Carpal tunnel release without a tourniquet

Release of the transverse carpal ligament can be performed safely under local anesthesia. The addition of epinephrine to the local anesthetic will cause sufficient vasoconstriction to maintain a dry field without the need of a tourniquet. This allows the procedure to be performed without regard to tourniquet pain. It has been our technique of choice in patients with functioning hemodialysis fistulae. The procedure was performed in 21 wrists to assess its safety. This approach was found to be a safe, effective, and efficient alternative to the standard tourniquet-dependent procedure.