Impact of WALANT Hand Surgery in a Secondary Care Hospital in Spain. Benefits to the Patient and the Health System.

Purpose: The aim of this study is to compare patient benefits and economic costs of hand surgeries using the wide-awake local anesthesia no tourniquet (WALANT) technique versus a conventional major outpatient suite and review outcomes and complications in a series of cases of patients operated on us...

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Autores: Far-Riera, Aina, Perez-Uribarri, Carlos, Esteras Serrano, Matias José, Rapariz, José María
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/24946
Acceso en línea:https://hdl.handle.net/20.500.13003/24946
Access Level:acceso abierto
Palabra clave:Carpal Tunnel Syndrome
Trigger Finger Disorder
Traumatology
Hand Injuries
Síndrome del Túnel Carpiano
Trastorno del Dedo en Gatillo
Traumatología
Traumatismos de la Mano
Carpal tunnel syndrome
Hand surgery
Nerve
Peripheral
Trigger finger
Visual Analogue Scale
WALANT
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spelling Impact of WALANT Hand Surgery in a Secondary Care Hospital in Spain. Benefits to the Patient and the Health System.Far-Riera, AinaPerez-Uribarri, CarlosEsteras Serrano, Matias JoséRapariz, José MaríaCarpal Tunnel SyndromeTrigger Finger DisorderTraumatologyHand InjuriesSíndrome del Túnel CarpianoTrastorno del Dedo en GatilloTraumatologíaTraumatismos de la ManoCarpal tunnel syndromeHand surgeryNervePeripheralTrigger fingerVisual Analogue ScaleWALANTPurpose: The aim of this study is to compare patient benefits and economic costs of hand surgeries using the wide-awake local anesthesia no tourniquet (WALANT) technique versus a conventional major outpatient suite and review outcomes and complications in a series of cases of patients operated on using the WALANT technique. Methods: A prospective cohort study was first conducted comparing 150 cases of ambulatory hand surgery (carpal tunnel syndrome and trigger finger) using the WALANT technique and not requiring an operating room setting with 150 cases of outpatient surgery performed in an operating room involving a preoperative evaluation and the use of sedation and tourniquet. Preoperative, intraoperative, and postoperative pain was monitored, and days requiring postoperative analgesia were recorded. The resources and costs were evaluated. and patient satisfaction was assessed using a specific survey.Subsequently, 580 patient medical records were retrospectively reviewed, including 419 carpal tunnel syndrome and 197 trigger finger interventions (616 WALANT surgeries). Results: Intraoperative pain was equivalent for both groups, and postoperative pain was significantly lower in the WALANT group, with a reduced need for analgesics. Satisfaction was greater for the local anesthesia group. The use of personnel resources and hospital materials was reduced in the WALANT group, with a total estimated cost savings of 1.019 USD per patient.There were no complications related to the WALANT technique and the lidocaine and adrenaline combination. We found a complication rate of 5.58%, and, in line with the literature, most complications were minor, managed conservatively, and not related to the anesthetic technique. Conclusions: Procedures such as carpal tunnel and trigger finger surgeries can be safely performed using wide-awake surgery. Patient satisfaction is higher than with the conventional procedure performed in the operating room. Pain control is excellent, especially during the postoperative period. Clinical relevance: Hand surgery patients benefit from the WALANT technique in terms of comfort and timeliness because there is no need for preoperative tests or evaluations. In addition, it represents significant savings in hospital resources. In our case series, complications were in line with those previously reported with other anesthetic techniques.Elsevier20222022-01-0120222022-01-01research articlehttp://purl.org/coar/resource_type/c_2df8fbb1info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.13003/24946reponame:Docusalutinstname:Conselleria de Salut i Consum del Govern de les Illes BalearsInglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:docusalut.com:20.500.13003/249462026-06-22T12:44:07Z
dc.title.none.fl_str_mv Impact of WALANT Hand Surgery in a Secondary Care Hospital in Spain. Benefits to the Patient and the Health System.
title Impact of WALANT Hand Surgery in a Secondary Care Hospital in Spain. Benefits to the Patient and the Health System.
spellingShingle Impact of WALANT Hand Surgery in a Secondary Care Hospital in Spain. Benefits to the Patient and the Health System.
Far-Riera, Aina
Carpal Tunnel Syndrome
Trigger Finger Disorder
Traumatology
Hand Injuries
Síndrome del Túnel Carpiano
Trastorno del Dedo en Gatillo
Traumatología
Traumatismos de la Mano
Carpal tunnel syndrome
Hand surgery
Nerve
Peripheral
Trigger finger
Visual Analogue Scale
WALANT
title_short Impact of WALANT Hand Surgery in a Secondary Care Hospital in Spain. Benefits to the Patient and the Health System.
title_full Impact of WALANT Hand Surgery in a Secondary Care Hospital in Spain. Benefits to the Patient and the Health System.
title_fullStr Impact of WALANT Hand Surgery in a Secondary Care Hospital in Spain. Benefits to the Patient and the Health System.
title_full_unstemmed Impact of WALANT Hand Surgery in a Secondary Care Hospital in Spain. Benefits to the Patient and the Health System.
title_sort Impact of WALANT Hand Surgery in a Secondary Care Hospital in Spain. Benefits to the Patient and the Health System.
dc.creator.none.fl_str_mv Far-Riera, Aina
Perez-Uribarri, Carlos
Esteras Serrano, Matias José
Rapariz, José María
author Far-Riera, Aina
author_facet Far-Riera, Aina
Perez-Uribarri, Carlos
Esteras Serrano, Matias José
Rapariz, José María
author_role author
author2 Perez-Uribarri, Carlos
Esteras Serrano, Matias José
Rapariz, José María
author2_role author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Carpal Tunnel Syndrome
Trigger Finger Disorder
Traumatology
Hand Injuries
Síndrome del Túnel Carpiano
Trastorno del Dedo en Gatillo
Traumatología
Traumatismos de la Mano
Carpal tunnel syndrome
Hand surgery
Nerve
Peripheral
Trigger finger
Visual Analogue Scale
WALANT
topic Carpal Tunnel Syndrome
Trigger Finger Disorder
Traumatology
Hand Injuries
Síndrome del Túnel Carpiano
Trastorno del Dedo en Gatillo
Traumatología
Traumatismos de la Mano
Carpal tunnel syndrome
Hand surgery
Nerve
Peripheral
Trigger finger
Visual Analogue Scale
WALANT
description Purpose: The aim of this study is to compare patient benefits and economic costs of hand surgeries using the wide-awake local anesthesia no tourniquet (WALANT) technique versus a conventional major outpatient suite and review outcomes and complications in a series of cases of patients operated on using the WALANT technique. Methods: A prospective cohort study was first conducted comparing 150 cases of ambulatory hand surgery (carpal tunnel syndrome and trigger finger) using the WALANT technique and not requiring an operating room setting with 150 cases of outpatient surgery performed in an operating room involving a preoperative evaluation and the use of sedation and tourniquet. Preoperative, intraoperative, and postoperative pain was monitored, and days requiring postoperative analgesia were recorded. The resources and costs were evaluated. and patient satisfaction was assessed using a specific survey.Subsequently, 580 patient medical records were retrospectively reviewed, including 419 carpal tunnel syndrome and 197 trigger finger interventions (616 WALANT surgeries). Results: Intraoperative pain was equivalent for both groups, and postoperative pain was significantly lower in the WALANT group, with a reduced need for analgesics. Satisfaction was greater for the local anesthesia group. The use of personnel resources and hospital materials was reduced in the WALANT group, with a total estimated cost savings of 1.019 USD per patient.There were no complications related to the WALANT technique and the lidocaine and adrenaline combination. We found a complication rate of 5.58%, and, in line with the literature, most complications were minor, managed conservatively, and not related to the anesthetic technique. Conclusions: Procedures such as carpal tunnel and trigger finger surgeries can be safely performed using wide-awake surgery. Patient satisfaction is higher than with the conventional procedure performed in the operating room. Pain control is excellent, especially during the postoperative period. Clinical relevance: Hand surgery patients benefit from the WALANT technique in terms of comfort and timeliness because there is no need for preoperative tests or evaluations. In addition, it represents significant savings in hospital resources. In our case series, complications were in line with those previously reported with other anesthetic techniques.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022-01-01
2022
2022-01-01
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.13003/24946
url https://hdl.handle.net/20.500.13003/24946
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Docusalut
instname:Conselleria de Salut i Consum del Govern de les Illes Balears
instname_str Conselleria de Salut i Consum del Govern de les Illes Balears
reponame_str Docusalut
collection Docusalut
repository.name.fl_str_mv
repository.mail.fl_str_mv
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