Pain and outcomes of carpal tunnel release under local anaesthetic with or without a tourniquet: a randomized controlled trial

Iqbal, Hafiz Javaid; Doorgakant, Ashtin; Rehmatullah, Nader; Ramavath, A.L.; Pidikiti, P; Lipscombe, S.

doi:10.1177/1753193418778999

Cited by 34 publications

(25 citation statements)

References 16 publications

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“…The operations for the present case series were performed under brachial plexus block with a tourniquet in the upper aim or under general anaesthesia. We have noted recent reports of using local anaesthesia without a tourniquet in replantation or flap transfer in the hand (Iqbal et al., 2018; Wong et al., 2017, Xing and Mao, 2018a, 2018b) and using local anaesthesia in hand surgery is becoming popular (Gong and Xing, 2017; Lalonde, 2017, Teo et al., 2013). We also use this approach rather extensively.…”

Section: Discussionmentioning

confidence: 99%

Vascularized flap transfer to fingers with volar digital veins as recipient vessels

Chen

Wang

et al. 2019

J Hand Surg Eur Vol

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Traditionally free vascularized flap transfers to the fingers connect to the proper digital artery and dorsal veins. We report our experience using the volar digital veins as recipient veins for free vascularized flap transfers in 14 fingers of 12 patients. One or two veins (three flaps with two veins, 11 flaps with one vein) of the flap were anastomosed to volar digital veins in the recipient site. The arteries of these flaps were connected to the proper digital arteries. All the transferred flaps survived. No vessel crisis occurred. Our patients demonstrated that volar veins can be the recipient veins for free flap transfers in the fingers without increased risk of venous crisis and flap loss. Level of evidence: IV

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Section: Discussionmentioning

confidence: 99%

Vascularized flap transfer to fingers with volar digital veins as recipient vessels

Chen

Wang

et al. 2019

J Hand Surg Eur Vol

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“…Literature search did not show any direct comparison regarding these modalities. Nevertheless, Iqbal et al (14) published a study in 2018 in which they randomized Carpal tunnel release cases to undergo either local anesthesia plus adrenaline or local anesthesia plus tourniquet and they found that early pain score was significantly higher in the latter group. Gunasagaran et al (15) compared WALANT technique to local anesthesia plus tourniquet in 72 cases with minor hand surgery and they reported lower early postoperative pain in subjects undergoing WALANT technique.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Wide Awake Local Anaesthesia No Tourniquet Technique with Tourniquet Application under General Anesthesia in Carpal Tunnel Syndrome: A Retrospective Study

Kır¹,

Bayraktar²,

Gürbüz³

2019

eamr

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Objective: Carpal tunnel syndrome is a common complaint in orthopedic practice and usually treated with surgical intervention. The aim of the study was to compare wide awake local anesthesia no tourniquet (WALANT) technique with general anesthesia and arm tourniquet in Carpal tunnel cases. Methods: Fifty-two patients who underwent surgery for Carpal tunnel syndrome were retrospectively divided into two groups as WALANT technique (Group W) and general anesthesia with arm tourniquet (Group G). In addition to the demographic data, visual analog scale (VAS), opioid consumption, early complications, duration of stay in operating room (DSOR) and first analgesic need time were evaluated. Results: When both groups were evaluated, early postoperative VAS scores, opioid consumption and DSOR were significantly lower in Group W than in Group G. Conclusion: In conclusion, WALANT technique was associated with reduced early postoperative pain, lower DSOR and opioid consumption compared to general anesthesia with tourniquet method for carpal tunnel release.

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“…4 However, to the authors' knowledge, there is no systematic analysis specifically deals with endoscopic CTR with WALANT, although numerous studies assessed WALANT for open CTR with good results. 5,6 We report a prospective case series assessing the patient and surgeon experience, as well as complications with WALANT for single-port endoscopic CTR.…”

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confidence: 99%

Endoscopic Carpal Tunnel Release Using Wide-Awake Anesthesia

Urban

Meuli‐Simmen

et al. 2020

Journal of Hand Surgery Global Online

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We report on patient and surgeon experience after single-port endoscopic carpal tunnel release (CTR) using wide-awake local anesthesia no tourniquet (WALANT) technique. Methods: From July to November 2018, patients undergoing endoscopic CTR with WALANT were prospectively included. Follow-up was 3 months. Patient ratings before, during, and after the operation were collected. We recorded the surgeon's experience during surgery compared with the endoscopic CTR under local anesthesia with exsanguination and tourniquet. Complications were defined as nerve injury, infection, or the need for revision surgery. Results: The cohort consisted of 20 patients (24 wrists). All patients except one reported a complete or substantial decrease of symptoms. The 2 surgeons involved judged the procedure to be technically more demanding owing to impaired visualization (33%) caused by increased bleeding and edema in the operative field. There was one conversion from endoscopic to open surgery. Conclusions: We recommend starting single-port endoscopic CTR using WALANT with a noninflated tourniquet in place for use when necessary. Type of study/level of evidence: Therapeutic IV.

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Pain and outcomes of carpal tunnel release under local anaesthetic with or without a tourniquet: a randomized controlled trial

Abstract: I.

Cited by 34 publications

References 16 publications

Vascularized flap transfer to fingers with volar digital veins as recipient vessels

Vascularized flap transfer to fingers with volar digital veins as recipient vessels

Comparison of Wide Awake Local Anaesthesia No Tourniquet Technique with Tourniquet Application under General Anesthesia in Carpal Tunnel Syndrome: A Retrospective Study

Endoscopic Carpal Tunnel Release Using Wide-Awake Anesthesia

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