WALANT 技术与镇静用于腕管松解内镜治疗。
WALANT Technique versus Sedation for Endoscopic Carpal Tunnel Release.
机构信息
University of Connecticut, Farmington, USA.
出版信息
Hand (N Y). 2023 Mar;18(2):214-221. doi: 10.1177/15589447211003180. Epub 2021 Apr 9.
BACKGROUND
This study sought to investigate complication rates/perioperative metrics after endoscopic carpal tunnel release (eCTR) via wide-awake, local anesthesia, no tourniquet (WALANT) versus sedation or local anesthesia with a tourniquet.
METHODS
Patients aged 18 years or older who underwent an eCTR between April 28, 2018, and December 31, 2019, by 1 of 2 fellowship-trained surgeons at our single institution were retrospectively reviewed. Patients were divided into 3 groups: monitored anesthesia care with tourniquet (MT), local anesthesia with tourniquet (LT), and WALANT.
RESULTS
Inclusion criteria were met by 156 cases; 53 (34%) were performed under MT, 25 (16%) under LT, and 78 (50%) under WALANT. The MT group (46.1 ± 9.7) was statistically younger compared with LT (56.3 ± 14.1, = .007) and WALANT groups (53.5 ± 15.8, = .008), (2, 153) = 6.465, = .002. Wide-awake, local anesthesia, no tourniquet had decreased procedural times (10 minutes, SD: 2) compared with MT (11 minutes, SD: 2) and LT (11 minutes, SD: 2), (2, 153) = 5.732, = .004). Trends favored WALANT over MT and LT for average operating room time (20 minutes, SD: 3 vs 32 minutes, SD: 6 vs 23 minutes, SD: 3, respectively, (2, 153) = 101.1, < .001), postanesthesia care unit time (12 minutes, SD: 7 vs 1:12 minutes, SD: 26 vs 20 minutes, SD: 22, respectively, (2, 153) =171.1, < .001), and door-to-door time (1:37 minutes, SD: 21 vs 2:51 minutes, SD: 40 vs 1:46 minutes, SD: 33, respectively, (2, 153) = 109.3, < .001). There were no differences in complication rates.
CONCLUSIONS
Our data suggest favorable trends for patients undergoing eCTR via WALANT versus MT versus LT.
背景
本研究旨在探讨在清醒、局部麻醉、无止血带（WALANT）与镇静或带止血带的局部麻醉下进行内镜腕管松解术（eCTR）后的并发症发生率/围手术期指标。
方法
回顾性分析 2018 年 4 月 28 日至 2019 年 12 月 31 日期间，由本机构的 2 名 fellowship培训外科医生对 156 例年龄在 18 岁及以上的患者进行 eCTR 的病例。患者被分为 3 组：带止血带的监护麻醉（MT）、带止血带的局部麻醉（LT）和 WALANT。
结果
符合纳入标准的有 156 例；其中 53 例（34%）为 MT 组，25 例（16%）为 LT 组，78 例（50%）为 WALANT 组。MT 组（46.1±9.7）的年龄明显小于 LT 组（56.3±14.1， =.007）和 WALANT 组（53.5±15.8， =.008），（2，153）=6.465， =.002。与 MT 组（11 分钟，SD：2）和 LT 组（11 分钟，SD：2）相比，WALANT 组的手术时间（10 分钟，SD：2）更短，（2，153）=5.732， =.004）。WALANT 组的平均手术时间（20 分钟，SD：3）、麻醉后护理室时间（12 分钟，SD：7）和门到门时间（1：37 分钟，SD：21）均优于 MT 组（32 分钟，SD：6）和 LT 组（23 分钟，SD：3）和 20 分钟，SD：22），（2，153）=101.1， <.001）、1：12 分钟，SD：26）和 1：46 分钟，SD：33），（2，153）=171.1， <.001）、1：37 分钟，SD：21）和 1：46 分钟，SD：33），（2，153）=171.1， <.001）。并发症发生率无差异。
结论
我们的数据表明，与 MT 组和 LT 组相比，WALANT 组患者行 eCTR 的结果有较好的趋势。
Zotero 插件