WALANT Special Issue
Intraoperative Active Motion Confirmation During Wide-Awake Local Anesthesia No Tourniquet SurgeryAs a recent advance in the field of hand surgery, the wide-awake local anesthesia no tourniquet surgical technique—performed using an epinephrine-containing local anesthetic without a tourniquet while the patient is awake—has attracted attention. The wide-awake local anesthesia no tourniquet technique has been indicated for surgeries such as trigger release, soft tissue tumor excision, surgery for Dupuytren contracture, thumb carpometacarpal arthroplasty, or any other tendon, nerve, or ligament surgeries, requiring intraoperative active motion confirmation.
How to Start WALANT Practice in South Africa: “Service With a Smile if You Are Willing to Wait Awhile.”Wide-awake local anesthesia no tourniquet (WALANT) hand surgery at 1 Military Hospital in South Africa resulted in a positive patient experience and beneficial financial outcomes in an economically constrained environment. Using the WALANT technique also effectively reduced the waiting time for elective surgery, which is considered to be synonymous with improvement in the public health sector in South Africa. Elderly patients and those medically unfit for general anesthesia successfully underwent WALANT surgery and returned to daily activities.
Economic and Environmental Impacts of the Wide-Awake, Local Anesthesia, No Tourniquet (WALANT) Technique in Hand Surgery: A Review of the LiteratureThe United States spends more on health care than any other country in the world based on the percentage of gross domestic product. This fact is coupled with health care facilities contributing nearly one-tenth of all greenhouse gas emissions in the United States, and with the health care industry’s waste contributions to landfills being second only to those of the food industry. In some instances, operating rooms produce the majority of total landfill waste from hospitals; therefore, patients undergoing surgical procedures can have both financial and environmental impacts.
Effective Things Surgeons Can Tell Patients During Wide-Awake Local Anesthesia No Tourniquet Surgery to Decrease Complications and Improve OutcomesSurgeons are familiar with surgical technique articles that provide step-by-step details of various surgical procedures relevant to clinical practice. This article is a communications technique article that provides step-by-step things that a surgeon can say to a wide-awake patient during the surgery to improve outcomes in clinical practice. The absence of anamnestic sedation enables memorable patient education from their surgeon to decrease the risk of postoperative complications.
The Impact of Intraoperative Nursing Care on Perioperative Complications During Wide-Awake Local Anesthesia Hand SurgeryThe wide-awake local anesthesia technique in hand surgery is widely used, but there are currently no guidelines or protocols for the number of operating room personnel required to optimize patient safety intraoperatively. This study aimed to evaluate perioperative complication rates of wide-awake local anesthesia hand surgeries performed at surgery centers that used different numbers of operating room nurses.