Saving Cost of Hospitalization with the WALANT technique in the surgical resolution of Carpal Tunnel syndrome and De Quervain’s tenosynovitis. Cost evaluation in a private hospital in the city of Quito
DOI:
https://doi.org/10.25214/28056272.1178Keywords:
Anesthesia, Local, Carpal Tunnel Syndrome, De Quervain DiseaseAbstract
Introduction: The benefits of the use of regional anesthetic technics have increased the interest in the last years as they allow to carry out several surgical procedures in the hand and the wrist safely performed on an outpatient basis, without the side effects of the general anesthesia or the need to monitoring in the post-anesthetic care unit, decreasing the usage of hospital resources.
Objective: To determine the economic impact of the WALANT technique compared to general anesthesia in surgical procedures of the hand.
Material and Methods: In this work, the costs of 14 patients operated with the WALANT anesthetic technique versus 13 patients operated under general anesthesia are presented.
Results: The surgeries carried out through WALANT were achieved in a lower cost in comparison to the general anaesthesia.
Conclusions: The Carpal Tunnel Syndrome and De Quervain’s Tenosynovitis surgery under local anaesthesia no tourniquet and with the patient awake (WALANT) allows reducing costs at an average of $391,80 54.36% percent.
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Nodwell T, Lalonde D. How Long does it Take Phentolamine to Reverse Adrenaline-Induced Vasoconstriction in the Finger and Hand? A Prospective, Randomized, Blinded Study: The Dalhousie Project Experimental Phase. Can J Plast Surg. 2003;11(4):187-90. DOI: 10.1177/229255030301100408. https://doi.org/10.1177/229255030301100408
Fitzcharles-Bowe C, Denkler K, Lalonde D. Finger Injection with High-Dose (1:1,000) Epinephrine: Does it Cause Finger Necrosis and Should it be Treated? Hand (NY). 2007;2(1):5-11. DOI: 10.1007/s11552-006-9012-4. https://doi.org/10.1007/s11552-006-9012-4
Lalonde DH. Conceptual origins, current practice, and views of wide awake hand surgery. J Hand Surg Eur Vol. 2017;42(9):886-95. DOI: 10.1177/1753193417728427. https://doi.org/10.1177/1753193417728427
Steiner MM, Calandruccio JH. Use of Wide-awake Local Anesthesia No Tourniquet in Hand and Wrist Surgery. Orthop Clin North Am. 2018;49(1):63-8. DOI: 10.1016/j.ocl.2017.08.008. https://doi.org/10.1016/j.ocl.2017.08.008
Lalonde D. Minimally Invasive Anesthesia in wide awake hand surgery. Hand Clin. 2014;30(1):1-6. DOI: 10.1016/j.hcl.2013.08.015. https://doi.org/10.1016/j.hcl.2013.08.015
Teo I, Lam W, Muthayya P, Steele K, Alexander S, Miller G. Patients' perspective of wide-awake hand surgery - 100 consecutive cases. J Hand Surg Eur Vol. 2013;38(9):992-9. DOI: 10.1177/1753193412475241. https://doi.org/10.1177/1753193412475241
Kazmers NH, Presson AP, Xu Y, Howenstein A, Tyser AR.. Cost Implications of Varying the Surgical Technique, Surgical Setting, and Anesthesia Type for Carpal Tunnel Release Surgery. J Hand Surg Am. 2018;43(11):971-7.e1. DOI: 10.1016/j.jhsa.2018.03.051. https://doi.org/10.1016/j.jhsa.2018.03.051
Bismil M, Bismil Q, Harding D, Harris P, Lamyman E, Sansby L. Transition to total one-stop wide-awake hand surgery service-audit: a retrospective review. JRSM Short Rep. 2012;3(4):23. DOI:10.1258/shorts.2012.012019. https://doi.org/10.1258/shorts.2012.012019
Rhee PC, Fischer MM, Rhee LS, McMillan H, Johnson AE. Cost Savings and Patient Experiences of a Clinic-Based, Wide-Awake Hand Surgery Program at a Military Medical Center: A Critical Analysis of the First 100 Procedures. J Hand Surg Am.2017;42(3):e147. DOI: 10.1016/j.jhsa.2016.11.019. https://doi.org/10.1016/j.jhsa.2016.11.019
Far-Riera AM, Pérez-Uribarri C, Sánchez Jiménez M, Esteras Serrano MJ, Rapariz González JM, Ruiz Hernández IM. Estudio prospectivo sobre la aplicación de un circuito WALANT para la cirugía del síndrome del túnel carpiano y dedo en resorte. Rev Esp Cir Ortop Traumatol. 2019;63(6):400-7. DOI: 10.1016/j.recot.2019.06.006. https://doi.org/10.1016/j.recot.2019.06.006
Gandhi R, Zapolsky I, Gray B. Tips & Tricks: Local Anesthetic Techniques for the Hand. University of Pennsylvania Orthopaedic Journal. 2018;28:107-9.
O'Neill N, Abdall-Razak A, Norton E, Kumar A, Shah H, Khatkar H, et al. Use of Wide-Awake Local Anaesthetic No Tourniquet (WALANT) in upper limb and hand surgery: A systematic review protocol. Int J Surg Protoc. 2020;20:8-12. DOI: 10.1016/j.isjp.2020.03.001. https://doi.org/10.1016/j.isjp.2020.03.001
Lalonde DH. Reconstruction of the Hand with Wide Awake Surgery. Clin Plast Surg. 2011;38(4):761-9. DOI: 10.1016/j.cps.2011.07.005. https://doi.org/10.1016/j.cps.2011.07.005
Maliha SG, Cohen O, Jacoby A, Sharma S. A Cost and Efficiency Analysis of the WALANT Technique for the Management of Trigger Finger in a Procedure Room of a Major City Hospital. Plast Reconstr Surg Glob Open. 2019;7(11):e2509. DOI: 10.1097/GOX.0000000000002509. https://doi.org/10.1097/GOX.0000000000002509
Kim PT, Lee HJ, Kim TG, Jeon IH. Current Approaches for Carpal Tunnel Syndrome. Clin Orthop Surg. 2014;6(3):253-7. DOI: 10.4055/cios.2014.6.3.253. https://doi.org/10.4055/cios.2014.6.3.253
Bland JDP. Treatment of Carpal Tunnel Syndrome. Muscle Nerve. 2007;36(2):167-71. DOI: 10.1002/mus.20802. https://doi.org/10.1002/mus.20802
Leblanc MR, Lalonde J, Lalonde DH. A Detailed Cost and Efficiency Analysis of Performing Carpal Tunnel Surgery in the Main Operating Room versus the Ambulatory Setting in Canada. Hand (NY). 2007;2(4):173-8. DOI: 10.1007/s11552-007-9043-5. https://doi.org/10.1007/s11552-007-9043-5
Satteson E, Tannan SC. De Quervain Tenosynovitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021.
Patel KR, Tadisina KK, Gonzalez MH. De Quervain's Disease. Eplasty. 2013 Jul 16;13:ic52.
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