ReviewPlastic and reconstructive surgery. Global open2021
Wide-awake Local Anesthesia with No Tourniquet: An Updated Review.
Review in Plastic and reconstructive surgery. Global open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed.
- Randomized Prospective Study Comparing Wide-Awake Local Anesthesia No Tourniquet (WALANT) and Locoregional Anesthesia in Minimally Invasive Hallux Valgus Surgery: Preliminary Results.Foot & ankle orthopaedics · 2026Article
- The effect of WALANT on outcomes of flexor tenolysis.Joint diseases and related surgery · 2026Article
- Wide-awake vs. regional anesthesia for carpal tunnel release: a prospective study on pain, grip strength, and sleep quality.BMC surgery · 2025Observational
- Trans-Ulnar Single Incision Fasciotomy for Decompression of Forearm Compartment Syndrome: A Cadaveric Study.Orthopaedic surgery · 2025Article
- Impact of Wide-Awake Local Anesthesia No Tourniquet Surgery on Education During Surgical Training: A Survey of Residents and Fellowship Directors.Journal of hand surgery global online · 2025Article
- Clinical Outcomes Following Endoscopic Carpal Tunnel Release With the Arthrex NanoScopic Release System-A Single Surgeon Experience.Journal of hand surgery global online · 2025Article
- Article
- Myth or Modality? Exploring the current perceptions and practices of adrenaline use in musculoskeletal extremities surgery in Pakistan.Pakistan journal of medical sciences · 2025Article
- Under 2$ hand anesthesia? Our first 800 cases with Wide-Awake Local Anesthesia No Tourniquet (WALANT) in hand surgery.Musculoskeletal surgery · 2025Article
- Rupture of the Fibro-Osseous Septum of the Second Extensor Compartment as the Cause of True Dorsal Trigger Wrist: Case Report.Hand (New York, N.Y.) · 2025Article
- WALANT Scaphoid Fixation Under Field Sterility: A Case Report and Description of Technique.Plastic surgery (Oakville, Ont.) · 2025Article
- A Comparative Analysis of Endoscopic Carpal Tunnel Release Performed Under Wide-Awake, Local Anesthesia, No Tourniquet in an Office-based Procedure Room Versus Operating Room Setting.Journal of hand surgery global online · 2025Article
- Plate osteosynthesis of phalanx fractures using wide-awake local anesthesia no tourniquet technique is cost-effective and associated with less postoperative pain.Journal of the Chinese Medical Association : JCMA · 2025Article
- Main Operating Room Versus Field Sterility in Hand Surgery: A Review of the Evidence.Plastic surgery (Oakville, Ont.) · 2024Article
- Local/Regional Anesthesia Versus General Anesthesia in Phalanx Fractures/Dislocations.Plastic surgery (Oakville, Ont.) · 2024Article
- Management of Scaphoid Pseudoarthrosis Surgery with Wide-Awake Local Anesthesia No Tourniquet (WALANT) Versus Axillary Block Anesthesia: Comparison of Patient Satisfaction.Plastic surgery (Oakville, Ont.) · 2024Article
- Evaluating patient satisfaction with WALANT for hand surgery: a comprehensive questionnaire-based study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Article
- Lessons From the Pandemic for Hand Surgery in Wales.Cureus · 2024Article
- Intraoperative Hemostasis Using WALANT Versus Tourniquet; A Focused Review on Carpal Tunnel Syndrome and Trigger Finger Release.World journal of plastic surgery · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The wide-awake local anesthesia with no tourniquet (WALANT) technique has become popularized for various hand/upper extremity procedures. Before surgery, patients receive local anesthetic, consisting of lidocaine with epinephrine, and remain awake for the entire procedure. The purpose of this review was to investigate the advantages, diverse application, outcomes, cost benefits, use in challenging environments, patient considerations, and contraindications associated with WALANT.
methodsA comprehensive review of the literature on the WALANT technique was conducted. Search terms included: WALANT, wide-awake surgery, no tourniquet, local anesthesia, hand, wrist, cost, and safety.
resultsThe WALANT technique has proven to be successful for common procedures such as flexor tendon repair, tendon transfer, trigger finger releases, Depuytren disease, and simple bony procedures. Recently, the use of WALANT has expanded to more extensive soft-tissue repair, fracture management, and bony manipulation. Advantages include negating preoperative evaluation and testing for anesthesia clearance, eliminating risk of monitored anesthesia care, removal of anesthesia providers and ancillary staff, significant cost savings, and less waste produced. Intraoperative evaluations can be performed through active patient participation, and postoperative recovery and monitoring time are reduced. WALANT is associated with high patient satisfaction rates and low infection rates.
conclusionsThe WALANT technique has proven to be valuable to both patients and providers, optimizing patient satisfaction and providing substantial healthcare savings. As its application continues to grow, current literature suggests positive outcomes.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.