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Patients' Perspective on Carpal Tunnel Release with WALANT or Intravenous Regional Anesthesia.
Plast Reconstr Surg. 2020 05; 145(5):1197-1203.PR

Abstract

BACKGROUND

The authors conducted a prospective study to compare patients' intraoperative experience of open carpal tunnel release under "wide awake, local anesthesia, no tourniquet" (WALANT) on the one hand and intravenous regional anesthesia on the other. The authors hypothesized that WALANT would offer a better intraoperative experience than intravenous regional anesthesia.

METHODS

Twenty-four patients with bilateral carpal tunnel syndrome had one hand operated on using WALANT and the contralateral hand with the intravenous regional anesthesia method. At the postoperative second hour, patients completed a questionnaire to quantify their pain levels on a numerical rating scale and compare the operation with dental procedures. They were also asked about their expectations and feelings about reoperation with the anesthesia methods. The results were compared for the two anesthesia methods.

RESULTS

There were no significant differences between numerical rating scale pain values during anesthetic administration or for surgical site pain on the WALANT and intravenous regional anesthesia sides. Patients reported moderate tourniquet pain for intravenous regional anesthesia sides. For WALANT sides, a significantly higher number of patients reported carpal tunnel release to be an easier procedure than dental procedures (91.6 percent WALANT and 37.5 percent intravenous regional anesthesia). For WALANT sides, a significantly higher number of patients reported carpal tunnel release to be an easier procedure than they expected (91.6 percent WALANT and 50 percent intravenous regional anesthesia). For the reoperation, 83.3 percent of patients preferred WALANT, 8.3 percent preferred intravenous regional anesthesia, and 8.3 percent reported no preference.

CONCLUSIONS

WALANT offered a better intraoperative experience. Tourniquet pain, preoperative preparation basics, and the extended anesthesia duration are likely the major drawbacks of the intravenous regional anesthesia method.

Authors+Show Affiliations

Ankara, Turkey From the Department of Orthopaedics and Traumatology, and the Department of Anesthesiology and Reanimation, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

32332539

Citation

Ayhan, Egemen, and Filiz Akaslan. "Patients' Perspective On Carpal Tunnel Release With WALANT or Intravenous Regional Anesthesia." Plastic and Reconstructive Surgery, vol. 145, no. 5, 2020, pp. 1197-1203.
Ayhan E, Akaslan F. Patients' Perspective on Carpal Tunnel Release with WALANT or Intravenous Regional Anesthesia. Plast Reconstr Surg. 2020;145(5):1197-1203.
Ayhan, E., & Akaslan, F. (2020). Patients' Perspective on Carpal Tunnel Release with WALANT or Intravenous Regional Anesthesia. Plastic and Reconstructive Surgery, 145(5), 1197-1203. https://doi.org/10.1097/PRS.0000000000006741
Ayhan E, Akaslan F. Patients' Perspective On Carpal Tunnel Release With WALANT or Intravenous Regional Anesthesia. Plast Reconstr Surg. 2020;145(5):1197-1203. PubMed PMID: 32332539.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patients' Perspective on Carpal Tunnel Release with WALANT or Intravenous Regional Anesthesia. AU - Ayhan,Egemen, AU - Akaslan,Filiz, PY - 2020/4/26/entrez PY - 2020/4/26/pubmed PY - 2020/7/23/medline SP - 1197 EP - 1203 JF - Plastic and reconstructive surgery JO - Plast. Reconstr. Surg. VL - 145 IS - 5 N2 - BACKGROUND: The authors conducted a prospective study to compare patients' intraoperative experience of open carpal tunnel release under "wide awake, local anesthesia, no tourniquet" (WALANT) on the one hand and intravenous regional anesthesia on the other. The authors hypothesized that WALANT would offer a better intraoperative experience than intravenous regional anesthesia. METHODS: Twenty-four patients with bilateral carpal tunnel syndrome had one hand operated on using WALANT and the contralateral hand with the intravenous regional anesthesia method. At the postoperative second hour, patients completed a questionnaire to quantify their pain levels on a numerical rating scale and compare the operation with dental procedures. They were also asked about their expectations and feelings about reoperation with the anesthesia methods. The results were compared for the two anesthesia methods. RESULTS: There were no significant differences between numerical rating scale pain values during anesthetic administration or for surgical site pain on the WALANT and intravenous regional anesthesia sides. Patients reported moderate tourniquet pain for intravenous regional anesthesia sides. For WALANT sides, a significantly higher number of patients reported carpal tunnel release to be an easier procedure than dental procedures (91.6 percent WALANT and 37.5 percent intravenous regional anesthesia). For WALANT sides, a significantly higher number of patients reported carpal tunnel release to be an easier procedure than they expected (91.6 percent WALANT and 50 percent intravenous regional anesthesia). For the reoperation, 83.3 percent of patients preferred WALANT, 8.3 percent preferred intravenous regional anesthesia, and 8.3 percent reported no preference. CONCLUSIONS: WALANT offered a better intraoperative experience. Tourniquet pain, preoperative preparation basics, and the extended anesthesia duration are likely the major drawbacks of the intravenous regional anesthesia method. SN - 1529-4242 UR - https://www.unboundmedicine.com/medline/citation/32332539/Patients'_Perspective_on_Carpal_Tunnel_Release_with_WALANT_or_Intravenous_Regional_Anesthesia_ L2 - https://Insights.ovid.com/pubmed?pmid=32332539 DB - PRIME DP - Unbound Medicine ER -