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CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Wide-Awake Local Anesthesia No Tourniquet in Adolescent Hand Surgery: A Systematic Review
Hannah Polley1, Benjamin Blackman1, John Tristan Cassidy2
1School of Medicine, University of Limerick, Limerick, Ireland.
Purpose:
Wide-awake local anesthesia no tourniquet (WALANT) allows for intraoperative assessment of function while minimizing systemic anesthesia effects and is frequently used in adult hand surgery. However, the safety and feasibility of WALANT in adolescents remains uncertain because of potential challenges with adherence and cooperation. This review aimed to compile the evidence for using WALANT in adolescents.
Methods:
PubMed, Medline, Embase, and Scopus were searched from inception to December 2024. Comparative and cohort studies were included. Outcomes, including procedure time, length of hospital stay, and pain scores, were analyzed. Because of the heterogeneity of outcomes investigated, a narrative review was performed.
Results:
Four studies, three case-control studies (n = 287) and one case series (n = 6), involving 166 WALANT surgeries were included. The mean age across all patients, including WALANT and control, was 14, with a range of 7-20 years old. The most common WALANT procedures were tendon repair (22.3%, n = 37) and ganglion removal (22.3%, n = 37), followed by digital nerve repair (18.1%, n = 30). One conversion (0.6%) to a general anesthetic was reported.
Conclusions:
Current evidence on the utilization of WALANT in adolescents is limited; WALANT may reduce procedure time, length of hospital stay, and improve pain scores.Type of study/level of evidence: Therapeutic IV.
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