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November 13, 2025Regional Anesthesia & Pain Medicine

Wide awake local anesthesia no tourniquet (WALANT) versus ultrasound-guided axillary block in carpal tunnel release: a non-inferiority randomized controlled trial

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Authors

MVMarie VirtosCCClément ChasseryPMPhilippe Marty

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Overview

Randomized trial shows WALANT achieves non-inferior surgical anesthesia in outpatient carpal tunnel release compared to USGAB, highlighting the effectiveness of local anesthesia.

Key Points

  • To compare the effectiveness of WALANT and USGAB for providing surgical anesthesia during carpal tunnel release.
  • A non-inferiority randomized controlled trial was conducted at a single center.
  • Patients undergoing endoscopic carpal tunnel release were randomized to receive either WALANT or USGAB with lidocaine.
  • Patient outcomes included success rate of anesthesia, postoperative function, and satisfaction scores.
  • WALANT achieved a 100% success rate in providing anesthesia, while USGAB had an 89% success rate.
  • Postoperative function was better in the WALANT group for the ability to dress (92% versus 58%).
  • No significant differences in intraoperative bleeding or regional anesthesia satisfaction were noted.

Cite This Study

Virtos et al. (2025) studied this question.

synapsesocial.com/papers/692523b2c0ce034ddc35479ahttps://doi.org/10.1136/rapm-2025-107152
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Clinical impact of wide-awake local anesthesia no tourniquet (WALANT) in carpal tunnel release: a systematic review and meta-analysis of randomized controlled trials2026
  2. 2Wide-awake local anesthesia no tourniquet (WALANT) versus brachial plexus block for upper extremity surgery: a systematic review and meta-analysis2026
  3. 3Comparison of infraclavicular block and wide-awake local anesthesia with no tourniquet for hand surgery: A prospective randomized controlled study2025
  4. 4Comparison of Ultrasound-Guided and Landmark-Based WALANT Techniques in Carpal Tunnel Surgery: A Cadaveric Evaluation with Radiological Imaging2025
  5. 5Patient Satisfaction and Perioperative Outcomes of Wide-Awake Local Anesthesia No Tourniquet Versus Supraclavicular Peripheral Nerve Block in Elective Hand and Forearm Surgery: A Prospective Comparative Study2026