Utility of local anesthesia for open carpal tunnel release in patients with psychiatric diagnoses

Ayyala, Haripriya S.; Castel, Nikki; Mohamed, Omar; Xue, Erica Y; Oleck, Nicholas C.; Lee, Edward S.

doi:10.1016/j.jpra.2019.10.002

Cited by 2 publications

(1 citation statement)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 26 Although there is concern that patients with psychiatric diagnoses might poorly tolerate wide-awake, local anesthesia, a study at a VAMC found no difference in requests for sedation, operative time, time in an operating room, or complications in patients with psychiatric diagnoses who underwent either awake or sedated CTR. 27 In our study, 52% of all patients were diagnosed with mental health comorbidities. A similar ratio of these patients underwent procedures in MPRs (52.4%) versus operating rooms (49.1%).…”

Section: Discussionmentioning

confidence: 56%

Outcomes of Orthopedic Hand Surgeries in Minor Procedure Rooms at a Veterans Affairs Medical Center

Look

Lalka

Korrell

et al. 2021

Journal of Hand Surgery Global Online

View full text Add to dashboard Cite

Purpose: There is a high demand for minor hand surgeries within the veteran population. The objective of this study was to compare clinical outcomes and resource use at a Veterans Affairs Medical Center (VAMC) of hand surgeries performed in minor procedure rooms (MPR) and operating rooms using local anesthesia with or without monitored anesthesia care. Methods: We retrospectively evaluated all patients undergoing carpal tunnel release, de Quervain's release, foreign body removal, soft tissue mass excision, or A1 pulley release at a VAMC over a 5-year period. Data collected included demographic information, mental health comorbidities, presence of preoperative and postoperative pain, complications after surgery, time to surgery, number of personnel in surgery, turnover time between cases, and time spent in the postanesthesia care unit. Statistical analysis included Fisher exact or chi-square analysis to compare MPR versus operating room groups and Student t test or Mann-Whitney test to compare continuous variables. Results: In this cohort of 331 cases, 123 and 208 patients underwent surgery in MPRs and operating rooms, respectively. Preoperative and postoperative pain were similar between the MPR and operating room groups. Complications were slightly lower in the MPR group versus the operating room group (0% MPR vs 2.9% operating room). Median time from surgical consult to surgery was 6 days less for MPR patients (15 vs 21). The MPR cases also used fewer personnel during surgery, averaging 4.76 versus 4.99 people. The MPR patients spent 9 minutes less in the postanesthesia care unit (median, 36 vs 45 minutes) and turnover time between cases was nearly 8 minutes faster in MPRs than in operating rooms (median, 20 vs 28 minutes). Conclusions: Minor procedure rooms at a VAMC allow more veteran patients to be scheduled for minor hand surgeries within a shorter time frame, utilize less staff and postoperative monitoring, and maintain excellent outcomes with limited complications. Clinical relevance: Minor hand surgeries in MPRs have outcomes equivalent to those of operating rooms with improved time savings and resource use.

show abstract

Section: Discussionmentioning

confidence: 56%