Patient experiences of WALANT for outpatient upper limb surgery: A cross-sectional study of perioperative pain and anxiety

Journal of the Colleges of Medicine of South Africa

 
 
Field Value
 
Title Patient experiences of WALANT for outpatient upper limb surgery: A cross-sectional study of perioperative pain and anxiety
 
Creator Govender, Reshlan Rocher, Antoine G.L. Rankin, Mario T. Sondovana, Khangelani Phenyane, Simphiwe C. O'Connor, Megan
 
Subject Orthopaedics; hand surgery; outpatient surgery WALANT; patient experience; VAS; anxiety; upper limb surgery; outpatient surgery; orthopaedic surgery; hand surgery.
Description Background: Demands on South African operating theatres have led to more outpatient upper limb surgery being performed under wide awake local anaesthesia no tourniquet (WALANT). This study aimed to determine patients’ anxiety and pain related to WALANT use in outpatient upper limb surgery, and to identify factors that increased the risk of heightened pain experiences.Methods: This multicentre cross-sectional study conducted between December 2022 and June 2024 utilised the ‘strengthening the reporting of observational studies in epidemiology guidelines’. Patients receiving outpatient upper limb surgery under WALANT were prospectively recruited for participation in an investigator-administered questionnaire of 15 questions regarding their demographics, procedure, anxiety and pain experiences. Patients’ anxiety and pain experiences were summarised, and relationships between demographic or procedural factors and anxiety or pain scores were tested.Results: In all, 85 patients were included. The most frequent procedures performed were tendon repairs and trigger releases (42% and 12% respectively). Of the total recruited patients, 45% reported moderate to severe anxiety perioperatively. The median visual analogue scale (VAS) score for pain of injection and procedure were 20 mm and 0 mm, respectively. Male patients and isiZulu speaking patients had lower VAS pain scores, while very anxious patients had higher VAS pain scores.Conclusion: Forty-five per cent of patients who underwent outpatient upper limb surgery under WALANT experienced perioperative anxiety. They did not experience the anaesthetic or surgery as painful on average. Pain scores were related to perioperative anxiety. Future investigation should further explore the relationship between perioperative anxiety and pain.Contribution: Wide awake local anaesthesia no tourniquet is well tolerated in patients undergoing outpatient upper limb surgery.
 
Publisher AOSIS
 
Contributor None
Date 2025-06-13
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Cross-sectional study
Format text/html application/epub+zip text/xml application/pdf application/pdf
Identifier 10.4102/jcmsa.v3i1.184
 
Source Journal of the Colleges of Medicine of South Africa; Vol 3, No 1 (2025); 6 pages 2960-110X 3105-4331
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://jcmsa.org.za/index.php/jcmsa/article/view/184/584 https://jcmsa.org.za/index.php/jcmsa/article/view/184/585 https://jcmsa.org.za/index.php/jcmsa/article/view/184/586 https://jcmsa.org.za/index.php/jcmsa/article/view/184/593 https://jcmsa.org.za/index.php/jcmsa/article/view/184/587
 
Coverage South Africa; KwaZulu-Natal 2022-2024 Anxiety; Pain; age; gender; home language
Rights Copyright (c) 2025 Reshlan Govender, Antoine G.L. Rocher, Mario T. Rankin, Khangelani Sondovana, Simphiwe C. Phenyane, Megan O’Connor https://creativecommons.org/licenses/by/4.0
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