Ten Questions About Wide Awake Local Anaesthesia No Tourniquet (WALANT) Surgery.

J Hand Surg Asian Pac Vol · Apr 2022 · Review

Lalonde DH

Dalhousie University, Saint John, Canada

Hand & Upper Extremity

SUMMARY — THE REDUCTIONWide awake local anesthesia without tourniquet (WALANT) hand surgery reduces costs and enables treatment in minor procedure rooms with comparable infection rates to traditional operating rooms.
Abstract, as published

The aim of this review article is to provide many important tips and tricks for surgeons to start Wide Awake Local Anaesthesia No Tourniquet (WALANT) hand surgery in their practice. The massive cost reduction of this disruptive new approach will enable them to increase access to hand surgery for their patients who cannot afford unnecessary sedation or unnecessary sterility of the expensive main operating room environment. Evidence-based sterility will permit surgeons to move a lot of their surgery out of the main operating room to minor procedure rooms without a significant increase in infection rates. Important pointers on how to inject minimally painful local anaesthesia will have patients thinking the surgeon injector is a bit of a magician. WALANT enables surgeons to improve the outcomes of many hand surgery procedures. Level of Evidence: Level V (Therapeutic).

Featured in the 2026-07-14 issue.

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