort of tourniquet application. SN - 2309-4990 UR - https://www.unboundmedicine.com/medline/citation/29141522/Perceived_comfort_during_minor_hand_surgeries_with_wide_awake_local_anaesthesia_no_tourniquet__WALANT__versus_local_anaesthesia__LA_/tourniquet_ L2 - http://journals.sagepub.com/doi/full/10.1177/2309499017739499?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -