Intravenous regional anaesthesia

A way of numbing the forearm and hand for surgery. A tourniquet is inflated on the arm and local anaesthetic is injected into a vein below it, so the drug stays in the limb while the tourniquet is up. Discomfort from the tourniquet can mean that sedation is needed.

Related terms

• Glossary

  Tourniquet

  An inflatable cuff placed around the upper arm or forearm and pumped up to keep the operating area free of blood, giving the surgeon a clear view. An inflated tourniquet is uncomfortable for an awake person, so it is often combined with a regional block, sedation or a general anaesthetic. WALANT avoids it by using adrenaline instead.

• Treatment

  Brachial plexus block

  Regional anaesthesia in which an anaesthetist injects local anaesthetic, usually under ultrasound guidance, around the nerves of the brachial plexus so that the whole arm is numb and still for the operation. It allows longer hand operations and the use of an upper-arm tourniquet without a general anaesthetic, and gives pain relief for some hours afterwards.

• Treatment

  WALANT

  Wide-awake local anaesthesia no tourniquet. Lignocaine with adrenaline is injected at the operation site, so a hand operation can be done without a tourniquet, sedation or a general anaesthetic. The patient stays awake and can move the hand when asked, so the surgeon can check movement before the skin is closed. Whether it suits a particular person depends on the operation, their circulation and general health, and their preference.

Articles mentioning this term

1. Clinician education · 11 October 2026

   Hand surgery under local anaesthesia (WALANT)

   How wide-awake local anaesthesia no tourniquet (WALANT) works for hand surgery, what the evidence shows, its limits, and who it may suit.

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