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WALANT: A Discussion of Indications, Impact, and Educational Requirements
Wide-awake, local anesthesia, no tourniquet (WALANT) is a technique that removes the requirement for operations to be performed with a tourniquet, general/regional anesthesia, sedation or an anesthetist. We reviewed the WALANT literature with respect to the diverse indications and impact of WALANT t...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Thieme Medical Publishers, Inc.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9340192/ https://www.ncbi.nlm.nih.gov/pubmed/35919552 http://dx.doi.org/10.1055/s-0042-1748659 |
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author | Shahid, Shahab Saghir, Noman Saghir, Reyan Young-Sing, Quillan Miranda, Benjamin H. |
author_facet | Shahid, Shahab Saghir, Noman Saghir, Reyan Young-Sing, Quillan Miranda, Benjamin H. |
author_sort | Shahid, Shahab |
collection | PubMed |
description | Wide-awake, local anesthesia, no tourniquet (WALANT) is a technique that removes the requirement for operations to be performed with a tourniquet, general/regional anesthesia, sedation or an anesthetist. We reviewed the WALANT literature with respect to the diverse indications and impact of WALANT to discuss the importance of future surgical curriculum integration. With appropriate patient selection, WALANT may be used effectively in upper and lower limb surgery; it is also a useful option for patients who are unsuitable for general/regional anesthesia. There is a growing body of evidence supporting the use of WALANT in more complex operations in both upper and lower limb surgery. WALANT is a safe, effective, and simple technique associated with equivalent or superior patient pain scores among other numerous clinical and cost benefits. Cost benefits derive from reduced requirements for theater/anesthetic personnel, space, equipment, time, and inpatient stay. The lack of a requirement for general anesthesia reduces aerosol generating procedures, for example, intubation/high-flow oxygen, hence patients and staff also benefit from the reduced potential for infection transmission. WALANT provides a relatively, but not entirely, bloodless surgical field. Training requirements include the surgical indications, volume calculations, infiltration technique, appropriate perioperative patient/team member communication, and specifics of each operation that need to be considered, for example, checking of active tendon glide versus venting of flexor tendon pulleys. WALANT offers significant clinical, economic, and operative safety advantages when compared with general/regional anesthesia. Key challenges include careful patient selection and the comprehensive training of future surgeons to perform the technique safely. |
format | Online Article Text |
id | pubmed-9340192 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Thieme Medical Publishers, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-93401922022-08-01 WALANT: A Discussion of Indications, Impact, and Educational Requirements Shahid, Shahab Saghir, Noman Saghir, Reyan Young-Sing, Quillan Miranda, Benjamin H. Arch Plast Surg Wide-awake, local anesthesia, no tourniquet (WALANT) is a technique that removes the requirement for operations to be performed with a tourniquet, general/regional anesthesia, sedation or an anesthetist. We reviewed the WALANT literature with respect to the diverse indications and impact of WALANT to discuss the importance of future surgical curriculum integration. With appropriate patient selection, WALANT may be used effectively in upper and lower limb surgery; it is also a useful option for patients who are unsuitable for general/regional anesthesia. There is a growing body of evidence supporting the use of WALANT in more complex operations in both upper and lower limb surgery. WALANT is a safe, effective, and simple technique associated with equivalent or superior patient pain scores among other numerous clinical and cost benefits. Cost benefits derive from reduced requirements for theater/anesthetic personnel, space, equipment, time, and inpatient stay. The lack of a requirement for general anesthesia reduces aerosol generating procedures, for example, intubation/high-flow oxygen, hence patients and staff also benefit from the reduced potential for infection transmission. WALANT provides a relatively, but not entirely, bloodless surgical field. Training requirements include the surgical indications, volume calculations, infiltration technique, appropriate perioperative patient/team member communication, and specifics of each operation that need to be considered, for example, checking of active tendon glide versus venting of flexor tendon pulleys. WALANT offers significant clinical, economic, and operative safety advantages when compared with general/regional anesthesia. Key challenges include careful patient selection and the comprehensive training of future surgeons to perform the technique safely. Thieme Medical Publishers, Inc. 2022-07-30 /pmc/articles/PMC9340192/ /pubmed/35919552 http://dx.doi.org/10.1055/s-0042-1748659 Text en The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Shahid, Shahab Saghir, Noman Saghir, Reyan Young-Sing, Quillan Miranda, Benjamin H. WALANT: A Discussion of Indications, Impact, and Educational Requirements |
title | WALANT: A Discussion of Indications, Impact, and Educational Requirements |
title_full | WALANT: A Discussion of Indications, Impact, and Educational Requirements |
title_fullStr | WALANT: A Discussion of Indications, Impact, and Educational Requirements |
title_full_unstemmed | WALANT: A Discussion of Indications, Impact, and Educational Requirements |
title_short | WALANT: A Discussion of Indications, Impact, and Educational Requirements |
title_sort | walant: a discussion of indications, impact, and educational requirements |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9340192/ https://www.ncbi.nlm.nih.gov/pubmed/35919552 http://dx.doi.org/10.1055/s-0042-1748659 |
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