Rocher, Antoine G.L.O’Connor, MeganKoch, Odette2022-11-292022-11-292022Rocher, A.G.L., O’Connor, M. & Koch, O. Wide awake local anaesthesia no tourniquet: a review of current concepts. South African Orthopaedic Journal 2022;21(3):172-179. http://dx.doi.org/10.17159/2309-8309/2022/v21n3a6.2309-8309 (online)1681-150X (print)10.17159/2309-8309/2022/ v21n3a6https://repository.up.ac.za/handle/2263/88540BACKGROUND : 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.en© 2022 Rocher AGL. This is an open-access article distributed under the terms of the Creative Commons Attribution Licence.Narrative reviewCurrent concept reviewAwake surgeryOrthopaedicWide awake local anaesthesia no tourniquet (WALANT)Local anaesthetic techniqueArticle