Journal of hand and microsurgery · 2024
Pillar pain incidence, duration, and psychological correlations in WALANT. A prospective study of 170 patients.
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Rellan Ignacio, Donndorff Agustín Guillermo, Gallucci Gerardo Luis, De Carli Pablo, Bronenberg Victorica Pedro, Avanzi Rocio, Huespe Ivan Alfredo, Boretto Jorge Guillermo
Аннотация
PURPOSE: To prospectively address our patients seeking carpal tunnel release (CTR) to evaluate the incidence, intensity, and duration of pillar pain (PP) and its correlation with catastrophic thinking, depression, and health anxiety.Methods: this is a prospective cohort study consisting of patients who underwent mini-open CTR under WALANT. Pillar pain was evaluated using the table test and was recorded as dichotomous variable and rated with a visual analogue scale (VAS). Patients with a positive result were evaluated on a monthly basis until the test yielded a negative result.To assess catastrophic thinking, health anxiety and depression levels, we employed the Pain Catastrophizing Scale (PCS) the Short Health Anxiety Inventory (SHAI), and the Beck scale respectively.
RESULTS: The study enrolled 170 patients who underwent CTR using WALANT technique. Among them, 84 patients (49 %) exhibited a positive table test. With exception of age and diabetes, both groups showed comparable demographic characteristics.The mean pain score for patients with a positive test was 3.5 ± 1.5, and the median duration of it was 3 months (interquartile range [IQR] 2-4). The median PCS score was 8 (IQR 2-14) in patients without PP, compared to 8 (IQR 4-11) in patients with PP. In the logistic regression model, the PCS variable had a crude odds ratio (OR) of 1 (95 % CI: 0.96-1.03) and an adjusted OR of 1 (95 % CI: 0.97-1.04). The SHAI score showed a crude OR of 0.97 (95 % CI: 0.93-1.01) and an adjusted OR of 0.97 (95 % CI: 0.92-1.01). The BECK score had a crude OR of 0.99 (95 % CI: 0.96-1.03) and an adjusted OR of 1.02 (95 % CI: 0.98-1.06).
CONCLUSION: Patients undergoing mini-open CTR have a risk of 49 % of experiencing PP, which typically registers a pain intensity of approximately 3 points and will last for a median of 3 months. The likelihood of experience it does not depend on catastrophic thinking, depression, and health anxiety.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.
RESULTS: The study enrolled 170 patients who underwent CTR using WALANT technique. Among them, 84 patients (49 %) exhibited a positive table test. With exception of age and diabetes, both groups showed comparable demographic characteristics.The mean pain score for patients with a positive test was 3.5 ± 1.5, and the median duration of it was 3 months (interquartile range [IQR] 2-4). The median PCS score was 8 (IQR 2-14) in patients without PP, compared to 8 (IQR 4-11) in patients with PP. In the logistic regression model, the PCS variable had a crude odds ratio (OR) of 1 (95 % CI: 0.96-1.03) and an adjusted OR of 1 (95 % CI: 0.97-1.04). The SHAI score showed a crude OR of 0.97 (95 % CI: 0.93-1.01) and an adjusted OR of 0.97 (95 % CI: 0.92-1.01). The BECK score had a crude OR of 0.99 (95 % CI: 0.96-1.03) and an adjusted OR of 1.02 (95 % CI: 0.98-1.06).
CONCLUSION: Patients undergoing mini-open CTR have a risk of 49 % of experiencing PP, which typically registers a pain intensity of approximately 3 points and will last for a median of 3 months. The likelihood of experience it does not depend on catastrophic thinking, depression, and health anxiety.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.