Comparison of Spinal Anesthesia and Wide-Awake Local Anesthesia No Tourniquet in Hallux Valgus Surgery.

Abstract

Purpose: This study investigated whether the Wide-Awake Local Anesthesia No Tourniquet (WALANT) technique, widely used in hand surgery, is safe and acceptable in elective hallux valgus (HV) surgery.

Methods: A total of 83 patients were included in this cross-sectional retrospective study, 38 of whom underwent surgery with WALANT and 45 of whom underwent surgery with spinal anesthesia (SA). The 2 groups were compared regarding demographic data, clinical results, and radiological outcomes.

Results: Preoperative preparation time and hospital stay were shorter in the WALANT group compared to the SA group. Visual analogue scale (VAS) values at the first, sixth, and 72nd hours after surgery were lower in the WALANT group. Intraoperative VAS-Anxiety (VAS-A) values were higher in the WALANT group, while postoperative VAS-A values at the sixth hour were lower. In the WALANT group, American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Rating System (AOFAS Hallux MT-IP) postoperative second-week values were found to be higher and the time to return to work was shorter than in the SA group. The groups had no significant difference regarding other variables.

Conclusion: The WALANT technique in HV surgery is a method that can be easily applied, is safe, and is not inferior to SA in terms of clinical results. The WALANT shortens preoperative patient-preparation time, hospital stay, operating room usage, and return-to-work time after HV surgery. It improves functional and clinical results with low postoperative complication rates.