Indications and Early Outcomes of WALANT among Patients Undergoing Surgical Procedures at a Tertiary Care Hospital, Mwanza, Tanzania

Abstract

Introduction: The concept of "Wide Awake Local Anesthesia No Tourniquet" (WALANT) technique is gaining popularity in the field of plastic, orthopedic and general surgery owing to its benefits of reduced cost, improved safety, improved patient satisfaction, avoiding costly preoperative tests, decreased operative time, reduced utilization of hospital resources and length of hospital stay. Objective: To determine indications for surgery and early outcomes of "Wide Awake Local Anesthesia No Tourniquet" among patients undergoing surgical procedures at Bugando Medical Centre (BMC). Method: This was a 4 months’ prospective longitudinal study conducted from April to July 2023 involving 91 patients aged 12 years and above who underwent surgical procedures from plastic, orthopaedics and general surgery departments at Bugando Medical Centre. Structured questionnaire was used to obtain operative information and the Visual Analogue Scale (VAS) was used to obtain intra operative pain score. Results: The most common indication for using WALANT was surgeon's preference (65/91,70%). The most common procedure done was sloughectomy (16/91,17.6%) the least being colostomy placement (1/91, 1.1%). Intraoperative VAS score range from 0 to 4 with a mean of 1.1 (±0.39). (88/91, 97%) of the participants had no any complication post-operatively and the majority of the remaining few presented with tachycardia (2/91, 2.2%). The level of satisfaction was significant associated with the length of hospital stay having the p-value of 0.00. Conclusions: The WALANT technique can be performed as the best alternative type of anesthesia for both minor and selected major surgeries with minimal pain score, high patient’s satisfaction rate, minimum risk of infection and significant reduced length of hospital stay.