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Is WALANT anesthesia safe and comfortable in emergency hand surgery?
Stuart Cannell1, Louis Charles Castel1, Thomas Gregory1
1Hôpital Avicenne, 125 route de Stalingrad, 93000 Bobigny, France.
Hand Surgery & Rehabilitation
|March 13, 2025
Summary
Wide-Awake Local Anesthesia No Tourniquet (WALANT) is safe and effective for emergency hand surgery. This technique offers high patient satisfaction with minimal pain during procedures for acute hand and wrist injuries.
Area of Science:
- Orthopedic Surgery
- Emergency Medicine
- Anesthesiology
Background:
- Wide-Awake Local Anesthesia No Tourniquet (WALANT) is established in elective procedures.
- Its application in emergency hand surgery is less explored.
- Emergency settings pose unique challenges like pain, stress, and tissue damage.
Purpose of the Study:
- To assess the efficacy and safety of WALANT for acute soft tissue and bone hand/wrist injuries.
- To evaluate patient pain experience and satisfaction with WALANT in emergency settings.
Main Methods:
- Prospective cohort study design.
- Inclusion of 207 patients with 245 acute hand injuries.
- Data collection on pain scores during injection and surgery, and patient satisfaction.
Main Results:
- Low intraoperative pain scores: 1.6/10 for wounds, 2.8/10 for bone procedures.
- High patient satisfaction: Over 96% satisfied or very satisfied.
- No observed complications associated with the WALANT procedure.
Conclusions:
- WALANT is a safe and well-tolerated anesthetic technique for emergency hand surgery.
- The procedure yields high patient satisfaction in acute hand and wrist injury cases.
- WALANT presents a viable option for managing acute hand injuries in emergency settings.
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