Introduction:

Procedures in hand surgery require tourniquet use to control bleeding and generally sedation by anesthesiology to manage the pain and discomfort of the tourniquet. A decade ago, local anesthesia without tourniquet or sedation was used in hand surgery as a safe and efficient option for surgical interventions, known as WALANT (Wide Awake Local Anesthesia with No Tournique) technique. The aim of the study is to evaluate a prospective series of patients who have undergone surgery with the WALANT technique in hand surgery.

Methods:

Consecutive series of cases that show the performance of a local anesthetic technique for procedures in hand surgery without sedation and without tourniquet. Surgery time, intra and postoperative pain and satisfaction level were evaluated. This study was accepted by the ethics committee.

Results:

Ninety-six patients underwent surgery, seventy-three were soft tissue surgery and twenty-three bone surgery. Ninety-two patients (96%) reported being satisfied and without postoperative pain. In four cases, intraoperative sedation was necessary. No patient required a tourniquet. It was not necessary to use volumes greater than 40 ml; however, these vary according to the type of intervention.

Conclusions:

This study shows that the technique works very well and is very useful in tendon surgeries, where the patient is required to be awake to evaluate intraoperative functioning. Surgery costs are cheaper, and it is a reproducible technique with satisfactory performance.