Local anaesthetic systemic toxicity

A potentially life-threatening toxic effect that occurs when too much local anaesthetic reaches the bloodstream. It most often affects the nervous system, sometimes with seizures, and can affect the heart and circulation. The risk depends on the drug, the dose and how it is given, which is why the total amount used is limited.

Related terms

• 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.

• 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.

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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