Awake Hand Surgery

If you need hand surgery, consider having your surgery performed without going to sleep. Traditional hand surgery is performed with a tourniquet on the arm to control bleeding, often with intravenous (IV) sedation anesthesia. For many procedures, this is the preferred approach. However, more and more patients can now be treated with a simpler technique, while remaining awake and comfortable.

Awake hand surgery with local anesthesia and no tourniquet has been practiced in Canada for many years, and this technique has become more popular in the United States within the past few years. Patients are not required to fast or discontinue their usual medications. There is less nausea, drowsiness, and medical complications with this technique, and it is considered safer for patients with certain medical problems such as diabetes or lung problems. Additionally, there is no anesthesia fee for this procedure, which can reduce out-of-pocket costs.

This technique uses a combination of lidocaine and epinephrine injection. The epinephrine constricts blood vessels at the site of the surgery to reduce bleeding. The lidocaine is a type of numbing medicine, often used at the dentist’s office.

Patients are given the local anesthesia injection in the pre-operative area prior to surgery, and within a few minutes, the surgical site is numb and pain-free for several hours. The hand surgery can then be performed without pain and without much bleeding. 

During surgery, the patient is resting on the surgical bed with the arm out to the side, talking to the nurse and the hand surgeon in the operating room. There is sterile covering, so that the patient does not need to see the surgery. For patients who are nervous, a Valium pill can be provided to the patient by the nurse to reduce anxiety.

Awake hand surgery is not for every patient. Talk to your doctor about this as an option to see if it is right for you.

Surgeries which can be performed by Dr. Erickson with the awake technique:

  • Open carpal tunnel release
  • Trigger finger release
  • DeQuervain’s release
  • Ganglion cyst excision
  • Tumor excision
  • Finger fracture repair
  • Tendon repair