Current Evidence Involving WALANT Surgery

Katherine M. Connors, Sara M. Guerra, Steven M. Koehler

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Wide-awake local anesthesia no-tourniquet (WALANT) surgery is an attractive option for hand surgeons, particularly during resource-scarce periods, as it eliminates dependence on main operating rooms or hospital-based procedures. The limited prepping or draping used for WALANT field sterility is as effective, if not more effective, than standard sterile prepping or draping. Patient anxiety surrounding WALANT surgery is similar to or less than that of general or local anesthesia with or without tourniquet. Patients use the same or lower amounts of postoperative narcotics after WALANT as compared to after the other anesthetic methods. Wide-awake local anesthesia no-tourniquet surgery saves significant costs for the same surgeries when performed under general or local anesthesia with or without tourniquet. There are very few complications associated with the WALANT method of anesthesia; rare case reports include vasovagal syncope and cardiac arrhythmia due to inadvertent intravascular injection of epinephrine.

Original languageEnglish (US)
Pages (from-to)452-455
Number of pages4
JournalJournal of Hand Surgery Global Online
Issue number6
StatePublished - Nov 2022


  • Field sterility
  • Lidocaine with epinepherine
  • Local anesthesia
  • WALEvidence
  • Wide-awakeANT

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Rehabilitation


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