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Endoscopic Carpal Tunnel Release with and without Sedation.

Jacob E Tulipan1,2, Nayoung Kim1,2, Asif M Ilyas1,2

  • 1Philadelphia, Pa.

Plastic and Reconstructive Surgery
|November 16, 2017
PubMed
Summary

Endoscopic carpal tunnel release using local anesthesia alone or with sedation yields similar patient satisfaction and outcomes. Both anesthetic methods are effective, allowing patient and surgeon choice.

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Area of Science:

  • Orthopedic Surgery
  • Anesthesiology
  • Patient Outcomes

Background:

  • Carpal tunnel release is a common surgical procedure.
  • Anesthesia choice for carpal tunnel release can impact patient experience.
  • Evaluating outcomes based on anesthesia type is crucial for optimizing patient care.

Purpose of the Study:

  • To compare patient outcomes and satisfaction after endoscopic carpal tunnel release under local anesthesia versus local anesthesia with sedation.
  • To test the hypothesis that anesthesia type does not affect patient outcomes or satisfaction.

Main Methods:

  • A prospective study of 154 patients undergoing endoscopic carpal tunnel release.
  • Patients received either local anesthesia only or local anesthesia with sedation.
  • Postoperative evaluation included satisfaction, symptoms, disability (using validated questionnaires), and complications at 2 weeks and 3 months.

Main Results:

  • High patient satisfaction reported in both groups (96% local anesthesia, 93% local anesthesia with sedation at 3 weeks).
  • No significant differences in disability, pain, or symptom scores between groups.
  • Patients receiving sedation reported higher preoperative anxiety and preferred sedation or general anesthesia if surgery were repeated.

Conclusions:

  • Endoscopic carpal tunnel release with local anesthesia or local anesthesia plus sedation results in comparable patient satisfaction and outcomes.
  • Both anesthetic techniques are effective and support shared decision-making between surgeons and patients.