Outcomes of flexor carpi radialis tendon transfer surgery for patients with radial nerve injury: a comparison of the wide-awake method and general anesthesia

Background: Advanced intraoperative anesthesia techniques have improved patient cooperation, stabilized hemodynamic status, and reduced postoperative pain and disability, especially in reconstructive limb surgeries. The Wide-Awake Local Anesthetic No Tourniquet (WALANT) technique has recently been...

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Main Authors: Parviz Ahangar, Hosein Pirmohamadi, Alireza Rahimnia, Mohammad Kazem Emami Meybodi, Mohammad Javanbakht, Mohsen Motalebi, Mehdi Raei, Asghar Yousefi, Seyed Ahmadreza Madinei
Format: Article
Language:English
Published: PAGEPress Publications 2025-06-01
Series:European Journal of Translational Myology
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Online Access:https://www.pagepressjournals.org/bam/article/view/13454
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author Parviz Ahangar
Hosein Pirmohamadi
Alireza Rahimnia
Mohammad Kazem Emami Meybodi
Mohammad Javanbakht
Mohsen Motalebi
Mehdi Raei
Asghar Yousefi
Seyed Ahmadreza Madinei
author_facet Parviz Ahangar
Hosein Pirmohamadi
Alireza Rahimnia
Mohammad Kazem Emami Meybodi
Mohammad Javanbakht
Mohsen Motalebi
Mehdi Raei
Asghar Yousefi
Seyed Ahmadreza Madinei
author_sort Parviz Ahangar
collection DOAJ
description Background: Advanced intraoperative anesthesia techniques have improved patient cooperation, stabilized hemodynamic status, and reduced postoperative pain and disability, especially in reconstructive limb surgeries. The Wide-Awake Local Anesthetic No Tourniquet (WALANT) technique has recently been adopted due to its peculiar advantages, but comparative studies of its benefits and limitations against general anesthesia are not well explored in FCR tendon transfer surgery. This study investigates outcomes of flexor carpi radialis (FCR) tendon transfer surgery in patients with radial nerve injuries using either the Wide-Awake approach or general anesthesia. Methods: In this cross-sectional study, we included patients with confirmed radial nerve injuries who underwent FCR tendon transfer from 2019 to 2024. Participants were then divided into two groups; one received the WALANT anesthesia (200 ml epinephrine 1:400000 and 0.25% lidocaine buffered with sodium bicarbonate), while the other received general anesthesia. Data was collected from the medical records and the Hospital Information System (HIS). The intensity of pain, postoperative opioid consumption, wrist and finger function, and levels of patient satisfaction were measured both before and one month after surgery. Results: There was no statistical difference between the groups regarding pain intensity, postoperative opioid dosage, and symptom severity. However, the WALANT group exhibited significantly less motor dysfunction in the postoperative period, which translated to a much higher level of patient satisfaction compared with general anesthesia. Conclusion: WALANT provides quicker recovery of motor function and results in higher patient satisfaction when compared to general anesthesia for FCR tendon transfer surgeries. This approach thus leads to an earlier return to daily activities and occupational duties, which in turn helps improve overall patient satisfaction post-surgery.
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spelling doaj-art-30ea2faa1a1a4d6495536afd4a31aaf62025-08-20T03:26:51ZengPAGEPress PublicationsEuropean Journal of Translational Myology2037-74522037-74602025-06-0110.4081/ejtm.2025.13454Outcomes of flexor carpi radialis tendon transfer surgery for patients with radial nerve injury: a comparison of the wide-awake method and general anesthesiaParviz Ahangar0Hosein Pirmohamadi1Alireza Rahimnia2Mohammad Kazem Emami Meybodi3Mohammad Javanbakht4Mohsen Motalebi5Mehdi Raei6Asghar Yousefi7Seyed Ahmadreza Madinei8Department of Orthopedic Surgery, Tehran University of Medical Sciences, TehranDepartment of Orthopedic Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, TehranOrthopedic Department, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, TehranDepartment of Orthopedic Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, TehranNephrology and Urology Research Center, Clinical Science Institute, Baqiyatallah University of Medical Sciences, TehranDepartment of Orthopedic Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, TehranDepartment of Epidemiology and Biostatistics, Faculty of Health, Baqiyatallah University of Medical Sciences, TehranTrauma Research Center, Faculty of Medicine, Baqiyatallah University of Medical Sciences, TehranDepartment of Orthopedic Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran Background: Advanced intraoperative anesthesia techniques have improved patient cooperation, stabilized hemodynamic status, and reduced postoperative pain and disability, especially in reconstructive limb surgeries. The Wide-Awake Local Anesthetic No Tourniquet (WALANT) technique has recently been adopted due to its peculiar advantages, but comparative studies of its benefits and limitations against general anesthesia are not well explored in FCR tendon transfer surgery. This study investigates outcomes of flexor carpi radialis (FCR) tendon transfer surgery in patients with radial nerve injuries using either the Wide-Awake approach or general anesthesia. Methods: In this cross-sectional study, we included patients with confirmed radial nerve injuries who underwent FCR tendon transfer from 2019 to 2024. Participants were then divided into two groups; one received the WALANT anesthesia (200 ml epinephrine 1:400000 and 0.25% lidocaine buffered with sodium bicarbonate), while the other received general anesthesia. Data was collected from the medical records and the Hospital Information System (HIS). The intensity of pain, postoperative opioid consumption, wrist and finger function, and levels of patient satisfaction were measured both before and one month after surgery. Results: There was no statistical difference between the groups regarding pain intensity, postoperative opioid dosage, and symptom severity. However, the WALANT group exhibited significantly less motor dysfunction in the postoperative period, which translated to a much higher level of patient satisfaction compared with general anesthesia. Conclusion: WALANT provides quicker recovery of motor function and results in higher patient satisfaction when compared to general anesthesia for FCR tendon transfer surgeries. This approach thus leads to an earlier return to daily activities and occupational duties, which in turn helps improve overall patient satisfaction post-surgery. https://www.pagepressjournals.org/bam/article/view/13454Wide-awake local anesthetic no tourniquetgeneral anesthesiatendon transfer
spellingShingle Parviz Ahangar
Hosein Pirmohamadi
Alireza Rahimnia
Mohammad Kazem Emami Meybodi
Mohammad Javanbakht
Mohsen Motalebi
Mehdi Raei
Asghar Yousefi
Seyed Ahmadreza Madinei
Outcomes of flexor carpi radialis tendon transfer surgery for patients with radial nerve injury: a comparison of the wide-awake method and general anesthesia
European Journal of Translational Myology
Wide-awake local anesthetic no tourniquet
general anesthesia
tendon transfer
title Outcomes of flexor carpi radialis tendon transfer surgery for patients with radial nerve injury: a comparison of the wide-awake method and general anesthesia
title_full Outcomes of flexor carpi radialis tendon transfer surgery for patients with radial nerve injury: a comparison of the wide-awake method and general anesthesia
title_fullStr Outcomes of flexor carpi radialis tendon transfer surgery for patients with radial nerve injury: a comparison of the wide-awake method and general anesthesia
title_full_unstemmed Outcomes of flexor carpi radialis tendon transfer surgery for patients with radial nerve injury: a comparison of the wide-awake method and general anesthesia
title_short Outcomes of flexor carpi radialis tendon transfer surgery for patients with radial nerve injury: a comparison of the wide-awake method and general anesthesia
title_sort outcomes of flexor carpi radialis tendon transfer surgery for patients with radial nerve injury a comparison of the wide awake method and general anesthesia
topic Wide-awake local anesthetic no tourniquet
general anesthesia
tendon transfer
url https://www.pagepressjournals.org/bam/article/view/13454
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