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WALANT

Perioperative and Anesthetic Care

WALANT (Wide Awake Local Anesthesia No Tourniquet) is a technique used in hand surgery on unsedated patients that combines local anesthesia with a hemostatic agent, such as 1 percent lidocaine with 1:100,000 epinephrine, sometimes buffered with sodium bicarbonate. The absence of a tourniquet avoids tourniquet-related discomfort and complications, while the epinephrine provides vasoconstriction that decreases blood loss enough to suit most hand procedures, making WALANT a safe, cost-effective, efficient and widely accessible approach with a low complication rate. The technique keeps the patient fully awake and able to use active movement, allowing the surgeon to assess tendon function, fracture stability or nerve decompression intraoperatively, and its exclusion of general anesthesia allows it to be performed in an office or outpatient setting, eliminating the need for operating room resources, anesthesia personnel and post-anesthesia care units.

Facts
Classification
Status
Standard of Care 1
Origin Year
2003 2
Sources
1. Wikipedia
Wikipedia contributors, Wikimedia Foundation
2. WALANT (Wikipedia)
  • History section
    Lalonde first published this method in 2003 to decrease surgical wait times; he formally proposed the concept in 2005, which has been internationalized since.
  • https://en.wikipedia.org/wiki/WALANT, lead section
    WALANT (Wide Awake Local Anesthesia No Tourniquet) is a technique that uses local anesthesia and hemostatic agent (e.g., 1% lidocaine with 1:100,000 epinephrine, sometimes buffered with sodium bicarbonate) in hand surgery in unsedated patients.
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