Regarding Hand Osteosyntheses in Sub-Saharan Africa, Which Type of Anaesthesia: WALANT and General Anaesthesia: Provides Better Postoperative Comfort?

Abstract Context: Hand osteosyntheses are essential for treating metacarpal and phalangeal fractures, particularly in sub-Saharan Africa, where trauma is frequent. However, management is often limited by a lack of resources and qualified surgeons. Wide awake local anaesthesia no tourniquet (WALANT) presents an effective alternative to general anaesthesia (GA), reducing postoperative pain and anaesthesia-related complications. Aims: To compare postoperative pain between these two types of anaesthesia. Settings and Design: An analytical case–control study included 34 patients, equally divided into two groups (WALANT and GA) over 3 years. Materials and Methods: Pain was assessed using the visual analogue scale (VAS) at 1, 6, 24 and 48 h postoperatively. Statistical Analysis Used: Statistical analysis was performed using the Mann–Whitney and Student’s t -tests. Results: The WALANT group had significantly lower VAS scores compared to the GA group at all time points ( P < 0.05). Fewer severe complications were observed with WALANT, including the absence of cardiac arrest and better perioperative tolerance. Conclusion: WALANT effectively reduces postoperative pain and complications, offering a safe and cost-effective alternative to GA. Its adoption in sub-Saharan Africa could improve surgical management of hand injuries.