Wide awake local anaesthesia no tourniquet: a review of current concepts

Authors

Keywords:

WALANT, wide-awake, narrative review, current concept review, awake surgery, orthopaedic

Abstract

Background: Wide awake local anaesthesia no tourniquet (WALANT) is a local anaesthetic technique that employs lignocaine combined with adrenaline to maintain a pain-free and bloodless field during surgery on an awake patient, without the use of a tourniquet.

Methods: This article is a narrative review of the literature on the use of this mode of anaesthesia in orthopaedic and hand surgery.

Results: The review summarises the existing research pertaining to WALANT. It discusses the anaesthetic solution constituents, administration technique and applications of WALANT, highlighting the safety profile and benefits to patients and healthcare systems alike.

Conclusion: The WALANT technique is safe, economical, and acceptable to patients. It should form part of the orthopaedic surgeon’s armamentarium. Future research should investigate the benefits of intraoperative functional assessment of the awake patient.

Level of evidence: Level 5

Author Biographies

Antoine GL Rocher, University of KwaZulu-Natal

Discipline of Orthopaedic Surgery, University of KwaZulu-Natal, Inkosi Albert Luthuli Central Hospital, Durban, South Africa

Megan O'Connor, University of KwaZulu-Natal

Discipline of Orthopaedic Surgery, University of KwaZulu-Natal, Inkosi Albert Luthuli Central Hospital, Durban, South Africa

Odette Koch, University of Pretoria

1 Military Hospital, Department of Orthopaedic Surgery, University of Pretoria; Netcare Pretoria East Hospital Suite M33, Pretoria, South Africa

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Published

2022-09-02

Issue

Section

Current Concept Review

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