CC BY-NC-ND 4.0 · J Hand Microsurg 2021; 13(02): 095-100
DOI: 10.1055/s-0040-1709087
Original Article

Wide Awake Open Carpal Tunnel Release: The Effect of Local Anesthetics in the Postoperative Outcome

Nikolaos Karamanis
1  Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
,
Georgia Stamatiou
2  Department of Anesthesiology, Iaso Thessalias General Hospital, Larissa, Greece
,
Dionysia Vasdeki
1  Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
,
Nikolaos Sakellaridis
3  Department of Pharmacology, School of Health Sciences, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece
,
Konstantinos C. Xarchas
4  Department of Orthopaedic Surgery, G. Gennimatas General Hospital of Athens, Athens, Greece
,
Sokratis Varitimidis
1  Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
,
1  Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
5  Hand, Upper Extremity and Microsurgery Unit, Iaso Thessalias General Hospital, Larissa, Greece
› Author Affiliations

Abstract

Introduction Wide awake open carpal tunnel decompression is a procedure performed under local anesthesia. This study aimed to present the effect of various local anesthetics in peri and postoperative analgesia in patients undergoing this procedure.

Materials and Methods A total of 140 patients, with 150 hands involved, underwent carpal tunnel release under local anesthesia. Patients were divided in five groups according to local anesthetic administered: lidocaine 2%, ropivacaine 0.75%, ropivacaine 0.375%, chirocaine 0.5%, and chirocaine 0.25%. Total 400 mg of gabapentin were administered to a subgroup of 10 cases from each group (50 cases totally), 12 hours before surgery. Patients were evaluated immediately, 2 weeks and 2 months after surgery according to VAS pain score, grip strength, and two-point discrimination.

Results In all patients, pain and paresthesia improved significantly postoperatively, while the use of gabapentin did not affect outcomes. Grip strength recovered and exceeded the preoperative value 2 months after surgery, without any difference between the groups. No case of infection, hematoma, or revision surgery was reported.

Conclusion Recovery after open carpal tunnel release appears to be irrelevant of the type of local anesthetic used during the procedure. Solutions of low local anesthetic concentration (lidocaine 2%, ropivacaine 0.375%, and chirocaine 0.25%) provide adequate intraoperative analgesia without affecting the postoperative course.



Publication History

Publication Date:
09 April 2020 (online)

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