The Patient's Perspective on Carpal Tunnel Surgery Related to the Type of Anesthesia: A Prospective Cohort Study

Davison, Peter G.; Cobb, Tyson K.; Lalonde, Donald H.

doi:10.1007/s11552-012-9474-5

Cited by 115 publications

(108 citation statements)

References 24 publications

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“…9 More than 70% of hand surgeons in Canada use local anesthesia for CTR with similar reported outcomes. 2 In addition to cost savings, local anesthesia is associated with shorter surgical wait times and increased convenience. 2,3,12 Patients can expect equivalent outcomes, complication rates, and patient satisfaction scores in comparison with general or regional anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Surgical Approach and Anesthetic Modality for Carpal Tunnel Release

Foster

Sivasundaram

Heckmann

et al. 2016

Hand (New York, N,Y.)

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Background: Carpal tunnel release (CTR) is commonly performed for carpal tunnel syndrome once conservative treatment has failed. Operative technique and anesthetic modality vary by surgeon preference and patient factors. However, CTR practices and anesthetic trends have, to date, not been described on a nationwide scale in the United States. Methods: The PearlDiver Patient Records Database was used to search Current Procedural Terminology codes for elective CTR from 2007 to 2011. Anesthetic modality (eg, general and regional anesthesia vs local anesthesia) and surgical approach (eg, endoscopic vs open) were recorded for this patient population. Cost analysis, patient demographics, regional variation, and annual changes in CTR surgery were evaluated. Results: We identified 86 687 patients who underwent carpal tunnel surgery during this 5-year time period. In this patient sample, 80.5% of CTR procedures were performed using general or regional anesthesia, compared with 19.5% of procedures performed using local anesthesia; 83.9% of all CTR were performed in an open fashion, and 16.1% were performed using an endoscopic technique. Endoscopic surgery was on average $794 more expensive than open surgery, and general or regional anesthesia was $654 more costly than local anesthesia. Conclusions: In the United States, open CTR under local anesthesia is the most cost-effective way to perform a CTR. However, only a small fraction of elective CTR procedures are performed with this technique, representing a potential area for significant health care cost savings. In addition, regional and age variations exist in procedure and anesthetic type utilized.

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Section: Discussionmentioning

confidence: 99%

Surgical Approach and Anesthetic Modality for Carpal Tunnel Release

Foster

Sivasundaram

Heckmann

et al. 2016

Hand (New York, N,Y.)

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“…Local anesthesia infiltration without sedation can be performed in an office setting with excellent results. 11,12 The hand surgeons performing carpal tunnel surgery in an office setting (N ¼ 17) prefer this method of anesthesia (59%), followed by use of a wrist block (29%). No other notable trends became apparent when results were broken down by practice location.…”

Section: Discussionmentioning

confidence: 99%

Trends in Carpal Tunnel Surgery: An Online Survey of Members of the American Society for Surgery of the Hand

Munns

Awan

2015

The Journal of Hand Surgery

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“…Similar to when they are having a dental procedure, patients who understand and are offered the wide awake alternative like the ideas of (1) no preoperative testing, (2) no tourniquet pain, (3) less time at the hospital to have the surgery, (4) the ability to speak to their surgeon during the surgery, and (5) no sedation to cloud their head when they get home from their surgery. 1 …”

mentioning

confidence: 99%