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Wide-Awake Local Anesthesia No Tourniquet (WALANT) Technique for Atraumatic Hand Surgery: A Systematic Review and Meta-analysis

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August 23, 2021

Wide-Awake Local Anesthesia No Tourniquet (WALANT) Technique for Atraumatic Hand Surgery: A Systematic Review and Meta-analysis

Vol: 4| Issue: 8| Number:4| ISSN#: 2563-559X

Authored By: Meng Zhu, Yaping Chang, Steve Phillips, Ayesha Siddiqua, Mohit Bhandari On Behalf of OrthoEvidence

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The wide-awake local anesthesia no tourniquet (WALANT) technique has become increasingly popular for various types of hand and upper extremity procedures. As the name indicates, WALANT is a technique in which patients undergo the surgery being wide awake, analgesia is delivered directly to the operative site via a local injection, and the use of tourniquet is avoided. Neutralized lidocaine and adrenaline (also known as epinephrine, which minimizes bleeding on the surgical field by imposing a vasoconstrictive effect in the subcutaneous layer) are often used for hand and upper extremity operations (Lalonde, 2010, 2014). WALANT is believed to have a number of advantages over the use of general or regional anesthesia with tourniquet for hand and upper extremity surgeries. For example, patients feel more comfortable without the use of a tourniquet, which may cause....
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Anonymous 2021-08-23

Orthopaedic Surgeon - Canada

Pre-op time can be mitigated by injecting next patient before starting the one prior. Not really relevant if u are organized. I wonder about the ganglion recurrence rate under local? Almost never see recurrences in those done under GA, but get sent few LA recurrences every year.

Anonymous 2021-08-31

Orthopaedic Surgeon - Canada

I have found 15 minutes from injection to incision is ample. Never had any complaints of intra-operative pain in 40 years.