WALANT Technique versus Sedation for Endoscopic Carpal Tunnel Release

Area of Science:

• Orthopedic Surgery
• Anesthesiology

Background:

• Carpal tunnel release is a common surgical procedure.
• Investigating perioperative metrics and complication rates is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare complication rates and perioperative metrics of endoscopic carpal tunnel release (eCTR) using Wide-awake, Local Anesthesia, No Tourniquet (WALANT) versus monitored anesthesia care with tourniquet (MT) and local anesthesia with tourniquet (LT).

Main Methods:

• A retrospective review of 156 eCTR cases performed between April 2018 and December 2019.
• Patients were categorized into three groups: MT, LT, and WALANT.
• Comparison of procedural times, operating room time, postanesthesia care unit (PACU) time, and door-to-door time.

Main Results:

• WALANT demonstrated significantly decreased procedural times (10 minutes) compared to MT (11 minutes) and LT (11 minutes).
• WALANT showed favorable trends in reduced operating room time, PACU time, and door-to-door time compared to MT and LT.
• No statistically significant differences in complication rates were observed among the three groups.

Conclusions:

• Endoscopic carpal tunnel release using WALANT presents favorable perioperative trends compared to monitored anesthesia care with tourniquet or local anesthesia with tourniquet.
• WALANT is a viable and efficient alternative for endoscopic carpal tunnel release, offering potential benefits in procedural and overall patient throughput without compromising safety.