Stuart Cannell, Louis Charles Castel, Thomas Gregory, Romain Allard
{"title":"Is WALANT anesthesia safe and comfortable in emergency hand surgery?","authors":"Stuart Cannell, Louis Charles Castel, Thomas Gregory, Romain Allard","doi":"10.1016/j.hansur.2025.102127","DOIUrl":null,"url":null,"abstract":"<div><div>The use of Wide-Awake Local Anesthesia No Tourniquet (WALANT) is well documented in elective surgery but remains understudied in emergency hand surgery. The emergency setting presents distinct challenges, including preoperative pain, patient stress, and inflamed or damaged soft tissue. This study aims to evaluate the efficacy and safety of the WALANT procedure for soft tissue and bone surgery in acute hand and wrist injuries. A prospective cohort study was conducted, involving 245 hand injuries in 207 patients. Pain scores during injection were 3.7/10 for wounds and 3.8/10 for bone procedures. Pain scores during surgery were 1.6 for wounds and 2.8 for bone procedures. Over 96% of patients reported being satisfied or very satisfied with the procedure. No complications were observed. These results suggest that WALANT is a safe and well-tolerated technique for emergency hand surgery, yielding high patient satisfaction.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"44 2","pages":"Article 102127"},"PeriodicalIF":0.9000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hand Surgery & Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468122925000490","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
The use of Wide-Awake Local Anesthesia No Tourniquet (WALANT) is well documented in elective surgery but remains understudied in emergency hand surgery. The emergency setting presents distinct challenges, including preoperative pain, patient stress, and inflamed or damaged soft tissue. This study aims to evaluate the efficacy and safety of the WALANT procedure for soft tissue and bone surgery in acute hand and wrist injuries. A prospective cohort study was conducted, involving 245 hand injuries in 207 patients. Pain scores during injection were 3.7/10 for wounds and 3.8/10 for bone procedures. Pain scores during surgery were 1.6 for wounds and 2.8 for bone procedures. Over 96% of patients reported being satisfied or very satisfied with the procedure. No complications were observed. These results suggest that WALANT is a safe and well-tolerated technique for emergency hand surgery, yielding high patient satisfaction.
期刊介绍:
As the official publication of the French, Belgian and Swiss Societies for Surgery of the Hand, as well as of the French Society of Rehabilitation of the Hand & Upper Limb, ''Hand Surgery and Rehabilitation'' - formerly named "Chirurgie de la Main" - publishes original articles, literature reviews, technical notes, and clinical cases. It is indexed in the main international databases (including Medline). Initially a platform for French-speaking hand surgeons, the journal will now publish its articles in English to disseminate its author''s scientific findings more widely. The journal also includes a biannual supplement in French, the monograph of the French Society for Surgery of the Hand, where comprehensive reviews in the fields of hand, peripheral nerve and upper limb surgery are presented.
Organe officiel de la Société française de chirurgie de la main, de la Société française de Rééducation de la main (SFRM-GEMMSOR), de la Société suisse de chirurgie de la main et du Belgian Hand Group, indexée dans les grandes bases de données internationales (Medline, Embase, Pascal, Scopus), Hand Surgery and Rehabilitation - anciennement titrée Chirurgie de la main - publie des articles originaux, des revues de la littérature, des notes techniques, des cas clinique. Initialement plateforme d''expression francophone de la spécialité, la revue s''oriente désormais vers l''anglais pour devenir une référence scientifique et de formation de la spécialité en France et en Europe. Avec 6 publications en anglais par an, la revue comprend également un supplément biannuel, la monographie du GEM, où sont présentées en français, des mises au point complètes dans les domaines de la chirurgie de la main, des nerfs périphériques et du membre supérieur.