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ʻWALANT carpal tunnel release: Technical considerations and pain outcomesʼ

      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.
      • Bismil M.S.K.
      • Bismil Q.M.K.
      • Harding D.
      • Harris P.
      • Lamyman E.
      • Sansby L.
      Transition to total one-stop wide-awake hand surgery service-audit: a retrospective review.
      Also known as WALANT, or Wide Awake Local Anaesthetic No Tourniquet,
      • Lalonde D.
      Wide awake hand surgery.
      we aimed to compare this technique to the ‘standard’ use of LA and tourniquet (LAT); in particular assessing patient discomfort, satisfaction and efficacy.
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      References

        • Bismil M.S.K.
        • Bismil Q.M.K.
        • Harding D.
        • Harris P.
        • Lamyman E.
        • Sansby L.
        Transition to total one-stop wide-awake hand surgery service-audit: a retrospective review.
        J R Soc Med Short Rep. 2012; 3: 1-9
        • Lalonde D.
        Wide awake hand surgery.
        CRC Press, 2016
        • Gunasagaran J.
        • Sean E.S.
        • Shivdas S.
        • Amir S.
        • Ahmad T.S.
        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
        • Iqbal H.J.
        • Doorgakant A.
        • Rehmatullah N.N.T.
        • Ramavath A.L.
        • Pidikiti P.
        • Lipscombe S.
        Pain and outcomes of carpal tunnel release under local anaesthetic with or without a tourniquet: a randomized controlled trial.
        JHSE. 2018; 43: 808-812