Comparative Analysis of Patient Perspectives on Surgical Centers: A Study of Carpal Tunnel Releases Performed At An Outpatient Surgery Center Versus Clinical Procedural Suite.

BACKGROUND: This study compares outcomes of carpal tunnel release (CTR) performed in a clinic procedural suite (PS) versus an ambulatory surgery center (ASC). CTR in the PS is performed using the wide-awake local anesthesia no tourniquet (WALANT) technique and does not require NPO compliance. In contrast, CTR in an ASC is performed in an operating room under either WALANT or monitored anesthesia care (MAC), the latter requiring preoperative NPO restrictions. Prior studies demonstrate that WALANT CTR performed in a PS is associated with significantly reduced in-house time, lower healthcare costs compared to MAC in the operating room (OR), less time off work, and similar patient satisfaction and infection rates. The purpose of this study was to compare patient outcomes between CTR performed in a PS versus an ASC.

METHODS: We performed a retrospective crosssectional study of adult patients who underwent isolated CTR by a single surgeon at an ASC or a PS between January 2022 and December 2023. Primary outcomes were validated patient-reported outcome measures, with secondary outcomes including demographics and time-based comparisons.

RESULTS: A total of 165 patients met inclusion criteria, including 29 who underwent WALANT CTR in a procedure suite and 136 who underwent CTR at an ASC. There were no significant differences in demographic characteristics or patient-reported outcome measures between groups. Patients treated at an ASC had significantly longer total in-house time compared with PS patients (mean difference 91.42 minutes; 95% CI, 76.72-106.13; p < 0.0001).

CONCLUSION: Carpal tunnel release performed in a PS optimizes access, efficiency, and cost while maintaining patient safety, satisfaction, and clinical outcomes comparable to those achieved in an ASC.

LEVEL OF EVIDENCE: IV.