CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(03): 538-542
DOI: 10.1055/s-0041-1735172
Nota Técnica
Mão

Ultrasound-Guided WALANT Technique in Carpal Tunnel Decompression Surgery[*]

Article in several languages: português | English
1   Faculdade de Medicina, Universidade de Araraquara/UNIARA, Araraquara, São Paulo, Brasil
2   Universidade de Araraquara/UNIARA, Araraquara, São Paulo, Brasil
,
Danilo C. Chagas
3   Faculdade de Medicina, Universidade de Araraquara/UNIARA, Araraquara, São Paulo, Brasil
,
Caetano T. Yamashita
3   Faculdade de Medicina, Universidade de Araraquara/UNIARA, Araraquara, São Paulo, Brasil
› Author Affiliations

Abstract

Carpal tunnel syndrome (CTS) is the most common compressive neuropathy in the human body. Its symptoms result from compression of the median nerve in the carpus. The treatment can be conservative, with medications and/or infiltrations that alleviate the symptoms, or surgical, which is more effective, with decompression of the median nerve by surgical section of the flexor retinaculum of the carpus. The anesthetic technique varies according to the anesthesia method: sedation, venous locoregional anesthesia and, more recently, wide-awake local anesthesia no tourniquet (WALANT), which can be performed by the surgeons themselves. The WALANT technique uses local anesthesia with a vasoconstrictor, and does not require the use of a tourniquet on the upper limb nor sedation. The median nerve block in ultrasound-guided WALANT provides better accuracy to the technique, with greater patient safety; in the present article, its use in the performance of carpal tunnel decompression is described, and the literature is reviewed.

Final considerations

In carpal tunnel decompression surgery, US to perform the WALANT technique enables the refinement of the anesthetic technique, with greater accuracy, effectiveness, and patient safety.


Financial Support

There was no financial support from public, commercial, or non-profit sources.


* Study developed at the School of Medicine, Universidade de Araraquara/UNIARA, Araraquara, São Paulo, Brazil.




Publication History

Received: 28 January 2021

Accepted: 18 May 2021

Article published online:
11 September 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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