TITLE: 

Comparison of analgesic  effect of wide awake local anaesthesia

no tourniquet (WALANT)  technique and regional

anaesthesia with tourniquet in hand surgery: A randomised control trial.

AIMS AND OBJECTIVES:

To compare intra-operative and post-operative analgesic efficacy, analgesic

requirements and complications between patients undergoing hand surgeries using either

WALANT technique or Brachial plexus block with tourniquet technique.

Primary objective:

To compare post-operative pain scores every 6 hourly up to first 24 hours among the two

groups using the Numerical Rating Scale (NRS)

Secondary objective:

1. To compare Intra-operative pain scores using NRS scale at every 1 hour time point

2. To compare intra operative blood loss

3. To compare Total surgical time between the two groups

4. To compare Total anaesthesia time between the two groups

5. To compare Quality of surgical field

6. To compare post operative analgesic consumption including opioid consumption.

7. To compare Post operative Adverse effects- incidence of tourniquet pain, digital necrosis,

residual weakness

METHEDOLOGY:

Patients meeting inclusion criteria posted for surgery in plastic surgery OT or ATC OT will

be assessed by the surgeons. Patients will be evaluated before surgery to assess their fitness

for the proposed surgical procedure, and written informed consent will be obtained at this14

stage. Patients will be instructed on the pain Numerical Rating Score before surgery, and will

be reminded before transfer to the operating theatre and in the post- anaesthesia care unit. All

patients will be fasted as per ASA guidelines .

In the operating theatre, ASA mandatory monitoring including NIBP (Non-Invasive Blood

Pressure), heart rate, continuous ECG, oxygen saturation and end-tidal carbon

dioxide will be placed. Intravenous access will be established and patients will receive 500

ml 0.9% normal saline. Depending on the group allocation the patient will be given allocated

mode of anaesthesia.