Related Experiment Video
Updated: Sep 27, 2025
04:08
Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
679
Open Carpal Tunnel Release Under WALANT - Suitable for All Ages?
Laura Lech1, Sebastian Leitsch2, Christian Krug2
1Department of General, Visceral, Transplantation, Vascular and Paediatric Surgery, University Hospital Wuerzburg, Wuerzburg, Germany.
Journal of Hand Surgery Global Online
|April 13, 2022
Summary
Wide-awake local anesthesia with no tourniquet (WALANT) offers high patient satisfaction for open carpal tunnel release. Older patients experience less pain with WALANT compared to intravenous regional anesthesia with a tourniquet (IVRA).
Area of Science:
- Orthopedic Surgery
- Anesthesiology
Background:
- Wide-awake local anesthesia with no tourniquet (WALANT) is increasingly used for open carpal tunnel release (OCTR).
- It is replacing intravenous regional anesthesia with a tourniquet (IVRA or Bier-block).
Purpose of the Study:
- Compare patient satisfaction between WALANT and IVRA for OCTR.
- Identify patient subgroups best suited for each anesthesia technique.
- Hypothesize older patients may prefer IVRA due to shorter surveillance.
Main Methods:
- Retrospective study evaluating patient satisfaction using a Swiss grading system.
- Assessed WALANT versus IVRA in 176 patients undergoing OCTR.
- Secondary outcomes included postoperative pain and satisfaction with tourniquet use.
Main Results:
- High patient satisfaction reported for both WALANT (5.5/6) and IVRA (5.5/6).
- Patients aged 80 and older experienced significantly less postoperative pain with WALANT (5.8/6) compared to IVRA (4.9/6).
Conclusions:
- WALANT is a safe and comfortable alternative to IVRA for OCTR.
- Older patients benefit from less postoperative pain with WALANT.
- WALANT is recommended for older patients due to its tourniquet-free nature.
