Endoscopic Carpal Tunnel Release with and without Sedation

Background: This study evaluates outcomes and complications with endoscopic carpal tunnel release (eCTR) performed with local anesthesia (LOCAL) only versus local anesthesia with sedation (SEDATION). We hypothesize that patient outcomes and satisfaction will be equivalent in both groups irrespective of anesthesia type. Methods: One hundred fifty-four consecutive patients undergoing eCTR with either LOCAL or SEDATION protocols were prospectively enrolled in a study of satisfaction and outcomes. The patients were surveyed preoperatively and at 2-weeks and 3-months postoperatively to evaluate satisfaction, symptoms, complications, and disability using the QuickDASH survey, the Levine-Katz carpal tunnel survey, and a customized LIKERT scale. Results: The hypothesis was upheld. Both groups of patients reported high levels of satisfaction (96% in LOCAL and 93% in SEDATION groups at 3 weeks). Disability, pain, and symptom scores did not differ significantly between groups at either postoperative time point. Following surgery, patients in the SEDATION group recalled more mean preoperative anxiety (4/10 versus 2.03/10 at 3 months). If they were to undergo the surgery again, patients in the SEDATION group were likely to desire either sedation (68%) or general anesthesia (29%) while patients in the LOCAL group were likely to wish for similar local-only anesthesia (78%). There were no reoperations or epinephrine-related complications in either group. Conclusions: Patients undergoing eCTR experience similar levels of satisfaction and outcomes with LOCAL and SEDATION protocols. The findings of this study confirm that both methods of anesthesia provide excellent results and allow for surgeons and patients to choose freely between the two anesthetic techniques. Financial Disclosure Statement: The authors have nothing to disclose. No funding was received for this research. Presented at: American Society for Surgery of the Hand annual meeting 2016 in Austin, TX, USA Author contributions: Tulipan: Data gathering, data analysis, manuscript preparation Kim: Data gathering, data analysis, manuscript preparation Ilyas: Data gathering, data analysis, manuscript preparation Matzon: Data gathering, data analysis, manuscript preparation This study was approved by the institutional review board at Thomas Jefferson University *CORRESPONDING AUTHOR: Jacob Tulipan, MD, 1025 Walnut St, Suite 516 College, Philadelphia, PA, United States. (215) 955-1500, (215) 503-0530, Jacob.tulipan@gmail.com ©2017American Society of Plastic Surgeons