Comparison of WALANT Technique and General Anesthesia in Single-portal Endoscopic Carpal Tunnel Release

WALANT technique is widely used in various procedures in hand surgery. This case series aimed to scrutinize the postoperative outcomes and perioperative metrics after single-portal endoscopic carpal tunnel release (eCTR) utilizing the WALANT technique in comparison to the employment of general anesthesia with a tourniquet in the Asian population.

Sixty-two patients (70 wrists) aged 18 years or older who underwent a single-portal eCTR between August, 2021, and March, 2024, by a specialized hand surgeon at our single institution were retrospectively reviewed. Of these, 66 (58 patients) cases met inclusion criteria; 26 (39%) eCTRs were performed under GA,and 40 (61%) under WALANT.

The study revealed that the WALANT group had shorter operating room and preparation time (44 vs. 62 minutes and 22 vs. 37 minutes, respectively). Recovery time after surgery was also significantly reduced in the WALANT group (11 days vs. 40 days). However, there were no notable differences in operation time, improvement of VAS score, or postoperative complications between the WALANT and GA groups.

• The reduced operating room time and preparation time observed in the WALANT group may have several implications for the healthcare system

• The trend of shorter recovery time after surgery in WALANT group may promote the patient's life quality and make the procedure more easily accepted

Keywords: WALANT, Technology in Hand Surgery, Microsurgery, Carpal Tunnel Syndrome