Clinically Important Pharmacologic Considerations for Wide Awake Local No Tourniquet (WALANT) Hand Surgery

Understanding the clinically important pharmacokinetics (what the body does to the drug) and pharmacodynamics (what the drug does to the body) of medications utilized in surgery will help surgeons to utilize them more safely and effectively. The goal of this article is to provide an overview of these considerations for the two medications, lidocaine, and epinephrine, utilized in Wide Awake Local Anesthesia No Tourniquet (WALANT) upper extremity surgery. After review of this article, the reader should have a better understanding of lidocaine and epinephrine for tumescent local anesthesia, as well as adverse reactions and how to manage them.