PDF herunterladen
Open Access
CC BY-NC-ND 4.0 · Asian J Neurosurg 2025; 20(03): 535-541
DOI: 10.1055/s-0045-1807760
Original Article

Comparison of Surgical Time and Clinical Outcomes for Intravenous Regional Anesthesia (IVRA) versus Wide-Awake Local Anesthesia No Tourniquet (WALANT) in Open Carpal Tunnel Release Surgery: A Comparative Study

Authors

  • Ali Guler

    1   Department of Neurologic Surgery, Ankara Bilkent City Hospital, Ankara, Türkiye

  • Yigit Can Senol 

    1   Department of Neurologic Surgery, Ankara Bilkent City Hospital, Ankara, Türkiye
    2   Department of Neurological Surgery, University of California, San Francisco, California, United States
Weitere Informationen
Auch verfügbar auf
  Lizenzen und Reprints
Preview

Abstract

Background

This study aimed to compare the efficacy and safety of two anesthetic techniques in patients undergoing carpal tunnel release surgery: intravenous regional anesthesia (IVRA) and the wide-awake local anesthesia no tourniquet (WALANT) technique.

Materials and Methods

A retrospective observational dual-center study was conducted, including 102 patients diagnosed with moderate-to-severe carpal tunnel syndrome (CTS) unresponsive to conservative treatment. Outcomes were assessed using the visual analog scale (VAS) for pain and the Duruoz Hand Index (DHI) for hand functionality. Comparisons were made based on age, gender, preoperative VAS scores, incision length, and surgical procedure duration.

Results

The outcomes of the WALANT (n = 51) and IVRA (n = 51) techniques in CTS surgery were compared. The IVRA group had a shorter operation time (2.49 ± 0.50 minutes) and faster return to daily activities (10.13 ± 9.50 days) compared with the WALANT group (operation time: 7.27 ± 1.35 minute, return to daily activities: 17.64 ± 2.52 days) (p < 0.05). Additionally, postoperative analgesic requirements were significantly lower in the IVRA group (8/51; 15.6%) than in the WALANT group (37/51; 72.5%) (p < 0.05). Both groups showed significant postoperative improvements in VAS and DHI scores (p < 0.05), with the IVRA group demonstrating a greater improvement in DHI scores (14.76 ± 0.43) compared with the WALANT group (12.76 ± 0.45) (p < 0.05).

Conclusion

IVRA with small incisions demonstrated superior outcomes in CTS surgery compared with WALANT, including shorter operation times, faster recovery, and reduced postoperative analgesic requirements. These findings suggest that IVRA may be a more favorable option for both patients and surgeons in carpal tunnel release surgery.

Keywords

carpal tunnel syndrome - IVRA - regional anesthesia - WALANT - wide awake local anesthesia


Publikationsverlauf

Artikel online veröffentlicht:
16. April 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India