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Open Carpal Tunnel Release Outcomes: Performed Wide Awake versus with Sedation
Journal article   Open access   Peer reviewed

Open Carpal Tunnel Release Outcomes: Performed Wide Awake versus with Sedation

Jacob E. Tulipan, Nayoung Kim, Jack Abboudi, Christopher Jones, Frederic Liss, William Kirkpatrick, Michael Rivlin, Mark L. Wang, Jonas Matzon and Asif M. Ilyas
Journal of hand and microsurgery, v 9(2), pp 74-79
01 Aug 2017
DOI: https://doi.org/10.1055/s-0037-1603200
PMID: 28867906
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1055/s-0037-1603200View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

Life Sciences & Biomedicine Science & Technology Surgery
Background Carpal tunnel release (CTR) is the most common surgery of the hand, and interest is growing in performing it under local anesthesia without tourniquet. To better understand differences, we hypothesized that patients undergoing CTR under wide-awake local anesthesia with no tourniquet (WALANT) versus sedation (monitored anesthesia care [MAC]) would not result in a difference in outcome. Methods Consecutive cases of electrodiagnostically confirmed open CTR across multiple surgeons at a single center were prospectively enrolled. Data included demographic data, visual analog scale, Levine-Katz carpal tunnel syndrome scale, QuickDASH questionnaire, customized Likert questionnaire, and complications. ResultsThere were 81 patients enrolled in the WALANT group and 149 patients in the MAC group. There were no reoperations in either group or any epinephrine-related complications in the WALANT group. Disability and symptom scores did not differ significantly between WALANT and sedation groups at 2 weeks or 3 months. Average postoperative QuickDASH, Levine-Katz, and VAS pain scales were the same in both groups. Both groups of patients reported high levels of satisfaction at 91 versus 96% for the WALANT versus MAC groups, respectively (p >0.05). Patients in each group were likely to request similar anesthesia if they were to undergo surgery again. Conclusion Patients undergoing open CTR experienced similar levels of satisfaction and outcomes with either the WALANT or MAC techniques. There was no statistically significant difference between either group relative to the tested outcome measures. These data should facilitate surgeons and patients' choosing freely between WALANT and MAC techniques relative to complications and outcomes.

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Collaboration types
Domestic collaboration
Web of Science research areas
Surgery
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