Postoperative Pain Management after Carpal Tunnel Syndrome Surgical Treatment: Comparing Practice with Guidelines

Utrobičić, Ivan; Utrobičić, Frane; Prološčić, Ivona; Utrobičić, Toni; Jerić, Milka; Kadić, Antonia Jeličić; Puljak, Livia

doi:10.20471/acc.2017.56.03.11

Cited by 4 publications

(4 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pain catastrophizing and pain anxiety are relatively common phenomena [23,[29][30][31][32]. Some studies suggest that effective treatment of perioperative pain is important for the quality of life and patient satisfaction after CTR [28]. In the present study higher levels of all assessed negative emotions in patients declaring "postoperative pain" were noted.…”

Section: Discussionsupporting

confidence: 54%

“…It may be associated with proper treatment of perioperative pain in the past and good experiences with past surgeries [26]. Nevertheless, attention should be paid to the treatment of perioperative pain in CTR, since some studies revealed VAS pain scores of above 5 in the first several hours after CTR [27,28]. In the present study mean VAS score for preoperative pain was 6.8.…”

Section: Discussionmentioning

confidence: 50%

See 1 more Smart Citation

Analysis of concerns among patients operated for carpal tunnel syndrome

Napora¹,

Gryglewsk²,

Piotrowicz³

et al. 2021

Chir. Narzadow Ruchu Ortop. Pol.

View full text Add to dashboard Cite

Introduction. Carpal tunnel release (CTR) is among the most commonly performed procedures within a hand, in a day surgery setting. Studies suggest that patient concerns and emotional state may influence CTR outcomes. Aim. To determine the frequency of preoperative concerns among patients operated for carpal tunnel syndrome (CTS) and their correlation with negative emotions, socio-demographic and clinical variables. Materials and methods. A total of 72 patients (81.9% women) scheduled for CTR were included in the study. Pain, anxiety, irritability, and depression were measured using the Visual Analogue Scale (VAS) on the day of surgery. Tailor-made questionnaires were used to explore patients’ concerns and to gather socio-demographic and clinical data. Statistical analysis was performed utilizing R language. α < 0.05 was considered significant. Results. At least one concern was declared by the vast majority of patients (93.1%). Postoperative pain was the most prevalent concern, declared by 49.3% of participants. “Outcomes will not meet my expectations” was a concern for 43.3% of participants. Concern related to intraoperative complications was declared by 34.3% of participants. Patients scheduled for CTR had high mean VAS scores of anxiety and irritability and low score of depression. Anxiety reached the highest level among measured variables. Patients who declared postoperative pain had statistically significantly higher levels of pain, anxiety, irritability, and depression than patients without this concern. Concern that surgery outcomes will not meet patient’s expectations was declared statistically significantly more frequently by patients with any surgery in history. Conclusions. Preoperative concerns among patients operated for carpal tunnel syndrome are extremely prevalent. Those concerns are accompanied by a high level of negative emotions. Therefore assessment of emotional status, addressing particular concerns, and tailored preoperative intervention, all are of crucial importance. A meticulous approach to postoperative pain and patients’ expectations regarding outcomes seem to be essential. The mentioned strategy may positively influence patients’ comfort and surgery outcomes.

show abstract

Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 50%

Analysis of concerns among patients operated for carpal tunnel syndrome

Napora¹,

Gryglewsk²,

Piotrowicz³

et al. 2021

Chir. Narzadow Ruchu Ortop. Pol.

View full text Add to dashboard Cite

show abstract

“…4 Even with the use of a minimally invasive technique, such as endoscopic, many patients report similar persistent pain, frequently leading them to the indiscriminate use of strong analgesic. 5,6 These persistent pains may be caused by sectioning the TCL in a zone with numerous nerve endings.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Mechanoreceptors and Free Nerve Endings of the Transverse Carpal Ligament

Lima

Freire

et al. 2022

Hand (New York, N,Y.)

View full text Add to dashboard Cite

Background: The treatment of carpal tunnel syndrome (CTS) by sectioning the transverse carpal ligament (TCL) is not exempt from complications. Some nerve branches may be damaged by the incision. The aim of this study is to identify and map the TCL nerve endings, serving as a guide for sectioning this structure in a zone with less nerve ending density. Methods: Ten TCLs were obtained from fresh frozen cadavers. The TCLs were measured, divided into 3 equal bands (radial, central, and ulnar), and submitted to cryostat sectioning. The sections were subjected to immunofluorescence with the protein gene product (PGP) 9.5 and confocal microscopy analysis. Results: All the specimens contained type I and type IV mechanoreceptors. Neural elements occupied 0.695 ± 0.056% of the ligament area. The density of the neural elements was greater in the radial, followed by the ulnar and central bands, with 0.730 ± 0.083%, 0.686 ± 0.009%, and 0.669 ± 0.031%, respectively. Conclusion: The present findings suggest that the region with the least potential for neural element injury during TCL release is the central third near the transition with the ulnar third. When performed distally to proximally with a slight inclination from the radial to the ulnar, this release compromises the lowest nerve element density. Topographically, the proximal limit of the release is the distal wrist crease, while the distal limit is the intersection of Kaplan cardinal line and the axis of the third webspace.

show abstract

“…Postoperative pain is a type of acute pain caused by surgical trauma and the associated inflammatory response 1 . Almost all patients undergoing a surgical procedure experience some degree of pain, but not all pain is adequately treated 2,3 . In the authors' experience, one of the first questions that patients ask after the surgical procedure is "will it hurt?…”

Section: Introductionmentioning

confidence: 99%

Postoperative Pain Following Functional Endoscopic Sinus Surgery

Kavangh

2022

ACC

View full text Add to dashboard Cite

We conducted a retrospective review of medical records using our institution electronic database with the purpose to identify factors that could influence postoperative pain after functional endoscopic sinus surgery. The studied factors were gender, age, American Society of Anesthesiologists (ASA) status, duration of surgery, extent of surgery, primary versus revision surgery, and extent of nasal packing. One hundred and twenty-four patients were enrolled in this study, 60.5% of them male, mean age 48 years. The mean postoperative pain reported on the visual analog scale was 1.20 on the day of surgery and 1.05 on postoperative day 1. On the day of surgery, patients who had unilateral type of surgery experienced less pain than patients with bilateral surgery (p<0.01). We did not find any statistically significant association of the reported postoperative pain with age, gender, ASA status, duration of surgery, antibiotic therapy, and type and extensiveness of nasal packing.

show abstract

Postoperative Pain Management after Carpal Tunnel Syndrome Surgical Treatment: Comparing Practice with Guidelines

Cited by 4 publications

References 25 publications

Analysis of concerns among patients operated for carpal tunnel syndrome

Analysis of concerns among patients operated for carpal tunnel syndrome

Analysis of Mechanoreceptors and Free Nerve Endings of the Transverse Carpal Ligament

Postoperative Pain Following Functional Endoscopic Sinus Surgery

Contact Info

Product

Resources

About