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Application of WALANT in Diaphyseal Plating of Forearm Fractures: An Observational Study

PURPOSE: Wide-Awake Local Anesthesia No Tourniquet (WALANT) is a novel anesthesia technique in distal radius and ankle fracture fixation. However, to date, there are limited studies in diaphyseal plating of forearm fractures under WALANT. This research is to study the feasibility of the use of WALAN...

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Autores principales: How, Hui Meng, Khoo, Brandon Liu Juan, Ayeop, Mohd Adham Shah, Ahmad, Abdul Rauf, Bahaudin, Norhaslinda, Ahmad, Amir Adham
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9678652/
https://www.ncbi.nlm.nih.gov/pubmed/36420459
http://dx.doi.org/10.1016/j.jhsg.2022.02.004
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author How, Hui Meng
Khoo, Brandon Liu Juan
Ayeop, Mohd Adham Shah
Ahmad, Abdul Rauf
Bahaudin, Norhaslinda
Ahmad, Amir Adham
author_facet How, Hui Meng
Khoo, Brandon Liu Juan
Ayeop, Mohd Adham Shah
Ahmad, Abdul Rauf
Bahaudin, Norhaslinda
Ahmad, Amir Adham
author_sort How, Hui Meng
collection PubMed
description PURPOSE: Wide-Awake Local Anesthesia No Tourniquet (WALANT) is a novel anesthesia technique in distal radius and ankle fracture fixation. However, to date, there are limited studies in diaphyseal plating of forearm fractures under WALANT. This research is to study the feasibility of the use of WALANT technique in plating of diaphyseal fractures of the forearm as well as peri-operative outcomes. METHODS: Sixty-one adult patients who underwent diaphyseal plating of the forearm under WALANT between the period of January 2019 and January 2021. It consists of 31 radius fractures, 15 ulna fractures and 15 ipsilateral radius and ulna fractures. Outcomes evaluated were duration of stay, peri-operative numerical pain rating scale, peri-operative blood pressure and heart rate, visual analogue scale for anxiety, blood loss, surgery duration, adverse effect, patient’s satisfaction and any complications at 6 months follow up. RESULTS: Fifty-four patients (88.5%) were male and 7 patients (11.5%) were female with a mean age of 31.7 years (SD = 13.564). Thirty-eight out of 61 patients were totally pain free throughout the surgery. Ten (13%) patients reported pain during muscle dissection, 14 (18%) patients reported pain during bone manipulation and 12 (16%) patients reported pain during bone drilling. There was no significant difference in pain score between radius and ulna bones (P > .05). There was a significant change in blood pressure after LA infiltration (P < .01). The mean estimated blood loss was 27.39 ml (SD = 11.44) and the mean duration of post-surgery hospital stay was 1 day (SD = 1.026). Fifty-six patients (92%) recommended diaphyseal plating of the forearm under WALANT. None of the patients required conversion to general anesthesia and had any adverse events or infection during 6 months follow up. CONCLUSIONS: Diaphyseal plating of the forearm under WALANT is a feasible alternative anesthesia technique and is well tolerated by patients. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.
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spelling pubmed-96786522022-11-22 Application of WALANT in Diaphyseal Plating of Forearm Fractures: An Observational Study How, Hui Meng Khoo, Brandon Liu Juan Ayeop, Mohd Adham Shah Ahmad, Abdul Rauf Bahaudin, Norhaslinda Ahmad, Amir Adham J Hand Surg Glob Online Scientific Article PURPOSE: Wide-Awake Local Anesthesia No Tourniquet (WALANT) is a novel anesthesia technique in distal radius and ankle fracture fixation. However, to date, there are limited studies in diaphyseal plating of forearm fractures under WALANT. This research is to study the feasibility of the use of WALANT technique in plating of diaphyseal fractures of the forearm as well as peri-operative outcomes. METHODS: Sixty-one adult patients who underwent diaphyseal plating of the forearm under WALANT between the period of January 2019 and January 2021. It consists of 31 radius fractures, 15 ulna fractures and 15 ipsilateral radius and ulna fractures. Outcomes evaluated were duration of stay, peri-operative numerical pain rating scale, peri-operative blood pressure and heart rate, visual analogue scale for anxiety, blood loss, surgery duration, adverse effect, patient’s satisfaction and any complications at 6 months follow up. RESULTS: Fifty-four patients (88.5%) were male and 7 patients (11.5%) were female with a mean age of 31.7 years (SD = 13.564). Thirty-eight out of 61 patients were totally pain free throughout the surgery. Ten (13%) patients reported pain during muscle dissection, 14 (18%) patients reported pain during bone manipulation and 12 (16%) patients reported pain during bone drilling. There was no significant difference in pain score between radius and ulna bones (P > .05). There was a significant change in blood pressure after LA infiltration (P < .01). The mean estimated blood loss was 27.39 ml (SD = 11.44) and the mean duration of post-surgery hospital stay was 1 day (SD = 1.026). Fifty-six patients (92%) recommended diaphyseal plating of the forearm under WALANT. None of the patients required conversion to general anesthesia and had any adverse events or infection during 6 months follow up. CONCLUSIONS: Diaphyseal plating of the forearm under WALANT is a feasible alternative anesthesia technique and is well tolerated by patients. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III. Elsevier 2022-03-03 /pmc/articles/PMC9678652/ /pubmed/36420459 http://dx.doi.org/10.1016/j.jhsg.2022.02.004 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Scientific Article
How, Hui Meng
Khoo, Brandon Liu Juan
Ayeop, Mohd Adham Shah
Ahmad, Abdul Rauf
Bahaudin, Norhaslinda
Ahmad, Amir Adham
Application of WALANT in Diaphyseal Plating of Forearm Fractures: An Observational Study
title Application of WALANT in Diaphyseal Plating of Forearm Fractures: An Observational Study
title_full Application of WALANT in Diaphyseal Plating of Forearm Fractures: An Observational Study
title_fullStr Application of WALANT in Diaphyseal Plating of Forearm Fractures: An Observational Study
title_full_unstemmed Application of WALANT in Diaphyseal Plating of Forearm Fractures: An Observational Study
title_short Application of WALANT in Diaphyseal Plating of Forearm Fractures: An Observational Study
title_sort application of walant in diaphyseal plating of forearm fractures: an observational study
topic Scientific Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9678652/
https://www.ncbi.nlm.nih.gov/pubmed/36420459
http://dx.doi.org/10.1016/j.jhsg.2022.02.004
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