SynthesisInternational orthopaedics2024
Complications and side effects of Wide-Awake Local Anaesthesia No Tourniquet (WALANT) in upper limb surgery: a systematic review and meta-analysis.
Synthesis in International orthopaedics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Review
- Wide-Awake Local Anaesthesia No Tourniquet Hand Surgery in Australia: An Analysis of Adoption, Perceptions and Implementation in a Global Context.ANZ journal of surgery · 2026Article
- Wide Awake Facial Reconstruction: A Literature Review, Cost Analysis, and Practical Guide.Plastic and reconstructive surgery. Global open · 2026Article
- Wide-Awake Local Anesthesia No Tourniquet: From Elective Hand Surgery to Fracture Fixation. A Systematic Review, Meta-Analysis, and Narrative Synthesis.Orthopedic reviews · 2026Article
- Cubital Tunnel Release Under Local and Regional Anesthesia: A Scoping Review.Plastic surgery (Oakville, Ont.) · 2025Review
- Article
- Hand Surgery Anaesthesia Innovations: Balancing Efficiency, Cost, and Comfort with WALANT, Ultrasound, and Emerging Adjuncts-A Narrative Review.Journal of clinical medicine · 2025Review
- Article
- Myth or Modality? Exploring the current perceptions and practices of adrenaline use in musculoskeletal extremities surgery in Pakistan.Pakistan journal of medical sciences · 2025Article
- Procedures under tourniquet in sickle cell disease: safety evaluated in two hundred and thirty three sickle-cell disease anaemia adult patients in comparison with outcomes in five hundred and seventy four sickle cell anaemia patients with procedures without tourniquet.International orthopaedics · 2025Article
- Patients Tracking Pain Episodes Show Wide-awake Local Anesthesia Without Tourniquet Can Be Nearly Painless.Plastic and reconstructive surgery. Global open · 2025Article
- Is WALANT Really Necessary in Outpatient Surgery?Journal of personalized medicine · 2024Article
- Reporting Clinical Outcomes in Hand Surgery Randomized Controlled Trials: A Systematic Review Using Wide-Awake Local Anesthesia No Tourniquet Studies as a Model.Journal of hand surgery global online · 2024Article
- Revolutionizing PIP joint fracture treatment: A case of surgical precision and rapid recovery.International journal of surgery case reports · 2024Article
- WALANT surgery of the hand: state of the art.EFORT open reviews · 2024Review
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWide-Awake Local Anaesthesia No Tourniquet (WALANT), a groundbreaking anaesthetic technique resurging in practice, warrants a comprehensive safety analysis for informed adoption. Our study aimed to identify complications/side effects of WALANT upper limb procedures through a systematic review and meta-analysis.
methodsThis PROSPERO-registered study was performed with strict adherence to PRISMA guidelines. Embase, OVIDMedline, Cochrane, Web of Science, and Scopus databases were searched until February 2023. Inclusion criteria involved English articles, reporting complications/side effects in primary WALANT upper limb surgeries. Outcomes included all complications and side effects, data on the anaesthetic mixture, publication year/location, study type, and procedures performed. The meta-analysis employed the Freeman-Tukey Double Arcsine Transformation, computed I
results2002 studies were identified; 79 studies met the inclusion criteria representing 15,595 WALANT patients. A total of 301 patients had complications, and the meta-analysis using a random effects model provided a complication rate of 1.7% (95% CI: 0.93-2.7%). The most reported complications were superficial infection (41%, n = 123/300), other/specified (12%, n = 37/300), and recurrent disease (6.7%, n = 20/300). A decade-by-decade analysis revealed no statistically significant difference in complication rates spanning the last three decades (p = 0.42). Adding sodium bicarbonate to the anaesthetic solution significantly reduced postoperative complications (p = 0.025).
conclusionWALANT has a low overall complication rate of 1.7%, with no significant temporal variation and a significant reduction in complications when sodium bicarbonate is added to the anaesthetic solution. Our findings support the safety of WALANT in upper limb procedures. REGISTRATION: PROSPERO: CRD42023404018.
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