Wide-Awake Hand Surgery

Posted on: May 2nd, 2022 Posted by: Puget Sound Orthopaedics Posted in: Health

Medically Reviewed by Dr. Robert Vercio

In wide-awake hand surgery, local anesthetic is administered to numb the area of a patient’s hand to be operated on. Since general anesthesia is not used, the patient is fully conscious throughout the operation. This provides many benefits, and is often a viable option for many hand and wrist procedures.

What is Local Anesthesia?

In the process of local anesthesia, where the patient remains fully awake and non-sedated, anesthetic medication is injected into the surgical site to numb it. Patients may feel some initial pain at the site of the injection, however this typically fades within a minute or two. Lidocaine and epinephrine are the medications typically used as local anesthetic. Lidocaine temporarily stops the sense of pain in a region of the body, while epinephrine controls bleeding by tightening blood vessels and allows for a longer lasting effects of the lidocaine.

This is different from general anesthesia, which involves “going to sleep” for surgery, as a combination of medications causes unconsciousness and general pain relief. This type of anesthesia is administered by an anesthesiologist by way of a breathing mask, tube, or IV.

What to expect on the day of surgery:

While everyone’s wide-awake local anesthesia surgical experience will be slightly different, in general the day is more relaxing than undergoing an operation that requires general anesthesia. On the day of surgery, you are able to eat a light breakfast, including coffee with cream, and you can drive yourself to your surgery.

In the pre-op area your surgeon will talk with you and go over the procedure and the plan. Next, the operative area of your hand will be numbed up. This takes about 30 seconds to 2 minutes and is slightly uncomfortable, but the pain will fade quickly as the medicine begins to work. As the medicine continues to work, you will be able to relax for about half an hour. No IV is necessary!

You will then head back for your procedure and the surgeon will talk you through the steps. You have the option of observing as much or little of the procedure as is wanted, as comfort remains a priority. If you prefer you can listen to music or simply relax. Once the procedure is complete your surgeon will go over everything you need to know for after surgery and you will be able to go home. There is no requirement to wait in the recovery room.

What orthopedic hand and wrist surgeries can be done while wide-awake?

A variety of finger, hand and wrist procedures can be completed safely under local anesthesia.

Common “wide-awake” procedures:

  • Carpal tunnel release
  • Tendon repair
  • Mass or excess tissue removal
  • Trigger finger release
  • Finger fracture repair

What are the benefits of undergoing hand surgery wide-awake?

There is a range of benefits to the wide-awake approach, including the convenience of a shorter surgical time, avoiding the risks and recovery period from general sedation, and the real-time communication with your surgeon during the surgery.

  • Patients will not experience the negative side effects from sedation such as confusion, nausea, vomiting and drowsiness.
  • The surgeon can communicate with the patient during the operation.
  • Patients may be able to drive themselves to and from their operation.
  • Lower overall cost than general anesthesia.
  • Patients can eat a light breakfast before the procedure, no fasting required.

Is wide-awake hand surgery the right option for you?

Following your consultation, your surgeon will recommend a procedure style that will work best for your personal needs and health goals. If applicable, patients have the option to undergo wide-awake hand procedures at the Puget Sound Surgery Center in Lakewood. The hand and upper extremity surgeons at Puget Sound Orthopaedics have years of experience performing safe and successful wide-awake hand surgeries.

Call us today to book an appointment with one of our orthopedic specialists, (253) 582-7257.