Wide Awake Local Anesthesia for Hand and Wrist Surgery Procedures

(Newswire.net — July 16, 2018) Bend, Oregon — The Center Orthopedic & Neurosurgical Care has seen an increase in the use of wide-awake local anesthesia for hand and wrist surgery procedures. Wide-awake local anesthesia is surgery performed with only local anesthesia, avoiding the use of general anesthesia. The technique is known as wide-awake local anesthesia, no tourniquet (WALANT).

Using the WALANT technique avoids all of the downsides, risks and costs associated with general anesthesia. This method has proven to be much safer for patients with health problems. Some of the pre-surgery benefits for patients utilizing the WALANT method include: no need for an EKG, chest x-ray, or preoperative blood test; no need to get undressed for surgery; no need to fast before surgery; no IV necessary; and a safer option for patients with heart, lung, or other medical conditions. There are further benefits during and after surgery including: no grogginess or other side effects of general anesthesia; ability to watch surgery if desired; ability to receive and remember education about surgery, postoperative rehab, and expected results; ability to actively test tendon repairs at the time of surgery to confirm good results before leaving the operating room; and the patient can drive him or herself home after surgery if necessary.

WALANT also typically decreases healthcare costs and patient expenses because there is no anesthesia charge. Surgeries utilizing the WALANT technique are generally performed as outpatient surgeries and do not require a stay in the hospital. Typical surgeries performed with WALANT include endoscopic carpal tunnel release, trigger finger release, De Quervaine’s release, thumb arthritis surgery, olecranon bursal surgery and most finger surgeries. Other less common surgeries that can be performed with WALANT include wrist fractures, proximal row carpectomies and partial wrist fusions for arthritis, ulnar nerve decompression and shortening osteotomies.

Before the procedure takes place, patients may receive anti-anxiety medications if desired, but no sedation is required for surgery. Injections are given to the patient using a small needle and injecting slowly, typically injecting areas that are already numb to minimize discomfort. Bicarbonate is placed in the numbing solution to buffer the normal tissue acidity and decrease the normal pain of an injection. Typically, 5-30 minutes elapse to allow the numbing solution to reach maximum efficacy before patients are taken to the operating room where their procedure is performed. If patients would like to view their surgery they are able to do so, if they do not wish to watch a drape will be put in place and patients can listen to music or even take a nap. WALANT typically provides 6-8 hours of complete pain relief and sometimes up to 24 hours of complete pain relief.

“I have performed over 1,000 wide-awake surgeries with only local anesthesia with excellent results, and no patients requiring a conversion to general anesthesia,” says orthopedic surgeon Dr. James Verheyden. “For the right patient, and the right indications, this can result in tremendous benefits to the patient and tremendous healthcare savings.”