Wide Awake Local Anesthesia No Tourniquet (WALANT) technique improves the efficiency of distal nerve blocks for carpal tunnel release
Authors' conclusion
This combined technique decreases perioperative pain scores, provides good surgery conditions, and reduces the risk of postoperative hematoma.
Study context
- Population
- Patients scheduled for endoscopic carpal tunnel release (endoscopic CTR (eCTR))
- Participants
- 60 patients
- Comparison
- Distal + Walant vs Distal block
- Primary endpoint
- Global pain score (sum of pain scores for puncture, local anesthetic injection, pneumatic tourniquet, surgical procedure, tourniquet deflation and residual sensitivity after surgery)
Methodological detailsopen-label
- Open-label
Primary result
As reported in the abstract
Distal + Walant
0.5
mean · SD 1.4
Distal block
2.2
mean · SD 2.4
P < 0.001
Further findings
| Outcome | Distal + Walant | Distal block | P value |
|---|---|---|---|
| Quality of visualizationHigh in both groups, better in the Distal block group | 4 (range 4–5) | 5 (range 5–5) | P < 0.001 |
Need for additional anesthetic procedure
- No need for an additional anesthetic procedure in the Distal + Walant group
Rescue tourniquet
- No rescue tourniquet necessary in the Distal + Walant group
Safety
Hematoma · 15 days post-surgery · significantly reduced in the Distal + Walant group
P < 0.01
Original publication
Wide Awake Local Anesthesia No Tourniquet (WALANT) technique improves the efficiency of distal nerve blocks for carpal tunnel release. Anaesth Crit Care Pain Med. Published 7 April 2023. doi:10.
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