Wide Awake Hand Surgery

Wide awake hand surgery

Wide Awake Local Anesthesia No Tourniquet (WALANT)

Anyone who has ever had an injury or medical condition affecting his or her hands knows just how debilitating it can be. Work duties and everyday tasks we once took for granted can seem overwhelming due to the pain caused by conditions like trigger fingers or carpal tunnel syndrome. When conservative treatment options fail to bring relief, there are surgical options. However, when a patient requires anesthesia and/or a tourniquet for a procedure, the inconvenience, discomfort, and risk factors dramatically increase. In today’s blog post, I’ll discuss Wide Awake Local Anesthesia No Tourniquet, or WALANT: an outpatient alternative to traditional hand surgery.

What exactly is WALANT?

Traditionally, many hand surgeries required general anesthesia or sedation and the use of a tourniquet to temporarily stop the flow of blood to surgical site. With the WALANT technique, anesthesia and a tourniquet are replaced with lidocaine and epinephrine.

Lidocaine blocks pain, and epinephrine controls bleeding. As a result, the surgeon can perform several types of hand surgeries while the patient remains fully awake and pain free without the need for an IV.

Who Can Benefit from WALANT?

Wide Awake Hand Surgery is a good option for most soft tissue procedures involving the hand or wrist. In addition to carpal tunnel decompression or trigger finger release, the WALANT procedure can be used for de Quervian’s release, tendon repairs and transfers, as well as fracture fixation to the fingers and hand.

What are the Benefits of Wide Awake Hand Surgery?

The WALANT technique is a safe option for patients who previously were not good candidates for surgery. WALANT enables patients with cardiac or lung disease, who were high risk with anesthesia, to have wide-awake hand surgery to treat their conditions. This also means they can continue taking all their medications without concerns about going under anesthesia.

Other benefits of WALANT:

Less Risk

The possible nerve and/or muscle damage associated with the use of a tourniquet is eliminated.

Shorter Surgery
Because preoperative anesthesia is no longer part of surgery, the entire surgical process is shorter. In addition, WALANT patients will not experience the sluggish recovery common after anesthesia.

No Fasting
No anesthesia means no fasting the night before.

No Disruption of Medication Schedules
Often, when you are put to sleep, you can’t take your regular medicines before and after surgery. However, the use of only lidocaine and epinephrine does not require holding any medicines.

Communication During Surgery
Because patients are awake during surgery, they can demonstrate hand function. This gives the surgeon critical feedback during procedures to repair trigger finger, tendon repairs, tendon reconstructions, and tendon transfers.

Less Expensive
Because general anesthesia isn’t necessary, much of the costs associated with the hospital, an anesthesiologist, and preoperative blood work are eliminated.

Is WALANT Right for You?

If you have been putting off dealing with a painful hand condition because of the risks associated with traditional hand surgery, WALANT may be a great option for you. WALANT is a faster, easier alternative to the traditional use of surgical anesthesia. Schedule an evaluation with Dr. Donnelly today, so you can get back to work and a more active lifestyle.

This site is not intended to and does not provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual. Through this website and links to other websites, Brandon P. Donnelly, MD provides general information for educational purposes only. The content provided in this website and links, is not a substitute for medical care or treatment. You should not use this information in place of a consultation or the advice of your healthcare provider. Brandon P. Donnelly, MD is not liable or responsible for any advice, course of treatment, diagnosis or any other information, services or product you obtain through this site.