Wide Awake Hand Surgery : Principles, Pain Management, and Outcomes

Wide Awake Local Anesthesia No Tourniquet (WALANT) hand surgery is safe, efficacious, and evolving to address expanding demands and indications. WALANT Surgery has demonstrated consistent and reproducible advantages for patients and providers alike. Over the past several years, WALANT techniques have been further honed and implemented throughout the hand and upper extremity surgery field. These advances have improved patient pre-, intra-, and postoperative pain during routine hand surgery procedures. These improvements and the elimination of intraoperative tourniquet pain and unpleasant general anesthetic sequelae have increased overall patient satisfaction. Additionally, the WALANT surgical technique has helped mitigate patient postoperative opiate needs and prescriptions. Regarding surgical outcomes, data is emerging to support the non-inferiority of WALANT versus conventional surgical techniques when applied to many procedures. The prospective growth of WALANT hand and upper extremity surgery is immense, with progressing indications and applications.