Local Anaesthesia (WALANT surgery)

Wide awake, local anaesthesia, no tourniquet (WALANT) surgery is a technique used in Fife to treat many hand and wrist conditions.

What is WALANT?
WALANT surgery uses a mixture of local anaesthesia and adrenaline in one injection. The local anaesthetic component provides a “field block” to the operative area. The adrenaline added to the local anaesthetic is a drug which shuts down the arteries temporarily in the region, and helps to stop bleeding during the procedure.

What happens when WALANT is used?
The anaesthetic injection is administered about 15 minutes prior to your operation, and works very quickly, within a minute or so. The surgeon will give an initial injection to numb the skin – this involves a jag to the skin, followed by a stinging sensation that lasts around 10 seconds. Once the initial injection produces numbness, very little of the anaesthetic injection can be felt. The effects of the injection can last up to 4-5 hours. A tourniquet may be applied but is not inflated unless necessary.

What are the advantages of WALANT?

  • There is no need to starve or stop medication prior to surgery
  • Patients can go home within an hour or two of their operation
  • Reduces the need for post-operative pain relief
  • The WALANT technique can be used for patients that are unable to have a general anaesthetic because of medical problems

Are there any disadvantages of WALANT surgery?
There are no major disadvantages, but some people feel apprehensive about being awake during an operation. It is a bit like going to the dentist, but most patients tell us the dentist is worse!

© Fife Hand Service 2021

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