Impact of Wide-Awake Local Anesthesia No Tourniquet for Ganglion Excision in Pediatric Patients.

PURPOSE: Wide-Awake Local Anesthesia No Tourniquet (WALANT) technique is proven safe and beneficial in the adult population. Limited studies exist regarding WALANT in the pediatric population. The purpose of this study was to evaluate outcomes after ganglion removal in pediatric patients performed under general anesthesia (GA) versus the WALANT technique.

METHODS

A retrospective chart review was performed of 58 patients undergoing ganglion excision by a single surgeon between 2017 and 2023. Patients were grouped by anesthesia type. Electronic medical records were reviewed for demographic information, procedure details, and surgical outcomes.

RESULTS

The WALANT group included 30 patients (11 men; age, 14.8 ± 2.2 years), and the GA group included 28 patients (11 men; age, 13.6 ± 2.7 years). There were no conversions or cancellations because of intolerance of the administration of the local anesthetic. Total operating room (OR) time was 41.6 minutes for GA and 36.2 minutes for WALANT. Average length of surgery was 23.5 and 24.8 minutes in GA and WALANT groups, respectively. Time in the postanesthesia care unit (PACU) was 63.9 minutes in the GA group and 20.6 minutes in the WALANT group. Immediate PACU pain scores in the GA group averaged 1.5, which was higher than 0.07 in the WALANT group. One patient had superficial wound dehiscence in the WALANT group, and one patient in the WALANT group and 2 patients in the GA group had recurrences.

CONCLUSIONS

Our results demonstrate that the WALANT technique can be used in pediatric patients undergoing ganglion removal with similar benefits previously demonstrated in the adult population.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.