Comparison of three different techniques of regional anaesthesia for wrist and hand surgeries in awake patients: local anaesthetic infiltration without tourniquet versus local anaesthetic infiltration with forearm tourniquet versus ultrasound guided peripheral nerve blocks

Comparison of wide awake local anaesthesia without tourniquet (WALANT) versus wide awake local anaesthesia and forearm tourniquet (WALA with FAT) and ultrasound guided individual peripheral nerve blocks (IPNB) for wrist and hand surgeries: a prospective randomised controlled trial

Status

Recruiting

Phases

Phase 3Phase 4

Study type

Interventional

Source

CTRI

Registry ID

CTRI/2022/01/039521

Enrollment

Registered

2022-01-18

Start date

Unknown

Completion date

Unknown

Last updated

2026-01-12

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Health Condition 1: O- Medical and Surgical

Interventions

Intervention1: Wide awake local anaesthesia no tourniquet (WALANT) group: Wide awake local anaesthesia no tourniquet (WALANT) includes subcutaneous infiltration of diluted 1% of lignocaine with 1:100

Eligibility

Inclusion criteria

Inclusion criteria: ASA physical status 1 and 2 undergoing wrist or hand surgery.

Exclusion criteria

Exclusion criteria: Patient refusal Allergy to local anaesthetics Coagulopathy Infection at site of block Peripheral vascular disease Psychiatric disorders

Design outcomes

Primary

Measure	Time frame
Comparison of intraoperative pain intensity using 0-100 Visual Analogue Scale (VAS) with the surgical procedures performed under WALANT, WALA with forearm tourniquet and ultrasound guided individual peripheral nerve block.Timepoint: 15 mins after surgical incision intra-operatively	—

Secondary

Measure	Time frame
1. Time taken for effective surgical anaesthesia from time of starting injection. 2.Sensory block achieved in the dermatomes supplied using IPNB technique, and at surgical site using WALANT or WALA. 3.Motor block achieved distal to IPNBs or at the surgical site. 4.Comparison of pain 30 min post-surgery using 0-100 Visual Analogue Scale (VAS) 5.Surgeon’s estimate of surgical site oozing, bleeding. 6.Surgeon satisfaction with ease of doing surgery. 7.Any failure or complications with any of the techniques. 8.Time to first postoperative analgesic requirement. 9.Need for rescue analgesia with diclofenac & tramadol in 24 hours will be noted. 10.Pain scores in the first 24 postoperative hours. VAS scores at 30min, 1hr, 2hr, 4hr, 6hr, 12hr and 24hr. Timepoint: 1. 2. and 3. preoperatively 4. 30 min post surgery 5. & 6. immediate postoperative 7. Pre or intra-operative 8.and 9. First 24 hours postoperatively 10. Postoperatively at at 30min, 1hr, 2hr, 4hr, 6hr, 12hr and 24hr.	—

Measure

Time frame

1. Time taken for effective surgical anaesthesia from time of starting injection. 2.Sensory block achieved in the dermatomes supplied using IPNB technique, and at surgical site using WALANT or WALA. 3.Motor block achieved distal to IPNBs or at the surgical site. 4.Comparison of pain 30 min post-surgery using 0-100 Visual Analogue Scale (VAS) 5.Surgeon’s estimate of surgical site oozing, bleeding. 6.Surgeon satisfaction with ease of doing surgery. 7.Any failure or complications with any of the techniques. 8.Time to first postoperative analgesic requirement. 9.Need for rescue analgesia with diclofenac & tramadol in 24 hours will be noted. 10.Pain scores in the first 24 postoperative hours. VAS scores at 30min, 1hr, 2hr, 4hr, 6hr, 12hr and 24hr. Timepoint: 1. 2. and 3. preoperatively 4. 30 min post surgery 5. & 6. immediate postoperative 7. Pre or intra-operative 8.and 9. First 24 hours postoperatively 10. Postoperatively at at 30min, 1hr, 2hr, 4hr, 6hr, 12hr and 24hr.

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Countries

India

Contacts

Public ContactDhanya KV

All India Institute of Medical Sciences

anjolie5@hotmail.com01126593974

Outcome results

None listed

Source: CTRI (via WHO ICTRP) · Data processed: Feb 4, 2026