Wide Awake Local Anestesia No Tourniguet (WALANT) Tekniği ile Yapılan Ortopedik Üst Ekstremite Cerrahilerinin Klinik ve Fonksiyonel Sonuçları

Abstract

Amaç: Wide Awake Local Anesthesia No Tourniqet (WALANT) yöntemi lokal anestezi altında turnikesiz olarak ekstremite cerrahilerinde kullanılan bir tekniktir. Bu araştırmanın amacı, üst ekstremite cerra-hilerinde WALANT tekniğinin etkinliğini ve kemik ve yumuşak doku cerrahilerinin karşılaştırmasınıkar-şılaştırmasını incelemektir. Materyal ve metod: Mayıs 2021 ile Nisan 2023 arasında, WALANT tekniği kullanılarak üst ekstremite cerrahisi geçiren 39 hasta çalışmaya dahil edildi. Hastalar iki gruba ayrıldı: grup A yumuşak doku ameli-yatları ve grup B kemik doku ameliyatları. Gruplar arasında postoperatif ağrı başlangıç zamanı, ağrı skoru, intraoperatif kanama, ek solüsyon gereksinimi, koter kullanımı ve cerrahi alanındaki kanama miktarı açısından karşılaştırma yapıldı. Cerrahi işlem sırasında ağrı seviyelerini değerlendirmek için Görsel Analog Skala (VAS) kullanıldı. Bulgular: İki grup arasında yaş, cinsiyet ve operasyon yapılan taraf açısından belirgin farklılık bulunma-dı. Her iki grup hastalarında, cerrahın değerlendirmesine göre ameliyat sırasında benzer bir kanama miktarı izlendi. Ek solüsyon ihtiyacı, koter kullanımı, ağrı başlangıç zamanı ve VAS skorları açısından gruplar arasında farklılık gözlenmedi. Sonuç: WALANT tekniği, uygun şekilde seçilmiş hastalarda üst ekstremite kemik ve yumuşak doku operasyonlarında kullanılabilen etkili ve güvenli bir yöntemdir. Genel veya geniş bölgesel anestezi yerine lokal anestezi altında turnike olmaksızın kanamasız bir ameliyat cerrah ve hasta konforu açısın-dan etkilidir. Tekniğin uygun bir şekilde uygulanması, olası komplikasyonları önlemek açısından önemlidir.

Keywords

• uyanık turnikesiz lokal anestezi
• lokal anestezi
• üst ekstremite

Ethical Statement

Etik kurulu onayı (tarih: 26.04.2021, HRU/21.09.24)

Orthopedic Upper Extremity Surgeries Performed with Wide Awake Local Anesthesia No Tourniquet (WALANT) Technique: Clinical and Functional Outcomes

Abstract

Background: The Wide Awake Local Anesthesia No Tourniquet (WALANT) method is a technique used in extremity surgeries under local anesthesia without the use of a tourniquet. The aim of this study is to examine the effectiveness of the WALANT technique in upper extremity surgeries and compare it with outcomes related to bone and soft tissue. Materials and Methods: Between May 2021 and April 2023, 39 patients who underwent upper extremity surgery using the WALANT technique were included in the study. The patients were divi-ded into two groups: Group A for soft tissue surgeries and Group B for bone tissue surgeries. A compa-rison was made between the groups regarding postoperative pain onset time, pain scores, intraopera-tive bleeding, additional solution requirements, cautery usage, and the amount of bleeding in the surgical field. The Visual Analog Scale (VAS) was used to assess pain levels during the surgical procedu-re. Results: There were no significant differences between the two groups in terms of age, gender, and the side of the operation. According to the surgeon's assessment, both groups exhibited similar amo-unts of bleeding during the surgery. Additionally, there were no differences between the two groups regarding the need for additional solutions, the use of cautery, the onset of pain, and VAS scores. Conclusions: The WALANT technique is an effective and safe method that can be used for bone and soft tissue surgeries of the upper extremity in appropriately selected patients. Performing surgery under local anesthesia without a tourniquet is beneficial for both the surgeon and the patient, as it results in a bloodless operation. Proper application of the technique is crucial to prevent potential complications.

Keywords

• wide-awake local anesthesia with no tourniquet
• local anesthesia
• upper extremity

References

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