Intraoperative Active Motion Confirmation During Wide-Awake Local Anesthesia No Tourniquet Surgery

As a recent advance in the field of hand surgery, the wide-awake local anesthesia no tourniquet surgical technique—performed using an epinephrine-containing local anesthetic without a tourniquet while the patient is awake—has attracted attention. The wide-awake local anesthesia no tourniquet technique has been indicated for surgeries such as trigger release, soft tissue tumor excision, surgery for Dupuytren contracture, thumb carpometacarpal arthroplasty, or any other tendon, nerve, or ligament surgeries, requiring intraoperative active motion confirmation. Herein, the surgical procedures performed with the wide-awake local anesthesia no tourniquet technique have been described; moreover, the indications and precautions of this technique have been reconsidered.