Dataset Information

Less Fluctuation in Hemodynamics of the Wide-Awake Local Anesthesia No Tourniquet Technique Than General Anesthesia in Distal Radius Plating Surgery: A Prospective Case-Control Study.

ABSTRACT: This prospective case-control study aimed to compare the intraoperative hemodynamic changes between the wide-awake local anesthesia no tourniquet (WALANT) technique and general anesthesia (GA) in patients undergoing distal radius plating surgery. Forty adults with distal radius fractures underwent plating surgery via the WALANT technique (20 patients) or GA (20 patients). Mean arterial pressure (MAP) and heart rate were recorded. Intraoperative pain intensity was measured using the visual analog scale (VAS) for pain in the WALANT group. The measures of hemodynamics and VAS were recorded at seven-time points perioperatively. The VAS score decreased significantly compared with the preoperative status in the WALANT group for most of the intraoperative period except during injections of local anesthetics and fracture reduction. The intraoperative MAP in the WALANT group showed no significant change during the perioperative period. In addition, the WALANT group showed fewer perioperative MAP fluctuations than the GA group (p < 0.05). The reduction and plating quality were similar between the two groups. WALANT provided a feasible technique with less fluctuation in hemodynamic status. With gentle manipulation of the fracture reduction, distal radius plating surgery using the WALANT technique is a well-tolerated surgical procedure and shows similar reduction and plating quality to GA.

SUBMITTER: Liu WC

PROVIDER: S-EPMC8875852 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Less Fluctuation in Hemodynamics of the Wide-Awake Local Anesthesia No Tourniquet Technique Than General Anesthesia in Distal Radius Plating Surgery: A Prospective Case-Control Study.

Liu Wen-Chih WC Lu I-Cheng IC Chang Chung-Chia CC Chen Chih-Ting CT Chen Chung-Hwan CH Shih Chia-Lung CL Fu Yin-Chih YC Jupiter Jesse Bernard JB

Journal of clinical medicine 20220221 4

This prospective case-control study aimed to compare the intraoperative hemodynamic changes between the wide-awake local anesthesia no tourniquet (WALANT) technique and general anesthesia (GA) in patients undergoing distal radius plating surgery. Forty adults with distal radius fractures underwent plating surgery via the WALANT technique (20 patients) or GA (20 patients). Mean arterial pressure (MAP) and heart rate were recorded. Intraoperative pain intensity was measured using the visual analog ...[more]

PMID: 35207401

Similar Datasets

Project description:BackgroundDistal radius fractures (DRF) are frequently treated with internal fixation under general anesthesia or a brachial plexus block. Recently, the wide-awake local anesthesia with no tourniquet (WALANT) technique has been suggested as a method that results in higher patient satisfaction. This study aimed to evaluate the functional outcomes, complications, and patient-reported outcomes of DRF plating surgery under both the WALANT and balanced anesthesia (BA).MethodsNinety-three patients with DRFs who underwent open reduction and plating were included. Regarding the anesthetic technique, 38 patients received WALANT, while 55 received BA, comprised of multimodal pain control brachial plexus anesthesia with light general support. The patient's overall satisfaction in both groups and the intraoperative numerical rating scale of pain and anxiety (0-10) in the WALANT group were recorded. The peri-operative radiographic parameters were measured; the clinical outcomes, including Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, wrist mobility, and grip strength, were recorded in up to 1-year follow-up. Results presented with a mean difference and 95% confidence intervals and mean ± standard deviation.ResultsThe mean age of patients in the WALANT group was higher than in the BA group (63 ± 17 vs. 54 ± 17, P = 0.005), and there were fewer intra-articular DRF fractures in the WALANT group than in the BA group (AO type A/B/C: 30/3/5 vs. 26/10/19, P = 0.009). The reduction and plating quality were similar in both groups. The clinical outcomes at follow-up were comparable between the two groups, except the WALANT group had worse postoperative 3-month pronation (88% vs. 96%; - 8.0% [ - 15.7 to - 0.2%]) and 6-month pronation (92% vs. 100%; - 9.1% [ - 17.0 to - 1.2%]), and better postoperative 1-year flexion (94% vs. 82%; 12.0% [2.0-22.1%]). The overall satisfaction was comparable in the WALANT and BA groups (8.7 vs. 8.5; 0.2 [ - 0.8 to 1.2]). Patients in the WALANT group reported an injection pain scale of 1.7 ± 2.0, an intraoperative pain scale of 1.2 ± 1.9, and an intraoperative anxiety scale of 2.3 ± 2.8.ConclusionThe reduction quality, functional outcomes, and overall satisfaction were comparable between the WALANT and BA groups. With meticulous preoperative planning, the WALANT technique could be an alternative for DRF plating surgery in selected patients. Trial registration This retrospective study was approved by the Institutional Review Board of Kaohsiung Medical University Hospital (KMUHIRB-E(I)-20210201).

Dataset Information

Less Fluctuation in Hemodynamics of the Wide-Awake Local Anesthesia No Tourniquet Technique Than General Anesthesia in Distal Radius Plating Surgery: A Prospective Case-Control Study.

Publications

Less Fluctuation in Hemodynamics of the Wide-Awake Local Anesthesia No Tourniquet Technique Than General Anesthesia in Distal Radius Plating Surgery: A Prospective Case-Control Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets