A systematic review of WALANT in Latin America and the Caribbean
Keywords:
WALANT, fully awake, hand surgery, Latin America, CaribbeanAbstract
Introduction: WALANT interventions have several advantages over conventional techniques, including the possibility of evaluating intraoperative active joint movement and reducing surgical costs. The global expansion of WALANT is evidenced by studies published in various journals and books.
Objectives: To understand the status of WALANT practice in Latin American and Caribbean countries through an analysis of publications on the topic in the region.
Methods: Articles published from 2014 to 2023 in various databases were selected. Keywords and authors' countries were used.
Results: Thirty-seven studies from Argentina, Brazil, Chile, Colombia, Cuba, Ecuador, Mexico, Puerto Rico, and Venezuela were analyzed. One thousand five hundred twenty-seven surgeries without complications (digital infarction, tissue necrosis, and amputation) related to epinephrine were reported.
Conclusions: The WALANT technique is considered safe in Latin American and Caribbean countries.
Downloads
References
1. Sardenberg T, Varanda D, Ramos CR, Cortopassi AC. El auge y la caída del mito de la epinefrina en la mano. Rev Cub Ortop Traumatol. 2022 [acceso 24/08/2023];36(2):e524. Disponible en: https://revortopedia.sld.cu/index.php/revortopedia/article/view/524/336
2. Denkler K. A comprehensive review of epinephrine in the finger: to do or not to do. Plast Reconstr Surg. 2001;108(1):114-24. DOI: https://doi.org/10.1097/00006534-200107000-00017
3. Thomson CJ, Lalonde DH, Denkler KA, Feicht AJ. A critical look at the evidence for and against elective epinephrine use in the finger. Plast Reconstr Surg. 2007;19(1):260-6. DOI: https://doi.org/10.1097/01.prs.0000237039.71227.11
4. Lalonde DH. Wide awake hand surgery. Boca Raton: CRC Press; 2016.
5. Lalonde DH. Conceptual origins, current practice, and views of wide awake hand surgery. J Hand Surg Eur. 2017;42(9):886-95. DOI: https://doi.org/10.1177/1753193417728427
6. Lalonde DH. Wide awake hand surgery and therapy tips. New York: Thieme; 2022.
7. Leblanc MR, Lalonde J, Lalonde DH. A detailed cost and efficiency analysis of performing carpal tunnel surgery in the main operating room versus the ambulatory setting in Canada. Hand. 2007;2(4):173-8. DOI: https://doi.org/10.1007/s11552-007-9043-5
8. Cayón FC, Serrano JPA. Ahorro del costo de hospitalización con técnica WALANT en la resolución quirúrgica del síndrome del túnel carpiano y tenosinovitis de De Quervain. Evaluación de costos en un hospital privado de Quito, Ecuador. Cir Mano Microcir. 2021;1(1):24-7. DOI: https://doi.org/10.25214/28056272.1178
9. Lalonde DH, Tang JB. How the wide awake tourniquet-free approach is changing hand surgery in most countries of the world. Hand Clin. 2019;35(1):12-3. DOI: https://doi.org/10.1016/j.hcl.2018.10.001
10. Ayhan E. WALANT: on the track of a paradigm shift. For all your wide awake needs. Charleston: Walant.Surgery; 2019 [acceso 22/07/2023]. Disponible en: https://walant.surgery/category/general/
11. Hearon BF, Isaacs-Pullins SR, Lalonde DH. Adoption of the wide-awake local anesthesia no tourniquet technique in hand surgery. JBJS Rev. 2023;11(7):e23.00068. DOI: https://doi.org/10.2106/jbjs.rvw.23.00068
12. Programa das Nações Unidas para o Desenvolvimento (PNUD). Relatório de Desenvolvimento Humano de 2021/2022. New York: PNUD; 2022 [acceso 24/08/2023]. Disponible en: https://www.undp.org/pt/brazil/desenvolvimento-humano/publications/relatorio-de-desenvolvimento-humano-2021-22
13. Álvarez JP. Quanto os países da América Latina contribuem para a economia mundial? Panama: Bloomberg Línea; 2022 [acceso 22/07/2023]. Disponible en: https://www.bloomberglinea.com.br/2022/09/25/quanto-os-paises-da-america-latina-contribuem-para-a-economia-mundial/
14. Comisión Económica para América Latina (CEPAL). IDH em America Latina e em Caribe? bases de dados y publicaciones estastísticas. Ciudad de México: CEPAL; 2023 [acceso 22/07/2023]. Disponible en: https://statistics.cepal.org/portal/cepalstat/index.html?lang=es
15. Faúndez MS, Sanhueza CA, Penna GC. Rotura espontánea del tendón extensor largo del pulgar-transferencia tendínea con técnica anestésica WALANT. Rev Chil Ortop Traumatol. 2017;58(2):71-5. DOI: https://doi.org/10.1055/s-0037-1606265
16. Romo RR, Pareyón VRP. Reparación de tendones flexores con WALANT: técnica quirúrgica y lesiones asociadas. An Med Asoc Med Hosp ABC. 2020;65(1):16-22. DOI: https://dx.doi.org/10.35366/92913
17. Moratelli L. Implantação da anestesia WALANT como protocolo para as cirurgias ortopédicas da mão e do punho: estudo piloto [Tesis de maestría]. Campinas: Universidade Estadual de Campinas; 2020. DOI: https://doi.org/10.47749/T/UNICAMP.2020.1129416
18. Novais RAF, Costa JRB, Carmo JMM. Uso da adrenalina com lidocaína na cirurgia da mão. Rev Bras Ortop. 2014;49(5):452-60. DOI: https://doi.org/10.1016/j.rboe.2014.09.006
19. Lalonde D, Bell M, Benoit P, Sparkes G, Denkler K, Chang P. A multicenter prospective study of 3,110 consecutive cases of elective epinephrine use in the fingers and hand: the Dalhousie project clinical phase. J Hand Surg Am. 2005;30(5):1061-7. DOI: https://doi.org/10.1016/j.jhsa.2005.05.006
20. Chowdhry S, Seidenstricker L, Cooney DS, Hazani R, Wilhelmi BJ. Do not use epinephrine in digital blocks: myth or truth? Part II. A retrospective review of 1111 cases. Plast Reconstr Surg. 2010;126(6):2031-4. DOI: https://doi.org/10.1097/PRS.0b013e3181f44486
21. Abdullah S, Hua LC, Yun LS, Devapitchai AST, Ahmad AA, Singh PSGN, et al. A review of 1073 cases of wide-awake-local-anaesthesia-no-tourniquet (WALANT) in finger and hand surgeries in an urban hospital in Malaysia. Cureus. 2021;13(7):e16269. DOI: https://doi.org/10.7759/cureus.16269
22. Ranjeet N, Onta PR, Sapkota K, Thapa P, Thapa UJ, Wahegaonkar K. The efficacy of WALANT technique in Hand Surgery. Asian J Med Sci. 2021;12(9):136-41. DOI: https://doi.org/10.3126/ajms.v12i9.37773
23. Bravo D, Townsend CB, Tulipan J, Ilyas AM. Economic and environmental impacts of the wide-awake, local anesthesia, no tourniquet (WALANT) technique in hand surgery: a review of the literature. J Hand Surg Glob Online. 2022;4(6):456-63. DOI: https://doi.org/10.1016/j.jhsg.2022.05.009
24. Ahmad MR, Abdel-Aal MHM, Sakr HA. Evaluation of wide-awake local anesthesia no tourniquet technique for extremity Surgeries. Egypt J Hosp Med. 2023;91(1):4837-40. DOI: https://doi.org/10.21608/ejhm.2023.300799
25. Feigoudozoui H, Parteina D, Soumaro K, Kouamé E. Evaluation of the local epinephrine anesthesia without tourniquet in the surgical treatment of hand injuries in adults: about 27 cases in Sub-Saharan Africa. Open J Orthop. 2023;13(2):62-70. DOI: https://doi.org/10.4236/ojo.2023.132007
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Trajano Sardenberg, Oswaldo Heber Avila Lyra, Rodrigo Thomazi Rodrigues, Juliana Lumi Muto Yamamoto, Henrique Maitto Benini, Denis Varanda, Andrea Christina Cortopassi
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
