Questioning the use of tourniquets in carpal tunnel surgery and determining ideal level

Abstract

Our aim was to determine if tourniquet use was a requirement in CTS release surgery, by evaluating patients in which tourniquets were used at different levels and patients in which tourniquets were not used during surgery. A total of 48 patients were included in the study. Eighteen patients had bilateral carpal tunnel syndrome. In these patients, the surgery of one side was performed with a forearm tourniquet, while the other side was performed with the conventional upper arm tourniquet. Thirty patients underwent carpal tunnel release surgery without a tourniquet. The duration of surgery, heart rate, blood pressure, pain status (visual analogue scale) of all patients, and the blood loss of patients who underwent surgery without a tourniquet were recorded. When the tourniquet and no-tourniquet groups were compared, there were no significant differences in terms of pain and physiological response. However, patient satisfaction was higher in the no-tourniquet group while operation times were longer. We believe that the local anesthetic + epinephrine without tourniquet method is advantageous compared to the other methods.

Minimising Tourniquet Time and Post-operative Pain During Carpal Tunnel Decompression

“…By carefully timing inflation and deflation of the tourniquet on decompression of the carpal tunnel, we were able to achieve an average tourniquet time of 5.5 minutes. This is shorter than documented times for upper-arm tourniquet which was on average 9.5 minutes [15]. 100% (43) of our patients who could have carpal tunnel decompression on the contralateral wrist agreed that they would have the procedure done in the same way, reflecting their overall satisfaction with the whole procedure.…”