New Frontiers in Wide-Awake Surgery | Journal CME Article-Journal CME Article: New Frontiers in Wide-Awake Surgery (Article)

Journal CME Article: New Frontiers in Wide-Awake Surgery (Article)

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The document highlights the advancements in wide-awake surgery, shifting the focus from the traditional sedation methods used since the late 19th century. It emphasizes the development of techniques that minimize the pain associated with local anesthesia injections, rendering certain surgeries painless without the need for sedation. The key innovations include the use of tumescent local anesthesia, which allows surgeons to perform procedures painlessly by blocking sensation in large body areas with minimal discomfort. Another innovation is the replacement of tourniquets with epinephrine vasoconstriction, making extremity surgeries less painful and eliminating the need for sedation.<br /><br />Wide-awake local anesthesia no tourniquet (WALANT) surgery offers numerous advantages. It reduces the complications associated with sedation, such as nausea and aspiration pneumonia, speeds up recovery time, and diminishes costs related to sedation requirements. This method also enhances patient outcomes by allowing real-time testing and adjustments during procedures like tendon repair and fracture fixation, often obviating the need for reoperations.<br /><br />The paper underscores the potential of moving many procedures from major operating rooms to minor procedure rooms without increasing infection rates. This shift could reduce surgical costs and environmental impact by minimizing waste produced in the operating room.<br /><br />The document encourages adoption across various medical disciplines, including orthopedic and general surgery, while noting the growing evidence supporting WALANT's efficacy and safety. With reduced infection rates, improved patient and surgical team experiences, and significant cost savings, wide-awake surgery is presented as a compelling future direction in the field.

Keywords

wide-awake surgery

local anesthesia

tumescent anesthesia

epinephrine vasoconstriction

WALANT

sedation alternatives

surgical cost reduction

patient outcomes

real-time procedure adjustments

infection rate reduction