Introduction: Wide Awake Local Anesthesia No Tourniquet (WALANT) technique has been widely used in hand surgery, but there are few prospective data on its use in forefoot surgery.
Hypothesis: The WALANT technique reduces pain compared to general anesthesia for bone surgery on the first ray of forefoot.
Methods: This was a prospective, longitudinal, comparative, non-randomized cohort study in adult patients undergoing bone surgery on the first ray of forefoot. The primary objective was the level of pain (0-10 visual analogic scale) 4 h after the procedure with WALANT technique versus general anesthesia supplemented by ropivacaine infiltration.
Results: A total 37 patients were analyzed in the WALANT group and 24 in the general anesthesia group (women, 90.2%; mean age, 51.3 years; hallux valgus, 85.2%; first metatarsal osteotomy, 80.3%). After generalized linear regression adjusted on a priori defined factors, there was no statistically difference for pain ≤3 at 4 h in WALANT vs. general anesthesia (odds-ratio 1.66; 95% CI, 0.17-20.49; p = 0.2548). At 24 h, pain level was also comparable in the two groups. Time spent in operating room was significantly shorter with WALANT (40.8 vs. 49.7 min; p = 0.0001). Mean length of stay in the recovery room was also significantly shorter with WALANT (4.4 vs. 75.6 min; p < 0.0001). Anxiety before/after surgery, uptake of analgesic/anti-inflammatory drugs and quality of life were comparable in the two anesthesia groups.
Conclusion: Postoperative pain with WALANT technique or general anesthesia was comparable. Time spent in the operating room and in recovery room was significantly shorter with WALANT technique.
Level Of Evidence: III; prospective non-randomized comparative study.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.otsr.2024.103947 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Potential role of electroencephalographic monitoring for diagnosis and treatment of local anesthetic systemic toxicity during general anesthesia: a case report.
JA Clin Rep
December 2024
Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Background: Local anesthetic systemic toxicity (LAST) is a rare but potentially life-threatening complication. Under general anesthesia, neurological signs are often masked, delaying diagnosis and increasing the risk of sudden cardiovascular collapse. Therefore, early detection methods are critically needed.
View Article and Find Full Text PDFSurgical ciliated cyst a newly added entity in WHO classification of head and neck tumours (2022): A case report.
Malays J Pathol
December 2024
Universiti Malaya, Faculty of Dentistry, Department of Oral & Maxillofacial Clinical Sciences, 50603, Kuala Lumpur, Malaysia.
The surgical ciliated cyst is a newly added entity under the cysts of the jaws in the World Health Organization (WHO) Classification of Head and Neck Tumours (2022). It is preceded by a prior surgery to the jaw many years before its diagnosis. A 53-year-old Chinese female, who had undergone cleft lip and palate repair followed by orthognathic surgery before the age of 20, was referred for management of an incidentally found cyst in the left maxilla.
View Article and Find Full Text PDFMolecular profiles of blood from numerous species that differ in sensitivity to acute inflammation.
Mol Med
December 2024
Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA.
Vertebrates differ over 100,000-fold in responses to pro-inflammatory agonists such as bacterial lipopolysaccharide (LPS), complicating use of animal models to study human sepsis or inflammatory disorders. We compared transcriptomes of resting and LPS-exposed blood from six LPS-sensitive species (rabbit, pig, sheep, cow, chimpanzee, human) and four LPS-resilient species (mice, rats, baboon, rhesus), as well as plasma proteomes and lipidomes. Unexpectedly, at baseline, sensitive species already had enhanced expression of LPS-responsive genes relative to resilient species.
View Article and Find Full Text PDFThe effect of different immobilization approaches on red-eared sliders.
Sci Rep
December 2024
Ministry of Education Key Laboratory for Ecology of Tropical Islands, Key Laboratory of Tropical Animal and Plant Ecology of Hainan Province, College of Life Sciences, Hainan Normal University, Haikou, 571158, China.
The ethical issues surrounding sacrifice methods in animal experimentation have garnered increasing attention, making immobilization and sedation an integral part of the sacrifice process for experimental animals. Currently, internationally recognized general sacrifice methods for commonly used laboratory animals have been established, but there remains significant controversy over the sacrifice methods for turtles. To explore the effectiveness of various immobilization methods and their impact on stress-related indicators in turtles, this study used red-eared sliders (Trachemys scripta elegans) as subjects.
View Article and Find Full Text PDFHygienic behaviors and use of dental care in patients with genetic syndromes.
Sci Rep
December 2024
Department of Paediatric Dentistry, Medical University of Warsaw, St. Binieckiego 6, 02-097, Warsaw, Poland.
Patients with genetic syndromes require special dental attention because they have symptoms that promote plaque accumulation, dental erosion, dental caries and gingival diseases. The aim of the study was to assess hygienic behaviors, use of dental care and frequency of professional preventive procedures among Polish children and adolescents with Prader-Willi, Down, Angelman, Silver-Russell and Smith-Lemli-Opitz syndromes. Parents/legal guardians of children and adolescents with genetic syndromes were included.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!