# 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.

## Key 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.