Hand Injury

Surgery for carpal tunnel, trigger finger, or other hand and wrist conditions once required general anesthesia.

With general anesthesia, someone must drive you to and from your surgery. You have to fast before surgery, and you may need preoperative tests and lab work.

The whole process can be both anxiety-producing and cumbersome.

“WALANT eliminates many of these fears and inconveniences for people,” says hand and upper extremity surgeon Neil Singh, DO at UPMC. WALANT stands for wide awake local anesthesia and no tourniquet.

As the name implies, patients are awake the entire time with WALANT. Dr. Singh injects a local anesthesia to numb the area. Patients don’t feel any pain.

The procedure also doesn’t require a tourniquet, so there is no discomfort around the arm.

What Are The Benefits Of WALANT?

With WALANT, you can drive yourself to the hospital, have the procedure, and drive home. (A recent study found that driving after WALANT was safe.) There’s virtually no postoperative recovery time because you don’t have to wake from sedation.

“You can change your clothes and go home,” Dr. Singh says.

Because you’re awake the whole time, you also can communicate with the surgeon. “I can check in real time with patients,” Dr. Singh says.

For example, he can ask them to move their hand or fingers during the surgery. He also can check range of motion, and make sure the tendon is fully repaired.

“It takes away the guesswork,” he says.

Patients can start therapy right away, knowing the surgery was a success. “It’s very motivating for patients,” Dr. Singh says.

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What To Expect With WALANT

“We use different techniques to make the injection fairly painless,” Dr. Singh says. There is a drape that keep you from seeing your hand during the operation, he adds. Some patients choose to watch the procedure.

“You even get to pick the music in the room,” he says.

A nurse sits with the patient during the surgery. “The nurses and staff are well trained,” he says. “They communicate with patients about what’s happening the whole time.”

Most surgeries are quick, lasting just 15 minutes or so. That’s not much different than going to the dentist, Dr. Singh says.

He acknowledges that WALANT is not for everyone. For some people, being awake causes more anxiety. For anyone who is on the fence, the benefits often encourage them to choose WALANT.

WALANT Is Growing In Popularity

Dr. Singh has special fellowship training in the technique. He currently uses WALANT for more than half of the hand and wrist tendon repairs he does. “It’s really taken off in hand surgery in the last few years,” he says.

Dr. Singh operates at UPMC Jameson, which serves Lawrence County and the surrounding area. With WALANT, people have access to the latest in hand surgery right in their community.

For more information about hand and upper extremity surgery at UPMC Jameson, call 724-983-7000.

Find out more about orthopaedic care at UPMC Jameson.

About UPMC Orthopaedic Care

As a national leader in advanced orthopaedic care, UPMC treats a full range of musculoskeletal disorders, from the acute and chronic to the common and complex. Whether you have bone, muscle, or joint pain, we provide access to UPMC’s vast network of support services for both surgical and nonsurgical treatments and a full continuum of care. As leaders in research and clinical trials with cutting-edge tools and techniques, UPMC Presbyterian Shadyside appears on U.S. News & World Report’s rankings of the top hospitals in the country for orthopaedics.