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Document Type

Original Article

Abstract

Background: Hand surgery under general or local anaesthesia with a tourniquet application has been changed in recent years. Wide-Awake Local Anaesthetic No Tourniquet (WALANT) involves the patient wide awake, local anaesthetic, often combined with epinephrine, and without tourniquet utilisation.

Aim of the work: Investigate the safety and efficiency of wide-awake local anaesthesia with no tourniquet in hand surgery.

Patient and methods: This study was a prospective observative study that has been conducted at the plastic surgery department, El-Hussin hospital, Al Azhar university from April 2021 till September 2022. Thirty patients are included in this study (24 male and 6 female) by using WALANT mixture (1ml epinephrine,50 ml lidocaine 2%, 50 ml normal saline and 10 ml 8.4%sodium bicarbonate). Intraoperative assessment of pain by using visual analogue scale (VAS) and monitoring of vital signs, assessment of epinephrine efficiency by number of blood socked gauzes, assessment of duration lidocaine effect, assessment of any signs or symptoms of toxicity of epinephrine and lidocaine.

Results: There were not any symptoms or signs of lidocaine toxicity or local digital ischemia to all patients. Objective assessment of pain through vital signs was at normal range furthermore, VAS score was ranged between 0-1 with mean 0.13±0.346. number of blood socked gauzes was ranged between 2-5 gauzes; the duration of lidocaine effect ranged from 3-6 hours.

Conclusion: WALANT technique was safe and efficient for patients. It is another tool in hand surgeries for a bloodless surgical field.

Keywords

WALANT; Epinephrine; Hand surgery.

Subject Area

Plastic surgery

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