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NCT Number: NCT07832591

Wide-Awake Local Anesthesia No-Tourniquet (WALANT) Procedures

The goal of this clinical trial is to learn whether a standardized preoperative educational video improves expectation management and the patient experience in adults undergoing Wide-Awake Local Anesthesia No Tourniquet (WALANT) hand surgery. The main questions it aims to answer are:

1. Does watching a preoperative educational video help patients better understand what to expect from their WALANT surgical experience? 2. Does watching the video impact anxiety scores, pain scores, overall satisfaction, and patient-reported functional outcomes?

Researchers will compare patients who receive traditional preoperative counseling plus the educational video with patients who receive traditional preoperative counseling alone to determine whether the video improves the patient experience.

Participants will:

* Complete questionnaires about their expectations, anxiety, pain, hand function, and satisfaction before, during, and after their WALANT procedure. * If assigned to the video group, watch a standardized educational video explaining what to expect before, during, and after WALANT surgery. * Complete their final study questionnaires at their 2-week postoperative follow-up visit.

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Key information

Conditions

Hand Injuries and Disorders Behavior Disease Hand Injuries Health Behavior Pathologic Processes Pathological Conditions, Signs and Symptoms Patient Satisfaction Treatment Adherence and Compliance Wounds and Injuries

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Carilion Clinic Institute for Orthopaedics and Neurosciences (ION)

Roanoke, Virginia, 24014, United States

Location contact

Hayden Fredericks, B.S.

CONTACT

[email protected]

(727) 439-8086

Natalie Vaughn, M.D.

PRINCIPAL_INVESTIGATOR

About this study

Wide-Awake Local Anesthesia No Tourniquet (WALANT) allows many hand and wrist procedures to be performed using a local anesthetic injection without the need for general anesthesia. Because patients remain awake throughout the procedure, adequate preoperative education and preparation are important for managing patient expectations and optimizing the overall surgical experience.

This prospective randomized clinical trial will evaluate the effect of a standardized preoperative educational video on the experience of patients undergoing WALANT hand surgery. All participants will receive traditional preoperative counseling as part of their clinical care. Following enrollment, participants will be randomized to either traditional preoperative counseling alone or traditional preoperative counseling plus the standardized educational video.

The educational video provides standardized information about the WALANT experience, including preparation for surgery, administration of the local anesthetic, the treatment room environment, sensations that may occur while awake during surgery, options for interacting with or observing the procedure, and expectations for postoperative recovery. The purpose of the video is to provide patients with a consistent understanding of what they may experience throughout the perioperative period.

Participants will complete study questionnaires at enrollment, on the day of surgery, and at their routine 2-week post-operative follow-up visit. The study will compare the experiences of participants in the two groups to determine whether adding standardized video-based education to traditional counseling improves expectation management and other aspects of the WALANT patient experience.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adults ≥18 years
  • Scheduled for an elective WALANT procedure with a Carilion Clinic hand surgeon
  • Able to read and understand English
  • Capacity to consent

Exclusion criteria

  • Prior WALANT surgery
  • Visual impairment that would prevent the participant from watching the preoperative educational video

Treatment and study plan

Preoperative WALANT Educational Video

Behavioral

A standardized preoperative educational video designed to prepare patients for their WALANT surgical experience. The video provides information about preparation for surgery, administration of the local anesthetic injection, the treatment room environment, sensations patients may experience while awake during surgery, options for interacting with or observing the procedure, postoperative recovery, and other expectations surrounding the WALANT experience.

Traditional Preoperative Counseling

Behavioral

Standard preoperative counseling provided by the treating physician as part of routine clinical care for patients undergoing WALANT hand surgery.

Primary outcomes

  1. Expectation Management Assessed by Adapted MODEMS

    Time frame: Day of surgery, repeat at 2-week postoperative follow-up visit

    Patient expectation management will be assessed using an adapted version of the Musculoskeletal Outcomes Data Evaluation and Management System (MODEMS). Participants complete preoperative MODEMS domains before surgery and corresponding postoperative domains following their WALANT procedure to assess their expectations and experiences.

Secondary outcomes

  1. Anxiety Assessed by Numeric Rating Scale (NRS-A)

    Time frame: At enrollment phone call, Day of surgery immediately before anesthesia, Day of surgery immediately before first incision

    Patient-reported anxiety will be assessed using the NRS-Anxiety at enrollment and at specified perioperative time points on the day of surgery. The rating scale will go from 0 = No anxiety, 1 to 3 = Mild anxiety, 4 to 6 = Moderate anxiety, 7 to 10 = Severe anxiety

  2. Pain Assessed by Numeric Rating Scale (NRS-Pain)

    Time frame: Day of surgery

    Patient-reported pain will be assessed following administration of the local anesthetic injection and following the first surgical incision. Rating scale scoring: 0 = No pain, 1 to 3 = Mild pain (nagging, annoying, interferes little with daily activities), 4 to 6 = Moderate pain, 7 to 10 = Severe pain

  3. Upper Extremity Function Assessed by QuickDASH

    Time frame: From enrollment through 2-week postoperative follow-up

    Patient-reported upper extremity function will be assessed using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire.

  4. Overall Patient Satisfaction

    Time frame: 2-week postoperative follow-up

    Overall satisfaction with the WALANT experience will be assessed using a 5-point Likert scale and a binary satisfaction question

Study contacts

Contact information is provided by the study sponsor or research team.

Hayden Fredericks, B.S.

CONTACT

[email protected]

(727) 439-8086

Sponsors and collaborators

Lead sponsor

Carilion Clinic

Other

Registry information

Official study title

Improving Patient Experience Through Preoperative Video Education: A Study of Video-Based Intervention in Wide-Awake Local Anesthesia No-Tourniquet (WALANT) Procedures

Acronym: WALANT

Important dates

Study start
2026
Primary completion
2028
Study completion
2028
First posted
Sep 22, 2026
Registry last updated
Sep 22, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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