Symptoms During or Shortly After Isolated Carpal Tunnel Release and Problems Within 24 hours After Surgery

Abstract

This study used the National Survey of Ambulatory Surgery (NSAS) database to measure the incidence of and risk factors for symptoms in the ambulatory surgery center and problems within 24 h after isolated carpal tunnel release (CTR). The NSAS contained records on 400,000 adult patients with carpal tunnel syndrome who were treated with CTR in 2006, based on ICD-9 codes. The type of anesthesia used and factors associated with symptoms and problems were sought in bivariate and multivariable statistical analyses. The mean duration of the procedure was 16±8.8 min. Only 5 % were performed under local anesthesia without sedation, 45 % with IV sedation, 28 % regional anesthesia, and 19 % general anesthesia. Symptoms in the ambulatory surgery center or a problem within 24 h after discharge were recorded in 10 % of patients, all of them minor and transient, including difficulties with pain and its treatment. The strongest risk factors were male sex, age of 45 years and older, and participation of an anesthesiologist. Local anesthesia and regional anesthesia were associated with more perioperative symptoms and postoperative problems. Most CTR are performed with some sedation in the United States. CTR is a safe procedure: one in 10 patients will experience a minor issue in the perioperative or immediate postoperative period.

Timing of Complications following Hand Surgery

“…Timing was significantly earlier in inpatients compared with outpatients for myocardial infarction (day 1 [IQR: [1][2][3] vs. day 3 [IQR: [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15], p = 0.006) (►Table 3 and ►Fig. 3).…”

“…The incidence and corresponding risk factors for complications following several hand surgeries have been well described in the literature. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Lipira et al, in a retrospective study analyzing the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database, found an overall complication rate within 30 days of hand surgery to be 2.5% with associated risk factors including male sex, increasing American Society of Anesthesiologists class, increasing wound class, preoperative transfusion, and inpatient surgery. 6 Whiting et al specifically compared complication rates in outpatient and inpatient distal radius open reduction internal fixation (ORIF) using the NSQIP database, showing significantly fewer total and major complications in the outpatient group.…”

Experience in the use of endoscopic technology in surgery for tunnel syndromes of the upper limb

“…(400 тыс. пациентов), сообщается о 10% осложнений после декомпрессии срединного нерва в карпальном канале [18]. По данным G.K. Faucher и соавт.…”

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

“…Despite the increasing popularity of local anesthetic methods, general and regional anesthesia techniques are still widely used (4). While elderly patients prefer local methods, younger patients often prefer general anesthesia (5). Adverse effects and complications may occur up to 25% of patients after Carpal tunnel surgery (5,6).…”

“…While elderly patients prefer local methods, younger patients often prefer general anesthesia (5). Adverse effects and complications may occur up to 25% of patients after Carpal tunnel surgery (5,6). Problems that may develop during the surgery or in the very first 24 hours include pain, airway obstruction, bleeding, difficulty in awakening, hypoxia, hypotension, hypertension, nausea and vomiting (5).…”