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
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 p...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-02-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/4/1123 |
| _version_ | 1797479026233704448 |
|---|---|
| author | Wen-Chih Liu I-Cheng Lu Chung-Chia Chang Chih-Ting Chen Chung-Hwan Chen Chia-Lung Shih Yin-Chih Fu Jesse Bernard Jupiter |
| author_facet | Wen-Chih Liu I-Cheng Lu Chung-Chia Chang Chih-Ting Chen Chung-Hwan Chen Chia-Lung Shih Yin-Chih Fu Jesse Bernard Jupiter |
| author_sort | Wen-Chih Liu |
| collection | DOAJ |
| description | 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 (<i>p</i> < 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. |
| first_indexed | 2024-03-09T21:40:00Z |
| format | Article |
| id | doaj.art-45c610c9a9cf47ecac13c4468d1b0407 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T21:40:00Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-45c610c9a9cf47ecac13c4468d1b04072023-11-23T20:32:06ZengMDPI AGJournal of Clinical Medicine2077-03832022-02-01114112310.3390/jcm11041123Less Fluctuation in Hemodynamics of the Wide-Awake Local Anesthesia No Tourniquet Technique Than General Anesthesia in Distal Radius Plating Surgery: A Prospective Case-Control StudyWen-Chih Liu0I-Cheng Lu1Chung-Chia Chang2Chih-Ting Chen3Chung-Hwan Chen4Chia-Lung Shih5Yin-Chih Fu6Jesse Bernard Jupiter7Department Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, TaiwanDepartment of Anesthesiology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 81267, TaiwanDepartment Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, TaiwanSchool of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, TaiwanDepartment Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, TaiwanDepartment of Medical Research, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi 60002, TaiwanDepartment Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, TaiwanHand and Arm Center, Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USAThis 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 (<i>p</i> < 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.https://www.mdpi.com/2077-0383/11/4/1123WALANTwide-awake local anesthesia no tourniquetwide-awake hand surgerydistal radius fracturebalanced anesthesia |
| spellingShingle | Wen-Chih Liu I-Cheng Lu Chung-Chia Chang Chih-Ting Chen Chung-Hwan Chen Chia-Lung Shih Yin-Chih Fu Jesse Bernard Jupiter 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 Journal of Clinical Medicine WALANT wide-awake local anesthesia no tourniquet wide-awake hand surgery distal radius fracture balanced anesthesia |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | WALANT wide-awake local anesthesia no tourniquet wide-awake hand surgery distal radius fracture balanced anesthesia |
| url | https://www.mdpi.com/2077-0383/11/4/1123 |
| work_keys_str_mv | AT wenchihliu lessfluctuationinhemodynamicsofthewideawakelocalanesthesianotourniquettechniquethangeneralanesthesiaindistalradiusplatingsurgeryaprospectivecasecontrolstudy AT ichenglu lessfluctuationinhemodynamicsofthewideawakelocalanesthesianotourniquettechniquethangeneralanesthesiaindistalradiusplatingsurgeryaprospectivecasecontrolstudy AT chungchiachang lessfluctuationinhemodynamicsofthewideawakelocalanesthesianotourniquettechniquethangeneralanesthesiaindistalradiusplatingsurgeryaprospectivecasecontrolstudy AT chihtingchen lessfluctuationinhemodynamicsofthewideawakelocalanesthesianotourniquettechniquethangeneralanesthesiaindistalradiusplatingsurgeryaprospectivecasecontrolstudy AT chunghwanchen lessfluctuationinhemodynamicsofthewideawakelocalanesthesianotourniquettechniquethangeneralanesthesiaindistalradiusplatingsurgeryaprospectivecasecontrolstudy AT chialungshih lessfluctuationinhemodynamicsofthewideawakelocalanesthesianotourniquettechniquethangeneralanesthesiaindistalradiusplatingsurgeryaprospectivecasecontrolstudy AT yinchihfu lessfluctuationinhemodynamicsofthewideawakelocalanesthesianotourniquettechniquethangeneralanesthesiaindistalradiusplatingsurgeryaprospectivecasecontrolstudy AT jessebernardjupiter lessfluctuationinhemodynamicsofthewideawakelocalanesthesianotourniquettechniquethangeneralanesthesiaindistalradiusplatingsurgeryaprospectivecasecontrolstudy |