Releasing the tourniquet in carpal tunnel surgery

The purpose of this study was to determine if letting down the tourniquet prior to closure after carpal tunnel release decreases the amount of post-operative ecchymosis and subsequent post-operative pain. We prospectively studied 18 consecutive patients who were undergoing bilateral open carpal tunnel releases. The side done first was randomized and the tourniquet was released to obtain hemostasis prior to closure on this side only. The second side was completed, closed, and dressed prior to letting the tourniquet down. The patients' pre-operative and post-operative pain scores were recorded, as was an ecchymosis score at the 10-day follow-up visit. The results showed no significant difference between the two groups in either pain or ecchymosis. We conclude that the added surgical time required for letting the tourniquet down and obtaining hemostasis prior to closure in a carpal tunnel is unnecessary.