Wide-Awake Local Anesthesia No Tourniquet in hand surgery: A systematic review and meta-analysis

IF 1 4区医学 Q4 ORTHOPEDICS Hand Surgery & Rehabilitation Pub Date : 2024-10-01 Epub Date: 2024-09-23 DOI:10.1016/j.hansur.2024.101778

Hugo Zimmermann , Cyril Quemeneur , Thibaut Goetsch , Frédéric Le Saché , Sébastien Bloc

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Abstract

WALANT (Wide Awake Local Anesthesia No Tourniquet) has been widely implemented in hand surgery. We conducted a systematic review from 1979 to 2022, led by a team of anesthesiologist. Only randomized studies comparing WALANT to other types of regional anesthesia were included. The outcomes studied were pain, duration of the procedure, intraoperative bleeding, complications, and patient satisfaction. Twelve articles were included in the analysis. We found a reduction of 2.77 on the VAS (95% CI −3.79; −1.75, I² 93%) for intraoperative pain in the WALANT group. There was no significant difference (MD 0.79, 95% CI 95% −0.11; 1.69, I² 73%) for duration of surgery. Patient satisfaction was consistently high in the WALANT group. Intraoperative bleeding was minimal and not clinically relevant. Compared to other types of regional anesthesia in hand surgery, the WALANT technique decreases pain for the patients without increasing the length of surgery.

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手外科手术中的 Walant：系统回顾和荟萃分析。

WALANT（宽醒局部麻醉无止血带）已在手外科手术中广泛实施。我们在麻醉师团队的领导下，对 1979 年至 2022 年期间的研究进行了系统性回顾。只纳入了将 WALANT 与其他类型区域麻醉进行比较的随机研究。研究结果包括疼痛、手术持续时间、术中出血、并发症和患者满意度。分析共纳入了 12 篇文章。我们发现 WALANT 组术中疼痛的 VAS 值降低了 2.77（95% CI -3.79；-1.75，I² 93%）。手术持续时间无明显差异（MD 0.79，95% CI 95% -0.11；1.69，I² 73%）。WALANT 组患者的满意度一直很高。术中出血量极少，与临床无关。与其他类型的手部手术区域麻醉相比，WALANT技术在不增加手术时间的情况下减轻了患者的疼痛。

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来源期刊

Hand Surgery & Rehabilitation Medicine-Surgery

CiteScore

1.70

自引率

27.30%

发文量

审稿时长

49 days

期刊介绍： As the official publication of the French, Belgian and Swiss Societies for Surgery of the Hand, as well as of the French Society of Rehabilitation of the Hand & Upper Limb, ''Hand Surgery and Rehabilitation'' - formerly named "Chirurgie de la Main" - publishes original articles, literature reviews, technical notes, and clinical cases. It is indexed in the main international databases (including Medline). Initially a platform for French-speaking hand surgeons, the journal will now publish its articles in English to disseminate its author''s scientific findings more widely. The journal also includes a biannual supplement in French, the monograph of the French Society for Surgery of the Hand, where comprehensive reviews in the fields of hand, peripheral nerve and upper limb surgery are presented. Organe officiel de la Société française de chirurgie de la main, de la Société française de Rééducation de la main (SFRM-GEMMSOR), de la Société suisse de chirurgie de la main et du Belgian Hand Group, indexée dans les grandes bases de données internationales (Medline, Embase, Pascal, Scopus), Hand Surgery and Rehabilitation - anciennement titrée Chirurgie de la main - publie des articles originaux, des revues de la littérature, des notes techniques, des cas clinique. Initialement plateforme d''expression francophone de la spécialité, la revue s''oriente désormais vers l''anglais pour devenir une référence scientifique et de formation de la spécialité en France et en Europe. Avec 6 publications en anglais par an, la revue comprend également un supplément biannuel, la monographie du GEM, où sont présentées en français, des mises au point complètes dans les domaines de la chirurgie de la main, des nerfs périphériques et du membre supérieur.