WALANT versus intravenous regional anesthesia for carpal tunnel syndrome: a randomized clinical trial

BACKGROUND: There are several anesthetic techniques for surgical treatment of carpal tunnel syndrome (CTS). Results from this surgery using the “wide awake local anesthesia no tourniquet” (WALANT) technique have been described. However, there is no conclusive evidence regarding the effectiveness of...

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Autores: Okamura, Aldo, Moraes, Vinicius Ynoe de, Fernandes, Marcela, Raduan-Neto, Jorge, Belloti, João Carlos
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:Brasil
Institución:Associação Paulista de Medicina
Repositorio:São Paulo medical journal (Online)
Idioma:inglés
OAI Identifier:oai:ojs.diagnosticoetratamento.emnuvens.com.br:article/542
Acceso en línea:https://periodicosapm.emnuvens.com.br/spmj/article/view/542
Access Level:acceso abierto
Palabra clave:Carpal tunnel syndrome
Clinical trial [publication type]
Anesthesia, local
Effectiveness
General surgery
Median nerve
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spelling WALANT versus intravenous regional anesthesia for carpal tunnel syndrome: a randomized clinical trialCarpal tunnel syndromeClinical trial [publication type]Anesthesia, localEffectivenessGeneral surgeryMedian nerveBACKGROUND: There are several anesthetic techniques for surgical treatment of carpal tunnel syndrome (CTS). Results from this surgery using the “wide awake local anesthesia no tourniquet” (WALANT) technique have been described. However, there is no conclusive evidence regarding the effectiveness of the WALANT technique, compared with the usual techniques. OBJECTIVE: To evaluate the effectiveness of the WALANT technique, compared with intravenous regional anesthesia (IVRA; Bier’s block), for surgical treatment of CTS. DESIGN AND SETTING: Randomized clinical trial, conducted at Hospital Alvorada Moema and the Discipline of Hand Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil. METHODS: Seventy-eight patients were included. The primary outcome was measurement of perioperative pain through a visual analogue scale (VAS). The secondary outcomes were the Boston Questionnaire score, Hospital Anxiety and Depression Scale (HADS) score, need for use of analgesics, operating room times, remission of paresthesia, failures and complications. RESULTS: The WALANT technique (n = 40) proved to be superior to IVRA (n = 38), especially for controlling intraoperative pain (0.11 versus 3.7 cm; P < 0.001) and postoperative pain (0.6 versus 3.9 cm; P < 0.001). Patients spent more time in the operating room in the IVRA group (59.5 versus 46 minutes; P < 0.01) and needed to use more analgesics (10.8 versus 5.7 dipyrone tablets; P = 0.02). Five IVRA procedures failed (5 versus 0; P = 0.06). CONCLUSIONS: The WALANT technique is more effective than IVRA for CTS surgery. TRIAL REGISTRY: NCT02986347. Clinical Question/ Level of Evidence: Therapeutic, II.São Paulo Medical JournalSão Paulo Medical Journal2021-11-04info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://periodicosapm.emnuvens.com.br/spmj/article/view/542São Paulo Medical Journal; Vol. 139 No. 6 (2021); 576-582São Paulo Medical Journal; v. 139 n. 6 (2021); 576-5821806-9460reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APMenghttps://periodicosapm.emnuvens.com.br/spmj/article/view/542/487https://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessOkamura, AldoMoraes, Vinicius Ynoe deFernandes, MarcelaRaduan-Neto, JorgeBelloti, João Carlos2023-10-05T12:11:08Zoai:ojs.diagnosticoetratamento.emnuvens.com.br:article/542Revistahttp://www.scielo.br/spmjPUBhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2023-10-05T12:11:08São Paulo medical journal (Online) - Associação Paulista de Medicinafalse
dc.title.none.fl_str_mv WALANT versus intravenous regional anesthesia for carpal tunnel syndrome: a randomized clinical trial
title WALANT versus intravenous regional anesthesia for carpal tunnel syndrome: a randomized clinical trial
spellingShingle WALANT versus intravenous regional anesthesia for carpal tunnel syndrome: a randomized clinical trial
Okamura, Aldo
Carpal tunnel syndrome
Clinical trial [publication type]
Anesthesia, local
Effectiveness
General surgery
Median nerve
title_short WALANT versus intravenous regional anesthesia for carpal tunnel syndrome: a randomized clinical trial
title_full WALANT versus intravenous regional anesthesia for carpal tunnel syndrome: a randomized clinical trial
title_fullStr WALANT versus intravenous regional anesthesia for carpal tunnel syndrome: a randomized clinical trial
title_full_unstemmed WALANT versus intravenous regional anesthesia for carpal tunnel syndrome: a randomized clinical trial
title_sort WALANT versus intravenous regional anesthesia for carpal tunnel syndrome: a randomized clinical trial
dc.creator.none.fl_str_mv Okamura, Aldo
Moraes, Vinicius Ynoe de
Fernandes, Marcela
Raduan-Neto, Jorge
Belloti, João Carlos
author Okamura, Aldo
author_facet Okamura, Aldo
Moraes, Vinicius Ynoe de
Fernandes, Marcela
Raduan-Neto, Jorge
Belloti, João Carlos
author_role author
author2 Moraes, Vinicius Ynoe de
Fernandes, Marcela
Raduan-Neto, Jorge
Belloti, João Carlos
author2_role author
author
author
author
dc.subject.por.fl_str_mv Carpal tunnel syndrome
Clinical trial [publication type]
Anesthesia, local
Effectiveness
General surgery
Median nerve
topic Carpal tunnel syndrome
Clinical trial [publication type]
Anesthesia, local
Effectiveness
General surgery
Median nerve
description BACKGROUND: There are several anesthetic techniques for surgical treatment of carpal tunnel syndrome (CTS). Results from this surgery using the “wide awake local anesthesia no tourniquet” (WALANT) technique have been described. However, there is no conclusive evidence regarding the effectiveness of the WALANT technique, compared with the usual techniques. OBJECTIVE: To evaluate the effectiveness of the WALANT technique, compared with intravenous regional anesthesia (IVRA; Bier’s block), for surgical treatment of CTS. DESIGN AND SETTING: Randomized clinical trial, conducted at Hospital Alvorada Moema and the Discipline of Hand Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil. METHODS: Seventy-eight patients were included. The primary outcome was measurement of perioperative pain through a visual analogue scale (VAS). The secondary outcomes were the Boston Questionnaire score, Hospital Anxiety and Depression Scale (HADS) score, need for use of analgesics, operating room times, remission of paresthesia, failures and complications. RESULTS: The WALANT technique (n = 40) proved to be superior to IVRA (n = 38), especially for controlling intraoperative pain (0.11 versus 3.7 cm; P < 0.001) and postoperative pain (0.6 versus 3.9 cm; P < 0.001). Patients spent more time in the operating room in the IVRA group (59.5 versus 46 minutes; P < 0.01) and needed to use more analgesics (10.8 versus 5.7 dipyrone tablets; P = 0.02). Five IVRA procedures failed (5 versus 0; P = 0.06). CONCLUSIONS: The WALANT technique is more effective than IVRA for CTS surgery. TRIAL REGISTRY: NCT02986347. Clinical Question/ Level of Evidence: Therapeutic, II.
publishDate 2021
dc.date.none.fl_str_mv 2021-11-04
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://periodicosapm.emnuvens.com.br/spmj/article/view/542
url https://periodicosapm.emnuvens.com.br/spmj/article/view/542
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://periodicosapm.emnuvens.com.br/spmj/article/view/542/487
dc.rights.driver.fl_str_mv https://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv São Paulo Medical Journal
São Paulo Medical Journal
publisher.none.fl_str_mv São Paulo Medical Journal
São Paulo Medical Journal
dc.source.none.fl_str_mv São Paulo Medical Journal; Vol. 139 No. 6 (2021); 576-582
São Paulo Medical Journal; v. 139 n. 6 (2021); 576-582
1806-9460
reponame:São Paulo medical journal (Online)
instname:Associação Paulista de Medicina
instacron:APM
instname_str Associação Paulista de Medicina
instacron_str APM
institution APM
reponame_str São Paulo medical journal (Online)
collection São Paulo medical journal (Online)
repository.name.fl_str_mv São Paulo medical journal (Online) - Associação Paulista de Medicina
repository.mail.fl_str_mv revistas@apm.org.br
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score 15.300724

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