Wide-awake wrist surgery: How WALANT (Wide-Awake Local Anesthesia No Tourniquet) works

WALANT (Wide-Awake Local Anesthesia No Tourniquet) was introduced and promoted by Donald Lalonde (Canada) and is now widely used for all types of hand/wrist surgery in hospitals and clinics of all levels. Over the past 15 years, this technique has been well established with a complete theoretical foundation and clinical applications. In my lecture on "Wide-awake wrist surgery: How WALANT works," I will introduce the WALANT method, which allows for wrist surgeries to be performed while the patient is fully awake, using only local anesthesia and without the need for a tourniquet.  This approach uses lidocaine to numb the surgical area, which allows the patient to remain conscious, communicate during the procedure, and avoid general anesthesia risks. Meanwhile, employing a combination of epinephrine significantly reduces the surgical site's blood flow without the discomfort of a tourniquet. We'll explore its application in carpal tunnel syndrome, De Quervain tenosynovitis, tendon repairs, wrist fracture, and arthroscopy. This technique decreases the overall procedure time and diminishes the need for preoperative preparation and postoperative recovery facilities, making it cost-effective and patient-friendly. This technique also facilitates patient interaction during the procedure, helping to ensure optimal outcomes. This talk aims to provide a comprehensive understanding of how WALANT enhances surgical efficiency and patient satisfaction in wrist-related surgeries.