Pain in Carpal Tunnel Release Wide-awake Local Anesthesia With no Tourniquet vs Local Anesthesia With Tourniquet

Hospital Italiano de Buenos Aires

Status: Completed

Conditions: Carpal Tunnel Syndrome

Treatments: Procedure: Carpal tunnel release, WALANT technique; Procedure: Carpal tunnel release using a tourniquet

Study type: Interventional

Funder types: Other

Identifiers

NCT05747846

5857

Details and patient eligibility

About

The aim of this study is to compare pain, satisfaction, and experience between patients who underwent Carpal Tunnel Release with wide-awake local anesthesia no tourniquet technique and local anesthesia with a tourniquet.

Full description

The surgical pathology of the hand has grown exponentially. In most cases, the resolution is performed in outpatients with short surgical times. Given the increased demand for this type of surgery, surgeons have sought different variables to reduce the costs and human resources. Thus, the wide-awake local anesthesia no tourniquet procedure (WALANT). It deals with the non-need for anesthetic monitoring and with the regional use of anesthesia with epinephrine.

Its use avoids placing a pneumatic cuff on the arm owing to the vasoconstrictive action of epinephrine. However, the drug takes 25-30 minutes to achieve the maximum hemostatic effect, and adverse effects, such as distal necrosis, have been reported.

Therefore, the technique of local anesthesia without epinephrine with a tourniquet (LA-T) is also used daily by hand surgeons.

The use of a tourniquet, a pneumatic cuff, for less than 20 minutes has been associated with the same or lower pain profiles than the wide-awake local anesthesia no tourniquet without running the risk of adverse effects of epinephrine.

The objective of this study is to compare and assess pain and patient experience after short-duration hand surgery using the WALANT and LA-T techniques. The investigators hypothesized that both types of procedures had a similar level of satisfaction.

Enrollment: 82 patients

Sex: All

Ages: 18 to 100 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Carpal tunnel syndrome with surgical resolution
• Surgical procedures takes less than 30 minutes

Exclusion criteria

• Lost follow-up

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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82 participants in 2 patient groups

wide-awake local anesthesia no tourniquet

Active Comparator group

Description:

Patients will be operated under local anesthesia without a tourniquet (WALANT technique)

Treatment:

Procedure: Carpal tunnel release, WALANT technique

Tourniquet

Active Comparator group

Description:

Patients will be operated under local anesthesia with the use of a tourniquet

Treatment:

Procedure: Carpal tunnel release using a tourniquet