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Reduction in pain associated with open carpal tunnel decompression
K Avramidis1, J C Lewis, P Gallagher
1Orthopaedic Department, Norfolk and Norwich NHS Healthcare Trust, Norwich, UK.
Journal of Hand Surgery (Edinburgh, Scotland)
|November 4, 2000
Summary
Pre-application of topical anesthetic cream significantly reduces pain during local anesthetic injection for open carpal tunnel surgery. This topical anesthetic cream offers a safe and effective method for pain management in such procedures.
Area of Science:
- Anesthesiology
- Orthopedic Surgery
- Pain Management
Background:
- Open carpal tunnel decompression often involves significant pain upon local anesthetic injection.
- Effective pain management strategies are crucial for improving patient experience during surgical procedures.
Purpose of the Study:
- To evaluate the efficacy of a topical lignocaine-prilocaine anesthetic cream in reducing pain associated with local anesthetic administration prior to open carpal tunnel decompression.
- To compare pain levels between anesthetic cream application and placebo.
Main Methods:
- A prospective, double-blind, randomized, placebo-controlled trial was conducted.
- Nineteen patients undergoing simultaneous bilateral open carpal tunnel decompression were included.
- Pain was assessed using a visual analogue scale and a four-point verbal rating scale.
Main Results:
- Topical anesthetic cream significantly reduced pain scores compared to placebo.
- Patients reported milder pain ('mild') with anesthetic cream versus moderate to severe pain with placebo.
- A greater reduction in pain was observed in female patients.
Conclusions:
- Topical lignocaine-prilocaine anesthetic cream is effective in alleviating injection pain during carpal tunnel surgery.
- The pre-application of this cream provides a safe and well-tolerated method for pain reduction.
- Further research may explore gender-specific differences in pain perception and dermal response.