الفهرس 
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Abstract
Many hand surgeons are moving away from traditional surgery using a tourniquet and sedation to an approach that utilizes wide-awake local anesthesia and no tourniquet (WALANT), Aim and objectives; to evaluate and compare the effect of WALANT technique versus local intravenous anesthesia in hand surgery regarding patient comfort and time of surgery, Subjects and methods; This study was conducted on 100 patients underwent hand surgery and referred at Menia university hospital. Patients were randomized into two groups according to anesthesia using either method included in the study (WALANT technique or Local intravenous), Result; the mean VAS score in WALANT group was 3.68± 1.79 and ranged from 0 to 8 while the in local IV group it ranged from 4 to 10 with mean± SD was 6.94± 1.24. VAS score was significantly lower in WALANT group compared to local IV group (p= 0.001), Conclusion; the WALANT technique was more effective than IVRA in relation to pain control. WALANT procedure was associated with lower discomfort (VAS score) among study participants.