Wide Awake Surgery Is Safe and Feasible in Pediatric Orthopaedic Surgery

Area of Science:

• Pediatric Surgery
• Anesthesiology
• Orthopedic Surgery

Background:

• Wide awake local anesthesia no tourniquet (WALANT) offers benefits like reduced costs and waste in adult hand surgery.
• Pediatric application of WALANT is limited by concerns regarding patient anxiety and tolerance.

Purpose of the Study:

• To evaluate the safety, efficiency, and feasibility of the WALANT technique in pediatric patients undergoing upper extremity surgery.
• To compare WALANT with general anesthesia in a pediatric cohort.

Main Methods:

• Retrospective chart review of 223 upper extremity surgeries in patients aged 7-20 years.
• Comparison between 86 patients undergoing WALANT and 76 patients receiving general anesthesia.
• Data collected included demographics, surgical/recovery times, pain scores, and complications.

Main Results:

• WALANT group showed significantly shorter surgery and recovery times than the general anesthesia group.
• Lower pain scores and reduced narcotic prescriptions were observed in the WALANT group.
• No increase in infection rates or complications, and no conversions to monitored anesthesia care were noted.

Conclusions:

• WALANT is a safe, efficient, and feasible anesthetic technique for select pediatric upper extremity surgeries.
• Implementing WALANT in pediatric surgery provides clinical, financial, and environmental advantages for patients and healthcare systems.