Comparison of Local Anesthesia With the Fully Awake Tourniquet-Free Local Anesthesia Technique (WALANT) in Central Venous Catheter Insertion Procedure
Phase: NA
Conditions: Trauma (Including Fractures), Dialysis Catheter, Malnutrition Severe
Sponsor: Ataturk University

WALANT Versus Local Anesthesia in Central Venous Catheter Insertion
Unique Protocol Id: B.30.2.ATA.0.01.00/830
Document Date: 01.11.2023

This was a single-center, prospective, observational study conducted between November 1, 
2023, and August 1, 2024. Sixty-four adult patients (≥18 years) requiring CVC placement 
were enrolled. Patients were excluded if they were pregnant, had a Glasgow Coma Scale 
score <15, were disoriented, had hemorrhagic shock stage >1, coagulopathy, local infection, 
or vascular obstruction. Eligible participants were randomized using a single-blind allocation 
method based on hospital file numbers: odd numbers received WALANT and even numbers 
received lidocaine. The WALANT solution was prepared according to the standard protocol 
and injected into a 3×3 cm target area 20 minutes before catheter insertion. CVCs were placed 
without ultrasound guidance in jugular, subclavian, or femoral veins by anatomical 
localization. Pain intensity was assessed using the Visual Analog Scale (VAS) before and 
after the procedure. 
For the control group, patients requiring CVCs were selected in the emergency resuscitation 
room and, unless contraindicated, the procedure was performed without any guidance such as 
ultrasound, after selecting the catheter insertion site (either the femoral vein, subclavian vein, 
or jugular vein). After marking the anatomical location, the vein to be used was identified by 
using a 10cc syringe and applying negative pressure to the skin and subcutaneous tissues. 
While the needle was slowly withdrawn, local anesthesia was induced with an average of 2-
10ml lidocaine (1.5-2 mg/kg) applied to the designated 3x3cm area. CVC insertion was then 
performed according to routine procedures. Patient assessments were recorded using a visual 
analog scale before and after the procedure.
Data from the case and control groups were statistically analyzed.