Below-knee Amputation with Minimally Painful Injection of Tumescent Local Anesthesia

Area of Science:

• Anesthesiology
• Surgical Procedures
• Public Health

Background:

• Lower limb amputations are often performed on frail patients with multiple comorbidities.
• Traditional amputation procedures may require sedation and tourniquets, posing risks for vulnerable individuals.
• Limited access to safe and affordable sedation services is a challenge in many low-resource settings.

Observation:

• A minimally painful injection of tumescent local anesthesia was successfully administered.
• This technique eliminated the need for a tourniquet and sedation during a below-knee amputation.
• The procedure was performed on a frail patient with multiple medical comorbidities in Mombasa, Kenya.

Findings:

• Wide awake local anesthesia no tourniquet (WALANT) pure local anesthesia is a viable alternative for below-knee amputation.
• The WALANT technique provides effective anesthesia with minimal pain.
• It negates the requirement for tourniquets and sedation, simplifying the surgical procedure.

Implications:

• WALANT can be a safe and effective option for amputations in frail patients, especially in resource-limited areas.
• This approach enhances patient safety by avoiding the risks associated with sedation.
• It offers a cost-effective and accessible solution for limb amputation surgeries globally.