Comparison of Complex Regional Pain Syndrome Prevalence Between WALANT and Regional Anesthesia in Distal Radius Fracture Surgery
نویسندگان
1 Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
6 Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
7 Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
8 Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
doi
10.30483/rjm.2026.254684.1454چکیده
Background: Distal radius fractures are among the most common skeletal injuries that require surgical intervention. This study compares the Wide-Awake Local Anesthesia No Tourniquet (WALANT) technique with regional anesthesia with respect to surgical outcomes and the incidence of complex regional pain syndrome (CRPS). Objective: This study aimed to compare the Wide-Awake Local Anaesthesia No Tourniquet (WALANT) technique with regional anaesthesia in patients undergoing distal radius fracture surgery. Specifically, it evaluated differences in surgical outcomes, including intraoperative blood loss, duration of surgery, postoperative pain, and changes in haemoglobin, and assessed the incidence of complex regional pain syndrome (CRPS) between the two groups. The findings were intended to inform clinical decision-making regarding anaesthesia selection for this common orthopaedic procedure. Methods: In this Non-Randomized Clinical Trial, 59 patients with distal radius fractures were divided into two groups: 30 received WALANT, and 29 received regional anesthesia. Outcomes assessed included intraoperative blood loss, hemoglobin drop, postoperative pain (VAS score), surgery duration, and CRPS incidence. Results: Blood loss was higher in the WALANT group (147 mL, SD = 29) compared to the regional anesthesia group (121 mL, SD = 39; p = 0.005). Hemoglobin drop was similar between groups (1.3 g/dL, SD = 2.2 vs. 1.0 g/dL, SD = 0.2; p = 0.574). Postoperative pain scores showed no significant difference (1.60, SD = 1.16 vs. 1.07, SD = 0.80; p = 0.081). Surgery duration was significantly shorter in the WALANT group (138 min, SD = 33 vs. 157 min, SD = 24; p = 0.022). CRPS incidence was lower in the WALANT group (30%) than in the regional anesthesia group (37.9%), but the difference was not statistically significant (p = 0.52). Conclusion: Both WALANT and regional anesthesia are safe and effective for distal radius fracture surgery. WALANT offers a shorter surgical time and eliminates the need for a tourniquet, despite higher blood loss. It may be a viable and efficient alternative.
