Comparison of infraclavicular block and wide-awake local anesthesia with no tourniquet for hand surgery: A prospective randomized controlled study

The aim of this study was to compare the wide awake local anesthesia no tourniquet (WALANT) technique and the infraclavicular brachial plexus block (ICB) in terms of effectiveness, safety, and patient satisfaction in hand and upper extremity surgeries. The patients were randomized into 2 groups as WALANT and ICB. The pain levels of the patients before, during, and after surgery were questioned and recorded according to the visual analog scale (VAS). Their satisfaction levels were evaluated using the Likert scale. The duration of anesthesia administration, onset of anesthesia effect, intraoperative additional analgesic needs, total duration of anesthesia effect, postoperative analgesic needs, length of hospital stay, total surgical duration, hospitalization costs and complications were evaluated. ICB (group 1) was applied to 28 (50.9%), while WALANT (group 2) was applied to 27 (49.1%) of the patients. The mean anesthesia application time and postoperative hospital stay duration in Group 1 was significantly higher than Group 2. The satisfaction levels and the VAS scores were found to be statistically similar in both groups. The mean duration of anesthesia application and the total anesthesia duration was significantly shorter in group 2. It has been determined that there is a significant lower cost in group 2. The WALANT anesthesia technique may be an alternative to ICB in hand surgery operations due to its fast application, onset time, similar VAS score and patient satisfaction, and low cost.