8 Reasons to Stay Awake During Hand Surgery


You may be thinking that you wouldn’t want to be awake during any surgery, but the benefits will surprise you. In fact, maybe you will rethink putting off that carpal tunnel surgery you have been dreading.

Over the past several years, we have seen significant advancements in hand and wrist surgeries, including on technique called Wide Awake Local Anesthesia No Tourniquet (WALANT).

Dr. Jonathan Slaughter, a hand and upper extremity surgeon from OrthoCincy Orthopaedics & Sports Medicine, performs surgery using the WALANT technique at St. Elizabeth Healthcare.

Slaughter describes the procedure, “Think about when you go to the dentist, you usually aren’t fully sedated or asleep, you get enough numbing so the dentist can work and not cause you any pain. WALANT is similar and the benefits for the patient are significant.”

Dr. Slaughter outlines the advantages to using the WALANT technique for hand and wrist procedures.

Top 8 advantages to hand and wrist surgery using the WALANT technique:

  1. Better outcomes – because you are awake you can talk to the doctor during the procedure as he explains the surgery. You can even watch the surgery as it happens. Some procedures, such as tendon repairs require tissues to move and glide around one another for the best outcome. Being awake, without any pain, you can move the repaired tendon so the surgeon can see and potential problem areas and fix them immediately
  2. Less pain – traditionally using a tourniquet can be painful if worn for more than a few minutes, and this pain can even continue for a few days afterward. With WALANT, this is avoided entirely.
  3. Saves you valuable time – when you undergo anesthesia you have to take off work and schedule pre-op testing for blood work and a chest x-ray, with WALANT you can skip that step.
  4. No fasting before surgery – everyone dreads the fasting that happens before surgery, but when you don’t undergo anesthesia you don’t need to fast. If you have diabetes, you don’t need to worry about altering medications prior to surgery.
  5. Quick hospital visit – no need to wait in recovery to come out of anesthesia. After the procedure you get up and walk out. Often times, the patient can drive themselves to and from the procedure.
  6. Less risk – although minimal, there are risks when you undergo anesthesia. If you have comorbidities that have prevented you from undergoing anesthesia, hand surgery may now be an option. Also, there is no need to stop other medications like blood thinners.
  7. Decreased cost – with the high deductible health plans today, we all have to think about the cost of a procedure. WALANT does not have the cost of pre-operative testing, the anesthesiologist, and shorter time in the hospital.
  8. No IV – without anesthesia there is no need for an IV.

WALANT can be used for several different hand and wrist surgeries, including:

  • Carpal tunnel
  • Trigger finger
  • Finger fractures
  • Fusions
  • Flexor and extensor tendon repairs
  • Removing small masses or cysts
  • DeQuervains

For more information or to schedule an appointment, please call our affiliated orthopaedic surgeons from OrthoCincy Orthopaedics and Sports Medicine at 859-301-BONE (2663).