WIDE AWAKE LOCAL ANESTHESIA NO TOURNIQUET (WALANT) IN HAND SURGERY - A RETROSPECTIVE STUDY ON 400 CASES

Authors

  • A. AMARANDEI “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
  • Bianca AVADANI “Sf. Spiridon” County Clinical Emergency Hospital Iasi
  • Malek BENAMOR “Sf. Spiridon” County Clinical Emergency Hospital Iasi
  • Andra-Irina BULGARU-ILIESCU ‟Grigore Popa” University of Medicine and Pharmacy Iași
  • Nina FILIP ‟Grigore Popa” University of Medicine and Pharmacy Iași
  • A. FILIP ‟Grigore Popa” University of Medicine and Pharmacy Iași
  • D.C. MORARU ‟Grigore Popa” University of Medicine and Pharmacy Iași
  • Mihaela PERTEA ‟Grigore Popa” University of Medicine and Pharmacy Iași

DOI:

https://doi.org/10.22551/ezwfg759

Abstract

The study aimed to evaluate and confirm the efficacy and safety of WALANT anesthesia in hand surgery. Materials and methods: A retrospective analysis was conducted on 400 hand surgeries performed under WALANT between January 2020 and December 2023. Diseases included carpal tunnel syndrome (CTS), Dupuytren disease (DD), trigger finger (TF), also tendon injuries, phalangeal and metacarpal fractures, and tumor excisions. Data collected included patient demographics, anesthetic dosage, onset time, dilutions, intraoperative incidents (pain, bleeding, discomfort), complications, surgical duration, hospitalization, patient satisfaction (VAS), and functional outcomes (DASH and MHQ scores). Statistical analysis was performed using SPSS version 29.0, with regressions (ANOVA) and Pearson correlation coefficients. Results: The mean hospitalization time was 3.5 hours, with 95% of patients discharged the same day. Complications were low (5%), and functional outcomes improved significantly, with DASH scores improving by 66.7% on average. No cases of digital necrosis or other vascular complications occurred. Conclusions: WALANT is a safe, effective, and resource-efficient technique for hand surgery. It optimizes hospital resources, enhances patient outcomes, minimizes costs, and supports sustainable healthcare. 

Author Biographies

  • A. AMARANDEI, “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania

    Clinic of Plastic Surgery and Reconstructive Microsurgery

  • Bianca AVADANI, “Sf. Spiridon” County Clinical Emergency Hospital Iasi

    Clinic of Plastic Surgery and Reconstructive Microsurgery 

  • Malek BENAMOR, “Sf. Spiridon” County Clinical Emergency Hospital Iasi

    Clinic of Plastic Surgery and Reconstructive Microsurgery 

  • Andra-Irina BULGARU-ILIESCU, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Medicine
    Department of Surgery (I)
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
    Clinic of Plastic Surgery and Reconstructive Microsurgery 

  • Nina FILIP, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Medicine
    Department of Morpho-Functional Sciences (II) 

  • A. FILIP, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Medicine
    Department of Surgery (II)
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
    Clinic of Orthopedics and Traumatology

  • D.C. MORARU, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Medicine
    Department of Surgery (II)
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
    Clinic of Plastic Surgery and Reconstructive Microsurgery 

  • Mihaela PERTEA, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Medicine
    Department of Surgery (I)
    Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
    Clinic of Plastic Surgery and Reconstructive Microsurgery

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Additional Files

Published

2025-04-07

Issue

Vol. 129 No. 1 (2025): The Medical-Surgical Journal

Section

SURGERY

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