María Solange Ferraguti
Hospital de Clínicas “José de San Martín”, ArgentinaTitle: WALANT in Carpal Tunnel Release. Comparative Study of Two Technical Variants in 89 Cases
Abstract
Objective: To evaluate the intraoperative and postoperative efficacy and comfort of two variants of anesthesia in two groups with carpal tunnel syndrome (CTS).
Materials and Methods: Descriptive, comparative, retrospective, observational study using a 12-item telephone questionnaire on local anesthesia without a tourniquet. We included patients with CTS who underwent surgerybetween 2008 and 2019 with a mini-open approach and divided them into two groups: 1) 2% lidocaine plus 0.5% bupivacaine plus1:200,000 epinephrine plus light sedation (n = 32) and 2) 2% lidocaine plus epinephrine 1:200,000 (n = 57).
Results: 89 patientswere evaluated (mean age 66.9 years). All patients were satisfied and confirmed they would choose this procedure again. Therewere no significant differences in comfort or the possible development of intra- or postoperative symptoms between the two groups. The postoperative stay was 1-3 hours; hospitalization was not required. The bleeding was minimal.
Conclusion: Carpal tunnelrelease under local anesthesia with lidocaine + epinephrine, without a tourniquet, has proven to be a safe procedure with no com-plications. The patients did not complain of local immediate intraoperative or postoperative pain or pain at the site of the tourniquet. The stay in the healthcare facility was shorter. The short stay and the fewer elements used (anesthetics, tourniquet) imply a reduc-tion in the costs of the procedure. Though the presence of an anaesthesiologist is recommended, the procedure can be performedin appropriate settings without one. We do not recommend its use without preoperative studies or outside the operating room.
Materials and Methods: Descriptive, comparative, retrospective, observational study using a 12-item telephone questionnaire on local anesthesia without a tourniquet. We included patients with CTS who underwent surgerybetween 2008 and 2019 with a mini-open approach and divided them into two groups: 1) 2% lidocaine plus 0.5% bupivacaine plus1:200,000 epinephrine plus light sedation (n = 32) and 2) 2% lidocaine plus epinephrine 1:200,000 (n = 57).
Results: 89 patientswere evaluated (mean age 66.9 years). All patients were satisfied and confirmed they would choose this procedure again. Therewere no significant differences in comfort or the possible development of intra- or postoperative symptoms between the two groups. The postoperative stay was 1-3 hours; hospitalization was not required. The bleeding was minimal.
Conclusion: Carpal tunnelrelease under local anesthesia with lidocaine + epinephrine, without a tourniquet, has proven to be a safe procedure with no com-plications. The patients did not complain of local immediate intraoperative or postoperative pain or pain at the site of the tourniquet. The stay in the healthcare facility was shorter. The short stay and the fewer elements used (anesthetics, tourniquet) imply a reduc-tion in the costs of the procedure. Though the presence of an anaesthesiologist is recommended, the procedure can be performedin appropriate settings without one. We do not recommend its use without preoperative studies or outside the operating room.
Biography
Solange Ferraguti She has specialized in hand surgery for the last 10 years at the University Hospital of the University of Buenos Aires, she has done fellowships in Argentina and the Netherlands on hand surgery, observerships in Europe and the United States, and volunteer work around the world.
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