Current Evidence Involving WALANT Surgery.
Katherine M Connors, Sara M Guerra, Steven M Koehler
https://pubmed.ncbi.nlm.nih.gov/36420465/Actively Recruiting
Led by University of California, Irvine · Updated on 2026-03-12
134
Participants Needed
1
Research Sites
13 weeks
Total Duration
This research aims to determine whether eating solid food before a wide-awake local-only no tourniquet WALANT procedure affects patient anxiety and other outcomes. The study compares patients who eat before the procedure to those who fast, evaluating anxiety, nausea, satisfaction, and other measures. Researchers hypothesize that eating before the procedure will reduce anxiety and nausea and improve satisfaction compared to fasting. Participants are randomly assigned to either a fasting group, instructed to avoid food after midnight and liquids 4 hours before surgery, or an eating group, told to consume a light meal within two hours before their procedure. All patients undergo the WALANT procedure with standard preoperative care. Follow-up visits occur at 2 and 6 weeks post-procedure, with additional monitoring for complications up to 6 months. During the study, participants provide demographic information and complete assessments including the Amsterdam Preoperative Anxiety and Information Score, pain and nausea scales, and the QuickDASH questionnaire. Vital signs such as heart rate and blood pressure are collected before and after surgery. Satisfaction is measured at the first postoperative visit. Complications are tracked from medical records without extra procedures after the second visit.
CONDITIONS
Effect of Fasting on Patient Outcomes After Wide-Awake, Local Anesthesia-only, No Tourniquet (WALANT) Procedures
M
Michael W Madsen, BA
M
Mikhail Pakvasa, MD
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University of California, Irvine
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Not Fasting (Eat Before Surgery) | Fasting (Standard Preoperative Instruction) |
|---|---|---|
| What it is | Patients are instructed to eat before their WALANT hand surgery using local anesthesia only, with no tourniquet used. | Patients are instructed to fast (abstain from food) before their WALANT hand surgery, even though they are receiving only local anesthesia without a tourniquet. |
| Role in this study | Tested to determine whether allowing patients to eat before WALANT surgery influences anxiety, satisfaction, or other outcomes compared to fasting. | Serves as the control reflecting the traditional approach of preoperative fasting, enabling direct comparison with the non-fasting protocol. |
| Primary use / rationale | Evaluates whether eating before WALANT surgery improves comfort, reduces anxiety and hunger, and maintains safety for adult patients. | Represents the standard precaution to reduce the risk of aspiration and potential nausea, as applied broadly in surgical settings, but its need is in question for WALANT procedures. |
| How it is given or performed | Patients are advised to eat as they normally would before coming for WALANT surgery with local anesthetic only. | Patients are instructed to abstain from food before the procedure, following traditional fasting guidelines as routinely advised for surgical patients. |
| Status of supporting evidence | Currently being studied in this randomized trial for effects on anxiety, comfort, and perioperative outcomes; some evidence from minor surgery supports patient comfort with less strict fasting but limited WALANT-specific data exist. | Widely adopted due to general anesthesia practice, but limited direct evidence supports the need for fasting in local anesthetic-only surgery. Safety margin is based more on tradition than WALANT-specific data. |
| Important limitations | Evidence for non-fasting is still emerging; outcomes specific to WALANT procedures have not yet been reported. Potential risks (such as rare aspiration) will be assessed in this trial, but precise incidence is unknown. | Routine fasting may cause unnecessary discomfort, anxiety, or hunger, especially given the low risk profile of WALANT surgery with local-only anesthesia. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
You may qualify if you...
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person or phone)
Duration - Day of procedure
Participants undergo their assigned fasting or eating protocol before their local anesthesia-only, no tourniquet procedure and then have the procedure performed.
1 visit (in-person, day of surgery)
Duration - 6 weeks
Participants are followed at 2 weeks and 6 weeks after their procedure to assess surgical satisfaction and arm function.
2 visits (approximately 2 weeks and 6 weeks post-procedure)
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Lead Sponsor