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Prospective study on the application of a WALANT circuit for surgery of tunnel carpal syndrome and trigger finger.
Rev Esp Cir Ortop Traumatol. 2019 Nov - Dec; 63(6):400-407.RE

Abstract

OBJECTIVES

To evaluate benefits for the patient and the economic impact for the implementation of a wide awake local anesthesia no tourniquet (WALANT) hand surgery compared to traditional major outpatient circuit.

METHODS

A prospective cohort study was planned comparing 150 cases of ambulatory hand surgery (carpal tunnel and trigger finger) using WALANT technique intervention out from the operating room; with another 150 which underwent intervention, outpatient setting, with preoperative evaluation, sedation and tourniquet, in the operation room. Preoperative, intraoperative and postoperative pain was monitored, as well as the days that required postoperative analgesia.The resources used and costs were evaluated. Satisfaction was evaluated using a specific survey.

RESULTS

The pain during the surgery was equivalent for both groups and was significantly lower postoperatively for the WALANT group, with less need for the use of analgesics. Satisfaction was greater for the local anesthesia group. The use of personnel resources and hospital material was less for the WALANT group, with total saving calculated by 1,019€ per patient.

CONCLUSIONS

Procedures such as carpal tunnel surgery and trigger finger surgery can be safely performed using wide awake surgery. Patient satisfaction is higher to conventional procedure in the operation room. Pain control is excellent, especially during the postoperative period. WALANT technique for hand surgery represents a benefit for the patient in comfort, timeliness and no need for preoperative tests or evaluation. In addition, it represents a significant savings in hospital resources.

Authors+Show Affiliations

Unidad de Cirugía de Mano y extremidad superior, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España. Electronic address: ainafar@gmail.com.Unidad de Cirugía de Mano y extremidad superior, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España.Unidad de Cirugía de Mano y extremidad superior, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España.Unidad de Cirugía de Mano y extremidad superior, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España.Unidad de Cirugía de Mano y extremidad superior, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España.Unidad de Cirugía de Mano y extremidad superior, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España.

Pub Type(s)

Journal Article

Language

eng spa

PubMed ID

31471242

Citation

Far-Riera, A M., et al. "Prospective Study On the Application of a WALANT Circuit for Surgery of Tunnel Carpal Syndrome and Trigger Finger." Revista Espanola De Cirugia Ortopedica Y Traumatologia, vol. 63, no. 6, 2019, pp. 400-407.
Far-Riera AM, Pérez-Uribarri C, Sánchez Jiménez M, et al. Prospective study on the application of a WALANT circuit for surgery of tunnel carpal syndrome and trigger finger. Rev Esp Cir Ortop Traumatol. 2019;63(6):400-407.
Far-Riera, A. M., Pérez-Uribarri, C., Sánchez Jiménez, M., Esteras Serrano, M. J., Rapariz González, J. M., & Ruiz Hernández, I. M. (2019). Prospective study on the application of a WALANT circuit for surgery of tunnel carpal syndrome and trigger finger. Revista Espanola De Cirugia Ortopedica Y Traumatologia, 63(6), 400-407. https://doi.org/10.1016/j.recot.2019.06.006
Far-Riera AM, et al. Prospective Study On the Application of a WALANT Circuit for Surgery of Tunnel Carpal Syndrome and Trigger Finger. Rev Esp Cir Ortop Traumatol. 2019 Nov - Dec;63(6):400-407. PubMed PMID: 31471242.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective study on the application of a WALANT circuit for surgery of tunnel carpal syndrome and trigger finger. AU - Far-Riera,A M, AU - Pérez-Uribarri,C, AU - Sánchez Jiménez,M, AU - Esteras Serrano,M J, AU - Rapariz González,J M, AU - Ruiz Hernández,I M, Y1 - 2019/08/28/ PY - 2018/09/28/received PY - 2019/06/20/revised PY - 2019/06/25/accepted PY - 2019/9/1/pubmed PY - 2020/5/1/medline PY - 2019/9/1/entrez KW - Ambulatory KW - Anestesia local KW - Carpal tunnel syndrome KW - Cirugía mayor ambulatoria KW - Dedo en resorte KW - Local anesthesia KW - Paciente despierto KW - Síndrome túnel del carpo KW - Trigger finger KW - WALANT KW - WAS KW - Wide awake SP - 400 EP - 407 JF - Revista espanola de cirugia ortopedica y traumatologia JO - Rev Esp Cir Ortop Traumatol VL - 63 IS - 6 N2 - OBJECTIVES: To evaluate benefits for the patient and the economic impact for the implementation of a wide awake local anesthesia no tourniquet (WALANT) hand surgery compared to traditional major outpatient circuit. METHODS: A prospective cohort study was planned comparing 150 cases of ambulatory hand surgery (carpal tunnel and trigger finger) using WALANT technique intervention out from the operating room; with another 150 which underwent intervention, outpatient setting, with preoperative evaluation, sedation and tourniquet, in the operation room. Preoperative, intraoperative and postoperative pain was monitored, as well as the days that required postoperative analgesia.The resources used and costs were evaluated. Satisfaction was evaluated using a specific survey. RESULTS: The pain during the surgery was equivalent for both groups and was significantly lower postoperatively for the WALANT group, with less need for the use of analgesics. Satisfaction was greater for the local anesthesia group. The use of personnel resources and hospital material was less for the WALANT group, with total saving calculated by 1,019€ per patient. CONCLUSIONS: Procedures such as carpal tunnel surgery and trigger finger surgery can be safely performed using wide awake surgery. Patient satisfaction is higher to conventional procedure in the operation room. Pain control is excellent, especially during the postoperative period. WALANT technique for hand surgery represents a benefit for the patient in comfort, timeliness and no need for preoperative tests or evaluation. In addition, it represents a significant savings in hospital resources. SN - 1988-8856 UR - https://www.unboundmedicine.com/medline/citation/31471242/Prospective_study_on_the_application_of_a_WALANT_circuit_for_surgery_of_tunnel_carpal_syndrome_and_trigger_finger_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1888-4415(19)30109-2 DB - PRIME DP - Unbound Medicine ER -