Tourniquet Use in Wide-Awake Carpal Tunnel Release. Hand (N Y) 2020 Jan;15(1):59-63
Date
07/14/2018Pubmed ID
30003819Pubmed Central ID
PMC6966303DOI
10.1177/1558944718787853Scopus ID
2-s2.0-85049899624 (requires institutional sign-in at Scopus site) 15 CitationsAbstract
Background: Carpal tunnel syndrome is a common cause of upper extremity discomfort. Surgical release of the median nerve can be performed under general or local anesthetic, with or without a tourniquet. Wide-awake carpal tunnel release (CTR) (local anesthesia, no sedation) is gaining popularity. Tourniquet discomfort is a reported downside. This study reviews outcomes in wide-awake CTR and compares tourniquet versus no tourniquet use. Methods: Wide-awake, open CTRs performed from February 2013 to April 2016 were retrospectively reviewed. Patients were divided into 2 cohorts: with and without tourniquet. Demographics, comorbidities, tobacco use, operative time, estimated blood loss, complications and outcomes were compared. Results: A total of 304 CTRs were performed on 246 patients. The majority of patients were male (88.5%), and the mean age was 59.9 years. One hundred patients (32.9%) were diabetic, and 92 patients (30.2%) were taking antithrombotics. Seventy-five patients (24.7%) were smokers. A forearm tourniquet was used for 90 CTRs (29.6%). Mean operative time was 24.97 minutes with a tourniquet and 21.69 minutes without. Estimated blood loss was 3.16 mL with a tourniquet and 4.25 mL without. All other analyzed outcomes were not statistically significant. Conclusion: Operative time was statistically longer and estimated blood loss was statistically less with tourniquet use, but these findings are not clinically significant. This suggests that local anesthetic with epinephrine is a safe and effective alternative to tourniquet use in CTR. The overall rate of complications was low, and there were no major differences in postoperative outcomes between groups.
Author List
Sasor SE, Cook JA, Duquette SP, Lucich EA, Cohen AC, Wooden WA, Tholpady SS, Chu MWAuthor
Sarah E. Sasor MD Assistant Professor in the Plastic Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Anesthesia, LocalAnesthetics, Local
Blood Loss, Surgical
Carpal Tunnel Syndrome
Decompression, Surgical
Epinephrine
Female
Humans
Male
Median Nerve
Middle Aged
Operative Time
Retrospective Studies
Tourniquets
Treatment Outcome
Wakefulness
