Complications and side effects of Wide-Awake Local Anaesthesia No Tourniquet (WALANT) in upper limb surgery: a systematic review and meta-analysis
<h3>Purpose</h3><p dir="ltr">Wide-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...
محفوظ في:
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| مؤلفون آخرون: | , , , , |
| منشور في: |
2024
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| الموضوعات: | |
| الوسوم: |
إضافة وسم
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| _version_ | 1864513544613003264 |
|---|---|
| author | Jad Lawand (21633647) |
| author2 | Ashraf Hantouly (14150289) Fadi Bouri (17346931) Mohammad Muneer (5937046) Abdulaziz Farooq (5345384) Elisabet Hagert (13528690) |
| author2_role | author author author author author |
| author_facet | Jad Lawand (21633647) Ashraf Hantouly (14150289) Fadi Bouri (17346931) Mohammad Muneer (5937046) Abdulaziz Farooq (5345384) Elisabet Hagert (13528690) |
| author_role | author |
| dc.creator.none.fl_str_mv | Jad Lawand (21633647) Ashraf Hantouly (14150289) Fadi Bouri (17346931) Mohammad Muneer (5937046) Abdulaziz Farooq (5345384) Elisabet Hagert (13528690) |
| dc.date.none.fl_str_mv | 2024-02-17T09:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1007/s00264-024-06104-9 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Complications_and_side_effects_of_Wide-Awake_Local_Anaesthesia_No_Tourniquet_WALANT_in_upper_limb_surgery_a_systematic_review_and_meta-analysis/29446148 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Clinical sciences Anesthesia Hand Trauma Upper limb WALANT Wrist |
| dc.title.none.fl_str_mv | Complications and side effects of Wide-Awake Local Anaesthesia No Tourniquet (WALANT) in upper limb surgery: a systematic review and meta-analysis |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Purpose</h3><p dir="ltr">Wide-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.</p><h3>Methods</h3><p dir="ltr">This 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<sup>2</sup> statistics, and utilized common or random effects models for pooled analysis.</p><h3>Results</h3><p dir="ltr">2002 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%, <i>n</i> = 123/300), other/specified (12%, <i>n</i> = 37/300), and recurrent disease (6.7%, <i>n</i> = 20/300). A decade-by-decade analysis revealed no statistically significant difference in complication rates spanning the last three decades (<i>p</i> = 0.42). Adding sodium bicarbonate to the anaesthetic solution significantly reduced postoperative complications (<i>p</i> = 0.025).</p><h3>Conclusion</h3><p dir="ltr">WALANT 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.</p><h2>Other Information</h2><p dir="ltr">Published in: International Orthopaedics<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s00264-024-06104-9" target="_blank">https://dx.doi.org/10.1007/s00264-024-06104-9</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_bcce472d978b987b3b5f7bd3213752ed |
| identifier_str_mv | 10.1007/s00264-024-06104-9 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/29446148 |
| publishDate | 2024 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Complications and side effects of Wide-Awake Local Anaesthesia No Tourniquet (WALANT) in upper limb surgery: a systematic review and meta-analysisJad Lawand (21633647)Ashraf Hantouly (14150289)Fadi Bouri (17346931)Mohammad Muneer (5937046)Abdulaziz Farooq (5345384)Elisabet Hagert (13528690)Biomedical and clinical sciencesClinical sciencesAnesthesiaHandTraumaUpper limbWALANTWrist<h3>Purpose</h3><p dir="ltr">Wide-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.</p><h3>Methods</h3><p dir="ltr">This 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<sup>2</sup> statistics, and utilized common or random effects models for pooled analysis.</p><h3>Results</h3><p dir="ltr">2002 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%, <i>n</i> = 123/300), other/specified (12%, <i>n</i> = 37/300), and recurrent disease (6.7%, <i>n</i> = 20/300). A decade-by-decade analysis revealed no statistically significant difference in complication rates spanning the last three decades (<i>p</i> = 0.42). Adding sodium bicarbonate to the anaesthetic solution significantly reduced postoperative complications (<i>p</i> = 0.025).</p><h3>Conclusion</h3><p dir="ltr">WALANT 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.</p><h2>Other Information</h2><p dir="ltr">Published in: International Orthopaedics<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s00264-024-06104-9" target="_blank">https://dx.doi.org/10.1007/s00264-024-06104-9</a></p>2024-02-17T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1007/s00264-024-06104-9https://figshare.com/articles/journal_contribution/Complications_and_side_effects_of_Wide-Awake_Local_Anaesthesia_No_Tourniquet_WALANT_in_upper_limb_surgery_a_systematic_review_and_meta-analysis/29446148CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/294461482024-02-17T09:00:00Z |
| spellingShingle | Complications and side effects of Wide-Awake Local Anaesthesia No Tourniquet (WALANT) in upper limb surgery: a systematic review and meta-analysis Jad Lawand (21633647) Biomedical and clinical sciences Clinical sciences Anesthesia Hand Trauma Upper limb WALANT Wrist |
| status_str | publishedVersion |
| title | Complications and side effects of Wide-Awake Local Anaesthesia No Tourniquet (WALANT) in upper limb surgery: a systematic review and meta-analysis |
| title_full | Complications and side effects of Wide-Awake Local Anaesthesia No Tourniquet (WALANT) in upper limb surgery: a systematic review and meta-analysis |
| title_fullStr | Complications and side effects of Wide-Awake Local Anaesthesia No Tourniquet (WALANT) in upper limb surgery: a systematic review and meta-analysis |
| title_full_unstemmed | Complications and side effects of Wide-Awake Local Anaesthesia No Tourniquet (WALANT) in upper limb surgery: a systematic review and meta-analysis |
| title_short | Complications and side effects of Wide-Awake Local Anaesthesia No Tourniquet (WALANT) in upper limb surgery: a systematic review and meta-analysis |
| title_sort | Complications and side effects of Wide-Awake Local Anaesthesia No Tourniquet (WALANT) in upper limb surgery: a systematic review and meta-analysis |
| topic | Biomedical and clinical sciences Clinical sciences Anesthesia Hand Trauma Upper limb WALANT Wrist |