WALANT: wide-awake hand surgery with no tourniquet
WALANT (Wide Awake Local Anaesthesia No Tourniquet) is an anaesthetic technique for hand surgery: an injection of local anaesthetic combined with adrenaline numbs the area being operated on and limits bleeding, so no tourniquet is needed on the arm. You stay awake and comfortable, and you go home quickly.
How does it work?
Using a fine needle, the surgeon injects a local anaesthetic combined with a small dose of adrenaline. The anaesthetic takes away the pain; the adrenaline narrows the small blood vessels and reduces bleeding. The tourniquet, often the most uncomfortable part of hand surgery under conventional local anaesthesia, is no longer needed.
Which procedures?
Dr Cievet-Bonfils uses WALANT for certain procedures, for example:
- Trigger finger
- Carpal tunnel syndrome
- Flexor tendon sheath cyst
Other procedures can be performed under WALANT on a case-by-case basis.
Whether it is suitable for you is discussed at the consultation, depending on the procedure, your health and your preferences.
The benefits
- No tourniquet, no anaesthesia of the whole arm
- You stay awake: the surgeon can ask you to move your fingers during the procedure to check the result (tendons, trigger finger)
- Quick discharge after the procedure, with no prolonged monitoring
- Fewer constraints for some frail patients or patients taking anticoagulants (blood thinners) (assessed case by case)
The limits
- WALANT is not suitable for every procedure, especially longer or more extensive ones
- Some patients prefer not to be awake: regional anaesthesia of the arm remains possible in that case
- Practical arrangements (fasting, anaesthetic consultation, medicines to stop) depend on the procedure and the hospital or clinic; they are explained to you before the operation
Frequently asked questions
Will I feel anything?
The initial injection feels like a needle prick and a brief burning sensation. After that, the area is numb; you may feel that your hand is being touched, but without pain.
Will I see the operation?
No, a surgical drape hides your hand. You can talk with the team during the procedure.
Can I go home on my own?
As the procedure is performed under local anaesthesia, discharge is quick. It is recommended that someone accompanies you home.
Consultations in Lyon
Dr Maxime Cievet-Bonfils sees patients at:
- ICMMS – Centre Eiffel, 18-20 rue Tronchet, 69006 Lyon (3rd floor)
- Clinique de l'Infirmerie Protestante, 3 chemin du Penthod, 69300 Caluire-et-Cuire (Building D, 4th floor)
Secretary (direct line): +33 4 87 25 83 35 · Consultations in French or English.
This page provides general information. It does not replace a consultation: every situation is different.