Systematic Review on Walnt Anaesthesia

Background: Wide-Awake Local Anesthesia No Tourniquet (WALNT) is a technique that has gained popularity in hand and upper limb surgeries. By eliminating the need for a tourniquet and general anesthesia, WALNT provides significant advantages, including reduced patient discomfort, lower risks of systemic complications, and enhanced intraoperative patient cooperation. However, concerns remain regarding its efficacy, safety, and patient acceptance. This systematic review evaluates the latest evidence on the effectiveness, advantages, and limitations of WALNT in various surgical settings. Objective: To assess the efficacy, safety, and clinical outcomes of WALNT in comparison with traditional anesthesia methods in hand and upper limb surgeries. Methods: A systematic literature search was conducted in PubMed, Scopus, and Cochrane Library for studies published between 2013 and 2023. Inclusion criteria included randomized controlled trials (RCTs), cohort studies, and meta-analyses evaluating WALNT in surgical procedures. Exclusion criteria included case reports, non-peer-reviewed articles, and studies focusing on non-surgical applications. Results: WALNT reduces intraoperative pain and enhances surgical precision by allowing active patient feedback (Table 1). Eliminating the tourniquet improves patient comfort and reduces the need for sedation (Table 2). WALNT significantly lowers operative costs and allows for faster postoperative recovery (Table 3). Reported complications are minimal, with infection rates comparable to traditional techniques (Table 4). Conclusion: WALNT is an effective alternative to traditional anesthesia, offering benefits in terms of patient comfort, surgical efficiency, and cost reduction. While generally safe, further research is needed to refine techniques and expand its applications in complex procedures.