Evaluation of surgical treatment of carpal tunnel syndrome using local anesthesia

Abstract

ObjectiveTo evaluate the results and complications from surgical treatment of carpal tunnel syndrome by means of an open route, using a local anesthesia technique comprising use of a solution of lidocaine, epinephrine and sodium bicarbonate.Material and methodsThis was a cohort study conducted through evaluating the medical files of 16 patients who underwent open surgery to treat carpal tunnel syndrome, with use of local anesthesia consisting of 20 mL of 1% lidocaine, adrenaline at 1:100,000 and 2 mL of sodium bicarbonate. The DASH scores before the operation and six months after the operation were evaluated. Comparisons were made regarding the intensity of pain at the time of applying the anesthetic and during the surgical procedure, and in relation to other types of procedure.ResultsThe DASH score improved from 65.17 to 16.53 six months after the operation (p < 0.01). In relation to the anesthesia, 75% of the patients reported that this technique was better than or the same as venous puncture and 81% reported that it was better than a dental procedure. Intraoperative pain occurred in two cases. There were no occurrences of ischemia.ConclusionUse of local anesthesia for surgically treating carpal tunnel syndrome is effective for performing the procedure and for the final result.

488 hand surgeries with local anesthesia with epinephrine, without a tourniquet, without sedation, and without an anesthesiologist

“…The results of the present study were similar to those reported by Lalonde et al 8 in 2005 (3110 surgeries) and Crowdhry et al 9 in 2010 (1111 surgeries), as well as to the studies conducted in Brazil by Novais Junior et al 10 in 2014 (41 surgeries) and Barros et al 11 in 2016 (16 surgeries).…”

“…Although Novais Junior et al 10 in 2014 and Barros et al 11 in 2016 published the use of this technique in hand surgery in a Brazilian journal, with highly favorable results, its use is not widespread in the country.…”

Carpal Tunnel Syndrome: Retrospective Analysis of 60 Consecutive Cases of Ambulatory Surgical Treatment With Local Anesthesia

“…The etiology and risk factors of CTS were not evaluated due to a lack of data in the medical records. 2,4,5,9,11,16 When comparing the surgical treatments of CTS, including the classical open technique, minimal incision open (mini-open) technique, and endoscopic tunnel release, it was concluded that the endoscopic technique results in less pain during the early postsurgical period and a faster return to work, but these effects are not statistically significant. No differences in long-term results were noted among the 3 techniques, although the recurrence rate was lower with the classical open technique, and it does not require special equipment or devices, which would increase the surgery cost.…”

“…The efficacy of this method was assessed by a postoperative interview after a minimum interval of 2 months, a physical examination with provocative tests (Phalen's and Tinel's tests), and a sensitivity test of the median nerve distribution, which was always performed by the same examiner, a physician who did not participate in the surgical procedures. [8][9][10][11] The safety criterion was the presence of any type of complication.…”

“…Currently, patients are being operated on with the same surgical technique but with local anesthesia and no anesthesiologist, sedation or hospitalization. 1,4,8,9 The objective of this study was to evaluate the efficacy and safety of this therapeutic management protocol.…”