Wide-Awake Surgery and Coronavirus Disease 2019: A Rural Experience

TL;DR

Hand surgeons adapted to the pandemic by performing procedures in clinics using wide-awake local anesthesia, which may influence future practices.

Contribution

The paper highlights how pandemic adaptations in hand surgery could reshape postpandemic clinic-based surgical practices.

Findings

Clinic-based procedures using wide-awake local anesthesia became more common during the pandemic.

Case volume trends from 2019 to 2022 suggest potential for expanding clinic-based surgeries in hand surgery.

Comparing surgical disciplines may help identify cost-effective and appropriate procedures for clinic settings.

Abstract

Surgeons across all subspecialties had to adapt to the Coronavirus disease 2019 pandemic to triage patients and steward hospital resources. Hand surgeons found themselves in a unique position to move some hospital-based procedures to a clinic-based setting, which has now impacted their postpandemic practices. Performing procedures in the clinic using the wide-awake local anesthesia no-tourniquet technique is interestingly similar to minor surgeries traditionally carried out in a general surgery clinic. By abstracting institutional case volumes from orthopedic, hand, and general surgery departments from 2019 to 2022, we identified trends that further support the potential for clinic-based procedures in hand surgery. This communication provides a foundation to compare cost and surgical indications for wide-awake local anesthesia across surgical disciplines.

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