Cubital Tunnel Decompression: Equivalent Outcome Scores when Procedure Performed with Local versus General Anesthetic

Area of Science:

• Orthopedic Surgery
• Neurology
• Anesthesiology

Background:

• Ulnar nerve compression at the cubital tunnel is a common upper limb neuropathy.
• Current surgical decompression predominantly uses general anesthesia (GA), raising concerns about safety and cost.
• This study evaluates outcomes comparing GA with local anesthesia (LA) for cubital tunnel decompression.

Purpose of the Study:

• To compare early and medium-term patient-reported outcome scores after cubital tunnel decompression.
• To assess the efficacy and safety of local anesthesia (LA) versus general anesthesia (GA) in this procedure.

Main Methods:

• A patient outcome evaluation was conducted involving patients treated by two upper limb surgeons.
• Postoperative outcomes were assessed using the patient-related ulnar nerve evaluation (PRUNE) questionnaire.
• Data were collected via phone, mail, and in-person clinic visits.

Main Results:

• Thirteen patients underwent decompression under LA, and ten under GA.
• The average PRUNE score was 33.8 for the LA group and 34.1 for the GA group.
• The difference in PRUNE scores between the LA and GA groups was not statistically significant (p > 0.05).

Conclusions:

• There is no significant difference in early and midterm outcomes for cubital tunnel decompression whether performed under general anesthesia (GA) or local anesthesia (LA).
• Local anesthesia (LA) is advocated due to decreased anesthetic risks and economic benefits, including reduced demands on theater and anesthetic resources.