Carpal Tunnel Syndrome Release under Local Anesthesia without Tourniquet

2023-01-20T15:40:11+00:00

Background: Surgical decompression of carpal tunnel syndrome is one of day case procedures and can performed under general or local anesthesia. Local anesthetics infiltration with adrenaline is used to provide dry surgical field and avoid tourniquet. Aim of study: mixing adrenaline with local anesthetics for control bleeding in simple decompression of carpal tunnel syndrome without tourniquet & prolong analgesia. Location and date: Basra general hospital from April 2017 to May 2022. Patient and methods: 400 patients (male and female) had unilateral surgical decompression of carpal tunnel syndrome with ASA I & II, all received local anesthetics block of 5ml lidocaine (2%) under ultrasound for median nerve in wrist and infiltration of 10 ml of mixture of 2% lidocaine and (1:80,000) adrenaline buffered with 8.4% sodium bicarbonate in subcutaneous tissue along incision site and in tunnel. Vital signs monitored, no tourniquet. Pain monitored by NPS (Numerical Pain Score).Results: During injection of drugs NPS mean was 4, after 3 to 5 minutes, there were no pain, most patients requested analgesia 6 to 8 hours later.17 patients received midazolam intraoperatively. Avoiding tourniquet made patients comfortable and gave surgeons more time along with dry field because vasoconstrictive effects of adrenaline. Conclusion: There are many studies on methods of anesthesia for carpal tunnel decompression, and we add our study on 400 patients to conclude that mixing adrenaline with local anesthetics is replacing tourniquet, prolong analgesia, avoiding narcotics, reducing hospitalization time.

Journal of Anesthesiology

Carpal Tunnel Syndrome Release under Local Anesthesia without Tourniquet