[Wide awake hand surgery based on application examples].

Area of Science:

• Anesthesiology
• Hand Surgery
• Local Anesthesia Techniques

Background:

• Hand surgeries traditionally require tourniquets and sedation, increasing risks and recovery time.
• The wide awake technique offers an alternative for unsedated patients, minimizing bleeding and complications.

Purpose of the Study:

• To evaluate the efficacy and patient experience of the wide awake local anesthesia no tourniquet (WALANT) technique for hand surgery.
• To assess bleeding levels, risk, and complication rates associated with WALANT.

Main Methods:

• Patients underwent hand surgery using WALANT, with local anesthetic infiltration (lidocaine/epinephrine/bicarbonate) 30 minutes prior.
• The technique involves careful injection to achieve a pale skin area and potential "hole-in-one" anesthesia.
• Patient suitability and individual risk factors were considered for the procedure.

Main Results:

• 38 patients underwent the procedure; 32 reported no stress, 6 reported mild stress.
• Average pain scores were low: 1.6 during infiltration, 0.5 during surgery, 3.5 during anesthesia reduction, and 2.9 post-op.
• All patients expressed willingness to undergo surgery again using the WALANT technique.

Conclusions:

• The wide awake local anesthesia no tourniquet technique is a viable and well-tolerated method for hand surgery.
• This technique provides low bleeding, risk, and complication rates, with high patient satisfaction.
• WALANT allows for functional testing during surgery and avoids the need for sedation or tourniquets.