{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:06:00Z","timestamp":1780499160021,"version":"3.54.1"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n               Hintergrund Die als WALANT (Wide Awake Local Anaesthesia No Tourniquet) bekannte An\u00e4sthesiemethode wird immer beliebter. Die Vorteile sind oft beschrieben. Komplikationen wurden bislang kaum aufgearbeitet. Daher haben wir unser Patientengut hinsichtlich Art und H\u00e4ufigkeit von Komplikationen retrospektiv ausgewertet.<\/jats:p><jats:p>\n               Patienten und Methoden Zwischen Januar 2013 und Juni 2017 wurden die Komplikationen eines einzelnen Operateurs untersucht. Eingeschlossen wurden alle elektiven (n\u2005=\u2005195) und akuten (n\u2005=\u200590) in WALANT durchgef\u00fchrten Operationen. Das Mindestalter der Patienten betrug 18\u2005Jahre. Bei allen Patienten wurde Articain 1\u2005% mit Suprarenin (1:200\u2005000) angewandt. Injiziert wurden unterschiedliche Mengen mit einer Einwirkzeit von mindestens 30\u2005Minuten. Komplikationen wurden retrospektiv anhand der Patientenakten sowie durch telefonische Befragung durchschnittlich 73\u2005Wochen postoperativ anhand eines standardisierten Fragebogens erfasst.<\/jats:p><jats:p>\n               Ergebnisse Bei 285\u2005Patienten traten insgesamt 13 (4,6\u2005%) Komplikationen auf. Bei einem Patienten trat nach Injektion von 16\u2005ml Articain\/Suprarenin ein Koronarspasmus auf, welcher nach Gabe von Nitro-Spray sistierte. Bei einem Patienten mit Gef\u00e4\u00df-Nervenb\u00fcndel-Verletzung in der Hohlhand lag nach 60\u2005Minuten keine ausreichende Bluttrockenheit vor, sodass zur Exploration kurz eine Blutsperre angelegt wurde. Bei einem Patienten musste bei Beugesehnentenolyse auf eine Vollnarkose mit Tourniquet gewechselt werden, da hier durch ausgepr\u00e4gtes Narbengewebe keine ausreichende Vasokonstriktion erreicht wurde. Ein Patient klagte \u00fcber eine lange ger\u00f6tete Injektionsstelle, 2 Patienten zeigten fl\u00e4chenhafte R\u00f6tungen am Handr\u00fccken und 7 Patienten berichteten \u00fcber mehr als eine Woche anhaltende Schwellungen der Hand.<\/jats:p><jats:p>\n               Schlussfolgerung Die WALANT-Methode ist sicher. Perioperative Komplikationen sind selten. Dennoch gilt es einige Nachteile der Methode zu bedenken.<\/jats:p><jats:p>Bei Gef\u00e4\u00dfverletzungen, insbesondere an den Fingern, sollte die Perfusion kritisch beobachtet und der \u201eoff-label-use\u201c bedacht werden, ebenso bei kardial vorerkrankten Patienten. Bei Verletzungen in der Hohlhand kann die kurzzeitige Anlage eines Tourniquets vonn\u00f6ten sein. Voroperiertes Gewebe scheint eher ungeeignet, da hier eventuell keine ausreichende Diffusion mehr gegeben ist. In seltenen F\u00e4llen kann es zu anhaltenden R\u00f6tungen oder Schwellungen kommen. Generell ist abzuw\u00e4gen, ob der Patient f\u00fcr eine Operation in \u00f6rtlicher Bet\u00e4ubung geeignet ist.<\/jats:p>","DOI":"10.1055\/a-1552-3567","type":"journal-article","created":{"date-parts":[[2022,2,15]],"date-time":"2022-02-15T23:30:33Z","timestamp":1644967833000},"page":"44-50","source":"Crossref","is-referenced-by-count":6,"title":["WALANT \u2013 Wide Awake Local Anaesthesia No Tourniquet: Komplikationen bei elektiven und akut-traumatologischen handchirurgischen Eingriffen"],"prefix":"10.1055","volume":"54","author":[{"given":"Stefanie","family":"Wieschollek","sequence":"additional","affiliation":[{"name":"Sch\u00f6n Klinik M\u00fcnchen Harlaching; Zentrum f\u00fcr Handund Ellenbogenchirurgie, Mikrochirurgie und Plastische Chirurgie"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selma","family":"Forster","sequence":"additional","affiliation":[{"name":"Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, Sektion f\u00fcr Handchirurgie"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Megerle","sequence":"additional","affiliation":[{"name":"Sch\u00f6n Klinik M\u00fcnchen Harlaching; Zentrum f\u00fcr Handund Ellenbogenchirurgie, Mikrochirurgie und Plastische Chirurgie"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,2,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1142\/S2424835519500619","article-title":"Wide-Awake Local Anesthesia No Tourniquet (WALANT) versus Local or Intravenous Regional Anesthesia with Tourniquet in Atraumatic Hand Cases in Orthopedics: A Systematic Review and Meta-Analysis","volume":"24","author":"TM P Evangelista","year":"2019","journal-title":"J Hand Surg Asian Pac Vol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2309499017739499","DOI":"10.1177\/2309499017739499","article-title":"Perceived comfort during minor hand surgeries with wide awake local anaesthesia no tourniquet (WALANT) versus local anaesthesia (LA)\/tourniquet","volume":"25","author":"J Gunasagaran","year":"2017","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1558944719861706","DOI":"10.1177\/1558944719861706","article-title":"Wide-Awake Anesthesia for Olecranon Fracture Fixation","author":"A A Ahmad","year":"2019","journal-title":"Hand (N Y)"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.hcl.2018.08.008","article-title":"The Current and Possible Future Role of Wide-Awake Local Anesthesia No Tourniquet Hand Surgery in Military Health Care Delivery","volume":"35","author":"P C Rhee","year":"2019","journal-title":"Hand Clin"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e2509","DOI":"10.1097\/GOX.0000000000002509","article-title":"A Cost and Efficiency Analysis of the WALANT Technique for the Management of Trigger Finger in a Procedure Room of a Major City Hospital","volume":"7","author":"S G Maliha","year":"2019","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1177\/1558944716669693","article-title":"An Economic Analysis of MAC Versus WALANT: A Trigger Finger Release Surgery Case Study","volume":"12","author":"J L Codding","year":"2017","journal-title":"Hand (N Y)"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1016\/j.jhsa.2005.05.006","article-title":"A multicenter prospective study of 3,110 consecutive cases of elective epinephrine use in the fingers and hand: the Dalhousie Project clinical phase","volume":"30","author":"D Lalonde","year":"2005","journal-title":"J Hand Surg Am"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"312","DOI":"10.5999\/aps.2014.41.4.312","article-title":"Tumescent local anesthesia for hand surgery: improved results, cost effectiveness, and wide-awake patient satisfaction","volume":"41","author":"D Lalonde","year":"2014","journal-title":"Arch Plast Surg"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.isjp.2020.03.001","article-title":"Use of Wide-Awake Local Anaesthetic No Tourniquet (WALANT) in upper limb and hand surgery: A systematic review protocol","volume":"20","author":"N O\u2018Neill","year":"2020","journal-title":"Int J Surg Protoc"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.rboe.2017.05.006","article-title":"Is it safe to use local anesthesia with adrenaline in hand surgery? 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