Walant-Efficient and Safe Technique-Key Treatment in Covid-19 Pandemic

Aim of the study The aim of the study was to confirm the effectiveness and safety of wide awake local anesthesia no tourniquet (WALANT) technique in hand surgery, as well as its necessity and importance during the COVID-19 pandemics. Material and methods A retrospective study was performed between March 2020 and September 2021 to evaluate advantages of WALANT, taking into consideration the rules imposed by the pandemic context. This study included 360 patients, treated for acute and chronic hand diseases. A statistical investigation was performed using SPSS 20.0 version software and applying the ANOVA regression, evaluating demographic, anatomical and surgical variables. Results: 234 males and 126 females, treated for acute hand trauma (metacarpal and phalanx fractures, tendon and nerves lesions) and chronic hand diseases such as carpal tunnel syndrome (CTS) dupuytren's disease (DD), trigger finger (TF), soft tissue and bone tumors. The average patient waiting time from admission in the operating room was 13.95 minutes, while the mean time of onset of local anesthesia was 12.15 minutes. No complications such as distal digital bleeding, hematoma, the necessity of using the antidote, or necrosis occurred, the outcomes were very good and the patient satisfaction high. Conclusions: The WALANT technique can be considered the "gold standard" in hand surgery anesthesia during the COVID-19 pandemic, ensuring a correct and safe surgical treatment in the restrictive conditions imposed by the epidemiological context.

WIDE AWAKE LOCAL ANESTHESIA NO TOURNIQUET TECHNIQUE IN HAND SURGERY DURING THE COVID-19 PANDEMIC - PERSONAL EXPERIENCE

Short-time exposure of the patient to the hospital environment and the significantly lower costs make WALANT technique a "gold-standard" anesthesia in hand surgery during the COVID-19 pandemic. Material and methods: We studied a group of 180 patients treated for acute and chronic conditions during the first 10 months of the COVID-19 pandemic. A statistical analysis was conducted in order to demonstrate the efficacy and usefulness of the WALANT technique. Results: The average length of hospital stay was 118.05 minutes, the mean time of onset of local anesthesia was 12.79 minutes, the average patient waiting time from admission to surgery was 15.72 minutes. We used ANOVA regression, establishing CI 95% and significance F of 95%. A p-value <0.05 was considered statistically significant. Conclusions: Using WALANT technique the length of hospital stays and implicitly the risk of contracting SARS-CoV-2 decreases and also the costs are lower, surgical care is good, and patient satisfaction is high.