Improved Resource Utilization Using WALANT Hand Surgery in Adolescents.

Area of Science:

• Orthopedic Surgery
• Pediatric Surgery
• Anesthesiology

Background:

• Wide awake, local anesthesia, no tourniquet (WALANT) is increasingly used in hand surgery due to cost, efficiency, patient preference, and safety.
• Its application and benefits in adolescent patients are not well-documented.
• This study investigates WALANT's impact on operative and hospital times in pediatric patients.

Purpose of the Study:

• To evaluate the efficiency and perioperative safety of WALANT compared to traditional anesthesia (TA) in adolescent hand surgery.
• To determine if WALANT reduces operating room (OR) and hospital stay duration in patients aged 10-17.
• To assess the feasibility and benefits of WALANT in a pediatric trauma hospital setting.

Main Methods:

• Retrospective review of 56 patients (ages 10-17) undergoing hand surgery.
• Propensity-matched cohort comparison of WALANT versus traditional anesthesia (TA) groups.
• Analysis of operative notes to identify WALANT use, excluding non-amenable procedures.
• Comparison of in-room to procedure time, total room time, and length of hospital stay.

Main Results:

• Operative times were similar between WALANT and TA groups.
• WALANT patients experienced shorter in-room to procedure times (15 vs. 22 minutes) and procedure end to out-room times (5 vs. 10 minutes).
• Total room time (52.81 vs. 63.68 minutes) and length of hospital stay (222 vs. 342 minutes) were significantly shorter for WALANT patients.

Conclusions:

• WALANT in adolescent hand surgery leads to significant time savings in the operating room and overall hospital stay.
• Implementing WALANT where feasible can offer substantial cost savings for healthcare systems, patients, and payers.
• Wider adoption of WALANT can optimize the utilization of anesthesia staff and perioperative nursing resources.