Carpal tunnel release (CTR) was historically performed in the operating theatre under
regional or even general anaesthetic. The majority are now completed with local anaesthetic
(LA) as a day case procedure. Performing CTR as simply as possible (i.e., in an outpatient
setting) streamlines provision in-line with a global need to better utilise healthcare
resources to match demand. Tourniquet use for CTR facilitates dissection; however,
not only is this uncomfortable, it requires an assistant and equipment not necessarily
available in minor operation rooms. The concept of ‘wide awake’ surgery has been adopted
variably in plastic surgery units, and proponents cite increased operative efficiency,
higher turnover, and reduced patient discomfort.
1
Also known as WALANT, or Wide Awake Local Anaesthetic No Tourniquet,
we aimed to compare this technique to the ‘standard’ use of LA and tourniquet (LAT);
in particular assessing patient discomfort, satisfaction and efficacy.To read this article in full you will need to make a payment
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References
- Transition to total one-stop wide-awake hand surgery service-audit: a retrospective review.J R Soc Med Short Rep. 2012; 3: 1-9
- Wide awake hand surgery.CRC Press, 2016
- Perceived comfort during minor hand surgeries with wide awake local anaesthesia no tourniquet (WALANT) versus local anesthesia (LA)/tourniquet.J Orthop Surg. 2017; 25: 1-4
- Pain and outcomes of carpal tunnel release under local anaesthetic with or without a tourniquet: a randomized controlled trial.JHSE. 2018; 43: 808-812
Article info
Publication history
Published online: May 21, 2019
Accepted:
May 16,
2019
Received:
April 25,
2019
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved.
