ArticleJournal of the American Academy of Orthopaedic Surgeons. Global research & reviews2020
Maintaining Access to Orthopaedic Surgery During Periods of Operating Room Resource Constraint: Expanded Use of Wide-Awake Surgery During the COVID-19 Pandemic.
Article in Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Complications and side effects of Wide-Awake Local Anaesthesia No Tourniquet (WALANT) in upper limb surgery: a systematic review and meta-analysis.International orthopaedics · 2024Pooled it
- A Practical Guide to Local Anesthetic Options for Wide-awake Hand Surgery (WALANT): A Laboratory-based Experimental Study.Plastic and reconstructive surgery. Global open · 2025Article
- Comparison of WALANT and general anaesthesia for trapeziectomy and abductor pollicis longus hammock ligamentoplasty.Journal of hand and microsurgery · 2025Article
- Plate osteosynthesis of phalanx fractures using wide-awake local anesthesia no tourniquet technique is cost-effective and associated with less postoperative pain.Journal of the Chinese Medical Association : JCMA · 2025Article
- Wide Awake Local Anesthetic No Tourniquet in Hand and Wrist Surgery: Current Concepts, Indications, and Considerations.Plastic and reconstructive surgery. Global open · 2024Article
- Successful Use of WALANT in Local and Regional Soft Tissue Flaps: A Case Series.Plastic and reconstructive surgery. Global open · 2023Article
- WALANT: A Discussion of Indications, Impact, and Educational Requirements.Archives of plastic surgery · 2022Article
- WALANT technique versus locoregional anesthesia in the surgical management of metacarpal and phalangeal fractures: Lessons from the Covid-19 crisis.Hand surgery & rehabilitation · 2022Article
- In-Office Needle Tendoscopy of the Tibialis Posterior Tendon with Concomitant Intervention.Arthroscopy techniques · 2022Article
- [The incidence of hand trauma the COVID-19 epidemic setting].Annales de chirurgie plastique et esthetique · 2022Article
- In-Office Needle Tendoscopy of the Peroneal Tendons.Arthroscopy techniques · 2022Article
- Metatarsal osteotomy for hallux valgus under wide-awake local anesthesia with no tourniquet technique.Joint diseases and related surgery · 2022Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWide-awake local anesthesia no tourniquet (WALANT) presents a nonstandard anesthetic approach initially described for use in hand surgery that has gained interest and utilization across a variety of orthopaedic procedures. In response to operating room resource constraints imposed by the COVID-19 pandemic, our orthopaedic service rapidly adopted and expanded its use of WALANT.
methodsA retrospective review of 16 consecutive cases performed by 7 surgeons was conducted. Patient demographics, surgical details, and perioperative outcomes were assessed. The primary end point was WALANT failure, defined as intraoperative conversion to general anesthesia.
resultsNo instances of WALANT failure requiring conversion to general anesthesia occurred. In recovery, one patient (6%) required narcotics for pain control, and the average postoperative pain numeric rating scale was 0.6. The maximum pain score experienced was 4 in the patient requiring postoperative narcotics. The average time in recovery was 42 minutes and ranged from 8 to 118 minutes.
conclusionThe WALANT technique was safely and effectively used in 16 cases across multiple orthopaedic subspecialties, including three procedures not previously described in the literature. WALANT techniques hold promise for use in future disaster scenarios and should be evaluated for potential incorporation into routine orthopaedic surgical care.
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Registered trials
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