The Many Advantages of Wide Awake Hand Surgery (WALANT)

The thought of staying awake for surgery might not sound too appealing, but when it comes to hand surgery, it’s growing in popularity. And there are good reasons for it. There are a number of benefits, from improved surgical outcomes to shorter recovery times, that make it worth considering.

WALANT, which stands for wide awake local anesthesia no tourniquet, is a type of surgery that doesn’t require general anesthesia. While traditional methods of hand and wrist surgery utilize a tourniquet on the arm and general anesthesia, WALANT procedures use local anesthesia, which means patients stay awake during surgery. 

Kristopher Downing, MD, and Daniel Brereton, DO, are proud to offer the latest and best surgical techniques to treat hand injuries at Upper Extremity Specialists in Chula Vista and La Jolla, California. As a part of Synergy Orthopedic Specialists Medical Group, we regularly perform WALANT surgeries for common hand injuries. In this blog, we discuss some of the advantages of WALANT procedures.

More accurate surgical outcomes

WALANT procedures can be a good option for a number of hand surgeries, including:

• Trigger finger release
• Tendon release
• Finger joint replacement 
• Arthritis treatment
• Fractures

Particularly with trigger finger and tendon release procedures, WALANT surgeries offer better outcomes than traditional methods. This is because patients can flex the region immediately after repair, allowing surgeons to evaluate the repair before closing the surgical site.

Shorter recovery times

By avoiding full sedation, recovery is usually easier. You don’t have to wake up slowly, and you can avoid complications, such as nausea. Furthermore, you can typically return to your normal daily activities sooner with WALANT surgery than with surgical methods that require general anesthesia. 

In addition to faster recovery times, there’s also less preparation required with WALANT surgeries. You don’t need to undergo as much preoperative testing, you don’t have to stop taking regular medications, and you don’t have to fast the day leading up to your surgery.

No need for general anesthesia

Traditional hand and wrist procedures require patients to be put to sleep with general anesthesia. Doctors then use a tourniquet on the arm to stop blood flow to the hand, and the patient can’t be awake because the tourniquet would be too painful.

WALANT surgeries use a combination of lidocaine and epinephrine. The combination acts as a local anesthetic and also helps to control bleeding. Because it doesn’t require general anesthesia, procedure times and recovery times are often shorter.  

Lower risk of side effects

Your risk of having side effects goes down if you don’t have general anesthesia. With WALANT surgeries, there’s no need for intravenous injections, and you’re less likely to experience common complications associated with full sedation, such as dizziness, nausea, and difficulty passing urine.

Furthermore, WALANT procedures make hand surgery accessible to patients who may not be able to undergo full sedation.

If you need hand surgery and want to learn more about WALANT surgery, book an appointment online or over the phone with Upper Extremity Specialists today.