Patients often dread the thought of going for a hand surgery because of fears or concerns related to anesthesia. Fortunately, new advances in hand surgery techniques are enabling surgeons to avoid the use of sedation or general anesthesia for a variety of common procedures.

Wide Awake Local Anesthesia No Tourniquet (W.A.L.A.N.T) is an emerging and revolutionary method that allows patients to be operated on under local anesthesia without the use of a tourniquet, while remaining completely conscious. 


What is WALANT Surgery

WALANT uses a combination of a local anesthetic drug (lidocaine) and a vasoconstrictive medication (epinephrine) to control bleeding. The method eliminates the need for preoperative tests,  improves patient comfort and surgical outcomes, and allows for a faster recovery time. 


Indications for WALANT Surgery

The performance of WALANT surgery may be indicated for the following hand injuries and disease conditions of the hand:

Benefits of WALANT Surgery

WALANT surgery benefits both the patient and the hand surgeon:

  • Facilitates preoperative assessment: Because there is no need to undergo tests such as an electrocardiogram, it is much faster and easier to prequalify a patient for surgery.
  • Saves Time: It is not associated with prolonged hospital stay and patients can return to work soon after the procedure.
  • Improves comfort: There is no need for pre-operative preparations like fasting, no tourniquet induced discomfort and no intravenous insertions.
  • Promotes intraoperative communication: There is a 2-way communication between the surgeon and the patient during WALANT surgery. This allows the surgeon to counsel and educate the patient during the surgery.
  • Ensures intraoperative monitoring and assessment: The hand surgeon can test repaired structures and make adjustments when necessary because the patients are responsive and cooperative during the procedure.

Comparison Between WALANT Surgery and General Anesthesia

A group of researchers conducted a study to compare the results of using WALANT and general anaesthesia on patients diagnosed with trigger finger. The researchers divided the patients into 2 groups: a group for WALANT and the other for monitored anesthesia.

It was discovered that the WALANT group had a shorter duration of surgery and recovery time coupled with a cheaper cost of surgery unlike the group that had general anesthesia.

Final Thoughts

Wide Awake Local Anesthetic No Tourniquet (WALANT) is a fast growing hand surgery technique among hand surgeons. WALANT ensures the patient stays conscious and comfortable during a hand surgery.

It benefits both patients and hand surgeons and it has been shown to be associated with a high satisfaction rate.