WALANT technique: A possible panacea in pandemic

Wide awake local anaesthesia no tourniquet (WALANT) is being employed beyond hand surgeries recently. COVID 19 shifted many orthopaedic practices with reliance on conservative treatment and deferment of elective procedures. WALANT techniques has a tendency to minimize the risk of aerosolized droplet contamination which is important in transmission of the disease. We studied the outcome of recalcitrant tennis elbow treated with either WALANT techniques or general anaesthesia.

Retrospective study of patient who underwent open release of recalcitrant tennis elbow with either WALANT or general anaesthesia with tourniquet. Outcome assessments were visual analogue score (VAS), quick disability of arm, shoulder and hand score (quick DASH) and the operative time.

46 patients were studied with average age of 49 years (SD=8.12), there was no difference in the mean of the quick DASH (GA 16.23±30.21, WALANT 0.00±0.00 p =0.07) and post-operative VAS (GA 2.61±3.17, WALANT 0.87± 1.80 p =0.17).  However, there was a significant difference in the operative time (GA 38.78±13.80, WALANT 19.88±8.24 p =0.00).

Both techniques have similar outcomes with respect to the quick DASH and VAS but procedures done with WALANT techniques are expedited with significant shorter duration. This study suggests WALANT technique might be relevant in surgical treatment of indicated patients during the COVID 19 pandemic and require wider acceptance in orthopaedic practice.


Funbi Anthony Ayeni, Syed Mannan, Tosin Akinyemi, Afolabi Awodiya and Aasiya S Mannan

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