Wide Awake Local Anesthesia no Tourniquet (WALANT) Surgery for Tendon Repair in Hand Trauma

Abstract

Objective: To compare the functional outcomes in terms of active range of motion for tendon repair surgeries under wideawake local anaesthesia versus general anaesthesia.

Study design: Comparative prospective study.

Place and Duration of Study: Department of Plastic & Reconstructive Surgery, Dr Ruth K.M. Pfau Civil Hospital Karachi Pakistan, from Jan to Sep 2020.

Methodology: Patients of either gender of age 15 years or above with hand injuries with tendon repair required, operated within the hospital premises were included in the study using the non-probability consecutive sampling technique. Individuals who were operated on under wide-awake local anaesthesia were taken as approach arms (n=65). While the patients undergoing tendon repair under general anaesthesia were considered as the study's control arm (n=65). The final functional outcomes were assessed in the sixth week of the surgery by calculating the total active range of motion.

Results: For the range of motion of the injured finger in the general anaesthesia group, 25 (38.5%) had excellent outcomes, 14 (21.5%) had a good outcome, and 8 (12.3%) had fair outcomes, while in the WALANT group, 30 (46.2%) had excellent outcome, 16 (24.6%) had a good outcome and 12 (18.5%) had a fair outcome. There was no relationship between the range of motion of the injured finger and the group (p=0.101).

Conclusion: The functional outcomes in active range of motion are better in the WALANT approach than in general anaesthesia.