Wide-awake local anesthesia surgery with no tourniquet, or WALANT, has become popular in surgery, especially among hand surgeons. With the increasing number of surgeons performing office-based procedures, this article provides guidelines that may be used in the office setting to help transition more traditional hospital operating room-based procedures to the office setting. This article outlines the benefits of performing office-based wide-awake local anesthesia surgery with no tourniquet and provides a step-by-step guide to performing procedures that can be easily incorporated into any hand surgeon's practice successfully and safely.
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http://dx.doi.org/10.1097/PRS.0000000000009850 | DOI Listing |
J Hand Microsurg
January 2025
Etlik City Hospital, Orthopedics and Neurology Hospital, Orthopedics Clinic, Ankara, Turkiye.
Background: Trapeziectomy and abductor pollicis longus hammock ligamentoplasty may be performed in the surgical management of trapeziometacarpal joint osteoarthritis (TMC OA). Several anaesthesia techniques are available for TMC joint surgery, including wide-awake local anaesthesia no tourniquet (WALANT), regional anaesthesia, and general anaesthesia (GA). The aim of this study was to compare the clinical outcomes of trapeziectomy and abductor pollicis longus hammock ligamentoplasty performed under WALANT versus GA.
View Article and Find Full Text PDFJ Hand Microsurg
January 2025
Department of Orthopedics, Hand, and Reconstructive Microsurgery, Olympia Hospital & Research Centre, 47, 47A Puthur High Road, Puthur, Trichy, Tamilnadu, India, 620017.
This article introduces a surgical technique for cross-intrinsic transfers (CIT) to correct ulnar drift in rheumatoid hands performed under wide-awake local anesthesia no tourniquet (WALANT). This approach allows real-time adjustment of tendon transfer tension and active patient participation in hand movements and deformity correction during the procedure. It can be combined with other surgeries such as prosthetic replacement arthroplasties of the MCP joints.
View Article and Find Full Text PDFJ Hand Surg Eur Vol
January 2025
St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford CM1 7ET, UK.
This bibliometric analysis aimed to define important topics and developments across wide awake local anaesthesia no tourniquet (WALANT) hand surgery, an innovative ambulatory technique that gained popularity during the COVID-19 pandemic. Articles were searched and screened using the Web of Science core collection database. VOSviewer 1.
View Article and Find Full Text PDFJ Hand Surg Eur Vol
January 2025
Wayne State University School of Medicine; 540 E. Canfield St, Detroit, MI 48201, USA.
This study aimed to establish whether virtual reality can reduce patient anxiety and improve surgical satisfaction during wide-awake local anaesthetic no tourniquet hand procedures. Previously validated questionnaires were used to assess subjective anxiety and patient satisfaction. Objective anxiety was determined using patient blood pressure and heart rate measured four times during the procedure.
View Article and Find Full Text PDFJ Pers Med
December 2024
Department of Orthopaedics and Traumatology, Universita' Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168 Rome, Italy.
: The Wide Awake Local Anesthesia No Tourniquet (WALANT) technique has revolutionized outpatient hand surgery, enabling procedures such as carpal tunnel release and trigger finger release without a tourniquet. Its benefits include patient cooperation during surgery, especially for tendon repairs. However, WALANT has limitations, including a steep learning curve, longer operative preparation time, and risks such as digital ischemia and adrenaline-induced cardiac ischemia.
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