Total trapeziometacarpal joint arthroplasty using wide awake local anaesthetic no tourniquet

J Hand Surg Eur Vol. 2021 Feb;46(2):125-130. doi: 10.1177/1753193420932465. Epub 2020 Jun 20.

Abstract

We conducted a descriptive study of 50 consecutive cases of total trapeziometacarpal joint arthroplasty by one surgeon using wide awake local anaesthetic no tourniquet to assess the usefulness and reliability of the anaesthesia, any adverse effects and patient acceptance. No difference was found when comparing the duration of surgery with 50 cases of total trapeziometacarpal joint arthroplasty inserted in a bloodless field under general or regional anaesthesia by the same surgeon. Wide awake local anaesthetic no tourniquet was found to be useful in providing adequate anaesthesia and haemostasis, and to be reliable and safe with no adverse effects. Patient satisfaction was high with 100% willing to repeat. Overall, wide awake local anaesthetic no tourniquet was a satisfactory method of anaesthesia for trapeziometacarpal joint arthroplasty with the potential for significant benefits to both patient and surgeon compared with traditional general anaesthesia and regional block.Level of evidence: II.

Keywords: WALANT; Wide awake local anaesthetic no tourniquet; patient satisfaction; reliability; trapeziometacarpal total joint arthroplasty; wide awake.

MeSH terms

  • Anesthesia, Local*
  • Anesthetics, Local*
  • Arthroplasty
  • Epinephrine
  • Humans
  • Reproducibility of Results

Substances

  • Anesthetics, Local
  • Epinephrine