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

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