急诊手外科手术中WALANT麻醉安全舒适吗？

IF 0.9 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation Pub Date : 2025-04-01 DOI:10.1016/j.hansur.2025.102127

Stuart Cannell, Louis Charles Castel, Thomas Gregory, Romain Allard

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引用次数: 0

摘要

广角清醒局麻无止血带（WALANT）在选择性手术中的应用已有文献记载，但在紧急手外科手术中的应用仍有待研究。急诊环境提出了不同的挑战，包括术前疼痛，患者压力，发炎或受损的软组织。本研究旨在评估WALANT手术在急性手部和腕部损伤的软组织和骨骼手术中的有效性和安全性。进行了一项前瞻性队列研究，涉及207例患者的245例手部损伤。注射时伤口疼痛评分为3.7/10，骨手术疼痛评分为3.8/10。手术期间伤口疼痛评分为1.6分，骨手术疼痛评分为2.8分。超过96%的患者对手术表示满意或非常满意。无并发症发生。这些结果表明，WALANT是一种安全且耐受性良好的紧急手部手术技术，患者满意度高。

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Is WALANT anesthesia safe and comfortable in emergency hand surgery?

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.

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来源期刊

Hand Surgery & Rehabilitation Medicine-Surgery

CiteScore

1.70

自引率

27.30%

发文量

审稿时长

49 days

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.