Prospective Evaluation of Opioid Consumption Following Hand Surgery Performed Wide Awake Versus With Sedation.

BACKGROUND

We prospectively evaluated opioid consumption postoperatively following trigger finger release (TFR) and open carpal tunnel release (CTR), and hypothesized that cases performed wide awake with local anesthesia and no tourniquet (WALANT) would result in increased opioid consumption compared with cases performed under monitored anesthesia care (MAC).

METHODS

Postoperative opioid consumption following CTR and TFR was prospectively collected over 6 months. The primary end points of the study were: (1) total opioid consumption; and (2) the number of days an opioid was used for both groups.

RESULTS

Mean opioid use and number of days the opioid was used for all MAC cases were 3.95 pills and 1.8 days, respectively. The results for WALANT were 3.85 pills and 1.6 days.

CONCLUSIONS

These results suggest that effective pain control postoperatively may be independent of anesthesia type for soft tissue procedures of the hand. Specifically, average opioid consumption and days of utilization were similar in both the MAC and WALANT groups. Average postoperative opioid consumption was approximately only 4 opioid pills. Consideration should be given to prescribing fewer opioids for surgeries such as CTR and TFR.