Comparison of Effectiveness in Flexor Tendon Hand Repairs between WALANT Technique and Conventional Method
Keywords:
Flexor tendon repairs, WALANT technique, Conventional methodAbstract
Objective: To compare the effectiveness in flexor tendon hand repairs between wide-awake local anesthesia no tourniquet (WALANT) technique and conventional method.
Methods: The study design of this study was randomized controlled trials (RCTs) in 92 patients with flexor tendon repairs. Patients were divided into 2 groups: 46 were operated under the WALANT technique and 46 controls were operated under the conventional method. All study subjects have hand tendons surgery at the Department of Orthopedics, Roi Et Hospital from June 1, 2018 to December 31, 2019. The pain score, total blood loss, duration time of surgery, and patient satisfaction were recorded. The statistics analyses were used descriptive and Mann-Whitney U test.
Results: The comparison of effectiveness in flexor tendon hand repairs between WALANT technique and the conventional method were found no significant differences between two groups in terms of pain score preoperative (p=0.941), pain score intraoperative (p=0.774), total blood loss (p=0.291), operative time (p=0.078), and overall satisfaction (p=0.274).
Conclusion: This study revealed that the effectiveness in flexor tendon hand repairs between WALANT technique and conventional method in terms of pain score, total blood loss, duration time of surgery and patient satisfaction is not significantly different.
Metrics
References
Huang YC, Hsu CJ, Renn JH, Lin KC, Yang SW, Tarng YW, et al. WALANT for distal radius fracture: open reduction with plating fixation via wide-awake local anesthesia with no tourniquet. J Orthop Surg Res. 2018; 13(1): 195.
Lalonde D, Martin A. Tumescent local anesthesia for hand surgery: improved results, cost-effectiveness, and wide-awake patient satisfaction. Arch Plast Surg. 2014; 41(4): 312-6.
Van Demark RE, Becker HA, Anderson MC, Smith VJS. Wide-Awake Anesthesia in the In-Office Procedure Room: Lessons Learned. Hand N Y N. 2018; 13(4): 481-5.
Lalonde D, Martin A. Epinephrine in local anesthesia in finger and hand surgery: the case for wide-awake anesthesia. J Am Acad Orthop Surg. 2013; 21(8): 443-7.
Steiner MM, Calandruccio JH. Use of wide-awake local anesthesia no tourniquet in hand and wrist surgery. Orthop Clin North Am. 2018; 49(1): 63-8.
Rhee PC, Fischer MM, Rhee LS, McMillan H, Johnson AE. Cost savings and patient experiences of a clinic-based, wide-awake hand surgery program at a military medical center: A critical analysis of the first 100 procedures. J Hand Surg Am. 2017; 42(3): e139-47.
Huang YC, Chen CY, Lin KC, Yang SW, Tarng YW, Chang WN. Comparison of wide-awake local anesthesia no tourniquet with general anesthesia with tourniquet for volar plating of distal radius fracture. Orthopedics. 2019; 42(1): e93-8.
Gunasagaran J, Sean ES, Shivdas S, Amir S, Ahmad TS. Perceived comfort during minor hand surgeries with wide-awake local anesthesia no tourniquet (WALANT) versus local anesthesia (LA)/tourniquet. J Orthop Surg (Hong Kong). 2017; 25(3): 2309499017739499.
Ruxasagulwong S, Kraisarin J, Sananpanich K. Wide awake technique versus local anesthesia with tourniquet application for minor orthopedic hand surgery: a prospective clinical trial. J Med Assoc Thai. 2015; 98(1): 106-10.
Tang JB, Xing SG, Ayhan E, Hediger S, Huang S. Impact of wide-awake local anesthesia no tourniquet on departmental settings, cost, patient and surgeon satisfaction, and beyond. Hand Clin. 2019; 35(1): 29-34.
Hoxhallari E, Behr IJ, Bradshaw JS, Morkos MS, Haan PS, Schaefer MC, et al. Virtual Reality Improves the Patient Experience during Wide-Awake Local Anesthesia No Tourniquet Hand Surgery: A Single-Blind, Randomized, Prospective Study. Plast Reconstr Surg. 2019; 144(2): 408-14.
Alter TH, Warrender WJ, Liss FE, Ilyas AM. A Cost Analysis of Carpal Tunnel Release Surgery Performed Wide Awake versus under Sedation. Plast Reconstr Surg. 2018; 142(6): 1532-8.
Lalonde D, Martin A. Epinephrine in local anesthesia in finger and hand surgery: the case for wide-awake anesthesia. J Am Acad Orthop Surg. 2013; 21(8): 443-7.
Tang JB, Gong KT, Zhu L, Pan ZJ, Xing SG. Performing hand surgery under local anesthesia without a tourniquet in China. Hand Clin. 2017; 33(3): 415-24.
Koegst WH, Wölfle O, Thoele K, Sauerbier M. [The "Wide Awake Approach" in hand surgery: a comfortable anaesthesia method without a tourniquet]. Handchir Mikrochir Plast Chir. 2011; 43(3): 175-80.
Sasor SE, Cook JA, Duquette SP, Lucich EA, Cohen AC, Wooden WA, et al. Tourniquet Use in Wide-Awake Carpal Tunnel Release. Hand (N Y). 2020; 15(1): 59-63.
Orbach H, Rozen N, Rubin G. Open reduction and internal fixation of intra-articular distal radius fractures under wide-awake local anesthesia with no tourniquet. J Int Med Res. 2018; 46(10): 4269-76.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 The Royal College of Orthopaedic Surgeons of Thailand
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.