do Rosario Saraiva M, Vázquez OS, Ortiz-Huerta JH, Santamaría-Vázquez M. The wide-awake local anesthesia no tourniquet (WALANT) technique in thumb injuries: a systematic review.
Eur J Trauma Emerg Surg 2024:10.1007/s00068-024-02579-8. [PMID:
38967789 DOI:
10.1007/s00068-024-02579-8]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 06/10/2024] [Indexed: 07/06/2024]
Abstract
Human hands have a complex anatomical structure. The thumb, being an integral part of the hand, has an essential function in gripping. In this sense, thumb fractures account for 4% of all hand fractures (it may occur in association with fractures of the trapezium). The majority of hand fractures should be treated non-surgically and surgeons must avoid unnecessary surgery. Historically, hand surgery has used a combination of local/regional/general anaesthesia and a tourniquet. This study aims to carry out a systematic review to determine whether the WALANT technique is an advantageous alternative to conventional anaesthesia for surgical procedures on thumb injuries, in terms of patient function and pain.
METHOD
We conducted a search in the following databases: Pubmed/Medline, EBSCOhost, Web of Science, Scopus, ScienceDirect and Google Scholar, using the equation "WALANT" OR "Wide Awake Local Anesthesia No Tourniquet" AND "thumb pathology".
RESULTS
In five of the 584 articles included, two studied trapeziometacarpal osteoarthritis, one De Quervain's disease and the remaining two flexor injuries. WALANT showed good results in active movements, but with similar levels of pain between anaesthetics. Patients were more anxious during general anaesthesia, plus the fact that they were fasting and suspending medication.
CONCLUSION
WALANT is a convenient and favourable option in several studies. It has been demonstrated the benefits in terms of return to function and pain.
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