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WALANT versus intravenous regional anesthesia for carpal tunnel syndrome: a randomized clinical trial
Okamura, Aldo; Moraes, Vinicius Ynoe de; Fernandes, Marcela; Raduan-Neto, Jorge; Belloti, João Carlos.
  • Okamura, Aldo; Universidade Federal de São Paulo. Discipline of Hand and Upper Limb Surgery. São Paulo. BR
  • Moraes, Vinicius Ynoe de; Universidade Federal de São Paulo. Discipline of Hand and Upper Limb Surgery. São Paulo. BR
  • Fernandes, Marcela; Universidade Federal de São Paulo. , Discipline of Hand and Upper Limb Surgery. São Paulo. BR
  • Raduan-Neto, Jorge; Universidade Federal de São Paulo. Discipline of Hand and Upper Limb Surgery. São Paulo. BR
  • Belloti, João Carlos; Universidade Federal de São Paulo. Discipline of Hand and Upper Limb Surgery. São Paulo. BR
São Paulo med. j ; 139(6): 576-578, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1352298
ABSTRACT
ABSTRACT

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.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Carpal Tunnel Syndrome / Anesthesia, Conduction Type of study: Controlled clinical trial / Diagnostic study Limits: Humans Country/Region as subject: South America / Brazil Language: English Journal: São Paulo med. j Journal subject: Cirurgia Geral / Ciˆncia / Ginecologia / Medicine / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Year: 2021 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal de São Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Carpal Tunnel Syndrome / Anesthesia, Conduction Type of study: Controlled clinical trial / Diagnostic study Limits: Humans Country/Region as subject: South America / Brazil Language: English Journal: São Paulo med. j Journal subject: Cirurgia Geral / Ciˆncia / Ginecologia / Medicine / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Year: 2021 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal de São Paulo/BR