By Dr. Garry Kitay
Use of Wide-Awake Local Anesthesia in Hand and Wrist Surgery
Preparing for a surgical procedure often creates significant anxiety for patients. There are pre-operative tests that frequently need to be completed, in addition to the concerns related to general anesthesia and the operating room costs. Multiple procedures can now be performed without general anesthesia or even sedation. The emergence of wide-awake local anesthesia and no tourniquet (WALANT), which was first popularized in Canada, has several advantages. The need for pre-operative testing is nearly eliminated. Moreover, the WALANT technique has been shown to lead to significant savings in time and costs.
The procedure is performed by injecting lidocaine with epinephrine into the planned operative region. This limits bleeding and has been shown to be safe and effective, including when used in the hand and fingers. A tourniquet, which can be painful for the patient, is not needed. The procedure can be performed in the operating room, but in many instances in the clinic setting. This has been shown in multiple studies to lead to greater patient satisfaction and convenience.
By: Dr. Garry Kitay
Dr. Kitay is board certified by the American Board of Orthopaedic Surgery. He is a member of the American Academy of Orthopaedic Surgeons and the American Society for Surgery of the Hand with a Certificate of Added Qualification in hand surgery.