Wide Awake Local Anesthesia No Tourniquet Endoscopic Cubital Tunnel Release

Area of Science:

• Orthopedic Surgery
• Minimally Invasive Procedures
• Nerve Surgery

Background:

• Increasing patient demand for faster recovery and improved cosmetic outcomes drives interest in minimally invasive surgical techniques.
• Wide-awake local anesthesia without tourniquet (WALANT) offers benefits but presents challenges for procedures like cubital tunnel release due to nerve anatomy.
• The ulnar nerve's position at the elbow makes endoscopic decompression under local anesthesia technically demanding.

Purpose of the Study:

• To describe a novel two-stage local anesthetic injection technique for wide-awake endoscopic cubital tunnel release.
• To address the technical challenges associated with performing this procedure under local anesthesia.
• To enhance patient comfort, surgical visualization, and the ability to address multiple compression points via a minimal incision.

Main Methods:

• A two-stage local anesthetic injection protocol was developed specifically for the cubital tunnel.
• The technique facilitates safe anesthetic delivery within the cubital tunnel space.
• This method aims to provide adequate anesthesia, visualization, and decompression capabilities through a small incision.

Main Results:

• The described method allows for safe and effective local anesthetic administration within the cubital tunnel.
• It provides sufficient visualization for the surgeon to perform the decompression.
• The technique enables addressing multiple sites of ulnar nerve compression through a single, minimal incision.

Conclusions:

• A two-stage local anesthetic injection method is presented as a solution for wide-awake endoscopic cubital tunnel release.
• This technique overcomes previous technical challenges, offering improved patient comfort and surgical outcomes.
• It facilitates minimally invasive decompression of the ulnar nerve at the elbow with enhanced visualization and efficiency.