WALANT in Carpal Tunnel Release. Comparative Study of Two Technical Variants in 89 Cases
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Abstract
Materials and Methods: Descriptive, comparative, retrospective, observational study using a 12 item telephone questionnaire on local anesthesia without a tourniquet. We included patients with CTS who underwent surgery between 2008 and 2019 with a mini-open approach and divided them into two groups: 1) 2% lidocaine plus 0.5% bupivacaine plus 1:200,000 epinephrine plus light sedation (n = 32) and 2) 2% lidocaine plus epinephrine 1:200,000 (n = 57).
Results: 89 patients were evaluated (mean age 66.9 years). All patients were satisfied and confirmed they would choose this procedure again. There were no significant differences in comfort or the possible development of intra- or postoperative symptoms between the two groups. The postoperative stay was 1-3 hours; hospitalization was not required. The bleeding was minimal.
Conclusion: Carpal tunnel release under local anesthesia with lidocaine + epinephrine, without a tourniquet, has proven to be a safe procedure with no complications. The patients did not complain of local immediate intraoperative or postoperative pain or pain at the site of the tourniquet. The stay in the healthcare facility was shorter. The short stay and the fewer elements used (anesthetics, tourniquet) imply a reductionin the costs of the procedure. Though the presence of an anaesthesiologist is recommended, the procedure can be performed in appropriate settings without one. We do not recommend its use without preoperative studies or outside the operating room.
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