The Journal of hand surgery · 2025
Intraoperative Pain During Carpal Tunnel Release Performed by Experienced Surgeons: A Prospective Randomized Trial Comparing WALANT with Local Anesthesia and Tourniquet.
СтатьяРандомизированное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Rellán Ignacio, Molho Nicolas Martin, Donndorff Agustín Guillermo, Gallucci Gerardo Luis, Ayerza Miguel Angel, Boretto Jorge Guillermo
Аннотация
PURPOSE: The purpose of this study was to compare the intraoperative pain in carpal tunnel decompression (CTD) using lidocaine + epinephrine (wide awake local anesthesia no tourniquet [WALANT]) versus local anesthesia (lidocaine) and tourniquet (LA-T).
METHODS: Patients with a diagnosis of carpal tunnel syndrome (CTS) and meeting the indications for surgical treatment were enrolled in a prospective, randomized, controlled study. Patients were randomized to two different local anesthetic techniques: WALANT and LA-T. All patients were operated on by a fellowship-trained hand surgeon not blinded to the intervention. After surgery, patients completed a questionnaire evaluating intraoperative pain using a visual analog scale. The minimal clinically important difference was assumed to be 2 points.
RESULTS: A total of 69 patients were enrolled, including 35 in the WALANT arm and 34 in the LA-T arm. All patients completed the questionnaire and complied with the prescribed follow-ups up to 28 days after surgery. Intraoperative pain was 1 point (interquartile range [IQR], 0-2) in the WALANT group and 2 points (IQR, 1-4) in the LA-T technique. Although this difference was statistically significant, it was not considered clinically relevant because it did not reach the minimal clinically important difference.
CONCLUSIONS: Carpal tunnel decompression performed under WALANT presents similar intraoperative pain scores compared to the LA-T technique when performed by an experienced surgeon. Our findings may not apply to other procedures that could potentially have a longer duration.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic II.
METHODS: Patients with a diagnosis of carpal tunnel syndrome (CTS) and meeting the indications for surgical treatment were enrolled in a prospective, randomized, controlled study. Patients were randomized to two different local anesthetic techniques: WALANT and LA-T. All patients were operated on by a fellowship-trained hand surgeon not blinded to the intervention. After surgery, patients completed a questionnaire evaluating intraoperative pain using a visual analog scale. The minimal clinically important difference was assumed to be 2 points.
RESULTS: A total of 69 patients were enrolled, including 35 in the WALANT arm and 34 in the LA-T arm. All patients completed the questionnaire and complied with the prescribed follow-ups up to 28 days after surgery. Intraoperative pain was 1 point (interquartile range [IQR], 0-2) in the WALANT group and 2 points (IQR, 1-4) in the LA-T technique. Although this difference was statistically significant, it was not considered clinically relevant because it did not reach the minimal clinically important difference.
CONCLUSIONS: Carpal tunnel decompression performed under WALANT presents similar intraoperative pain scores compared to the LA-T technique when performed by an experienced surgeon. Our findings may not apply to other procedures that could potentially have a longer duration.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic II.