Dataset Information

Plating Distal Radius Fractures Using Wide-Awake Local Anesthesia No Tourniquet (WALANT) Versus General Anesthesia: A Cohort Study.

ABSTRACT:

Purpose

This study compared outcomes of plating distal radius (DR) fractures using wide-awake local anesthesia no tourniquet (WALANT) versus general anesthesia (GA).

Methods

From March 2018 to March 2019, 20 patients with DR fracture underwent plating using WALANT whereas 20 patients who underwent plating under GA were used as controls. Outcomes evaluated were pain control, waiting time for the operation, hemodynamic changes, blood loss, the occurrence of adverse effects of medications used in WALANT and GA, and the duration of postoperative stay.

Results

The WALANT group experienced a significantly shorter waiting time for surgery (6 vs 20 days; P < .001) and a shorter postoperative stay (1 vs 2 days; P = .009) compared with the GA group. They also reported mild to no pain during surgery. The groups were similar with regard to blood pressure, blood loss, and operative time. None in the WALANT group required conversion to GA during surgery and no adverse effects were reported.

Conclusions

The WALANT approach is a viable alternative to GA for plating of DR fractures.

Type of study/level of evidence

Therapeutic III.

SUBMITTER: Yi LM

PROVIDER: S-EPMC8991627 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Publications

Plating Distal Radius Fractures Using Wide-Awake Local Anesthesia No Tourniquet (WALANT) Versus General Anesthesia: A Cohort Study.

Yi Liew Mei LM Ahmad Amir Adham AA Ruslan Shairil Rahayu SR Abdullah Shalimar S Ahmad Abdul Rauf AR

Journal of hand surgery global online 20201018 6

<h4>Purpose</h4>This study compared outcomes of plating distal radius (DR) fractures using wide-awake local anesthesia no tourniquet (WALANT) versus general anesthesia (GA).<h4>Methods</h4>From March 2018 to March 2019, 20 patients with DR fracture underwent plating using WALANT whereas 20 patients who underwent plating under GA were used as controls. Outcomes evaluated were pain control, waiting time for the operation, hemodynamic changes, blood loss, the occurrence of adverse effects of medica ...[more]

PMID: 35415527

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Project description:BackgroundDistal radius fractures (DRF) are frequently treated with internal fixation under general anesthesia or a brachial plexus block. Recently, the wide-awake local anesthesia with no tourniquet (WALANT) technique has been suggested as a method that results in higher patient satisfaction. This study aimed to evaluate the functional outcomes, complications, and patient-reported outcomes of DRF plating surgery under both the WALANT and balanced anesthesia (BA).MethodsNinety-three patients with DRFs who underwent open reduction and plating were included. Regarding the anesthetic technique, 38 patients received WALANT, while 55 received BA, comprised of multimodal pain control brachial plexus anesthesia with light general support. The patient's overall satisfaction in both groups and the intraoperative numerical rating scale of pain and anxiety (0-10) in the WALANT group were recorded. The peri-operative radiographic parameters were measured; the clinical outcomes, including Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, wrist mobility, and grip strength, were recorded in up to 1-year follow-up. Results presented with a mean difference and 95% confidence intervals and mean ± standard deviation.ResultsThe mean age of patients in the WALANT group was higher than in the BA group (63 ± 17 vs. 54 ± 17, P = 0.005), and there were fewer intra-articular DRF fractures in the WALANT group than in the BA group (AO type A/B/C: 30/3/5 vs. 26/10/19, P = 0.009). The reduction and plating quality were similar in both groups. The clinical outcomes at follow-up were comparable between the two groups, except the WALANT group had worse postoperative 3-month pronation (88% vs. 96%; - 8.0% [ - 15.7 to - 0.2%]) and 6-month pronation (92% vs. 100%; - 9.1% [ - 17.0 to - 1.2%]), and better postoperative 1-year flexion (94% vs. 82%; 12.0% [2.0-22.1%]). The overall satisfaction was comparable in the WALANT and BA groups (8.7 vs. 8.5; 0.2 [ - 0.8 to 1.2]). Patients in the WALANT group reported an injection pain scale of 1.7 ± 2.0, an intraoperative pain scale of 1.2 ± 1.9, and an intraoperative anxiety scale of 2.3 ± 2.8.ConclusionThe reduction quality, functional outcomes, and overall satisfaction were comparable between the WALANT and BA groups. With meticulous preoperative planning, the WALANT technique could be an alternative for DRF plating surgery in selected patients. Trial registration This retrospective study was approved by the Institutional Review Board of Kaohsiung Medical University Hospital (KMUHIRB-E(I)-20210201).

Dataset Information

Plating Distal Radius Fractures Using Wide-Awake Local Anesthesia No Tourniquet (WALANT) Versus General Anesthesia: A Cohort Study.

Purpose

Methods

Results

Conclusions

Type of study/level of evidence

Publications

Plating Distal Radius Fractures Using Wide-Awake Local Anesthesia No Tourniquet (WALANT) Versus General Anesthesia: A Cohort Study.

Similar Datasets

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