Median and ulnar nerve block for endoscopic carpal tunnel release

2006 ◽  
Vol 23 (6) ◽  
pp. 902-904 ◽  
Author(s):  
Tolga Tuzuner
Keyword(s):  
Ulnar Nerve ◽  
Nerve Block ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Endoscopic Carpal Tunnel Release

Endoscopic Carpal Tunnel Release: A Retrospective Study of the Modified Okutsu Technique Using Glass Tubes

Hand Surgery ◽  
1997 ◽  
Vol 02 (02) ◽  
pp. 123-127
Author(s):  
TM Tsai ◽  
M. Favetto ◽  
R. Elluru
Keyword(s):  
Retrospective Study ◽  
Grip Strength ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Patient Questionnaire ◽  
Endoscopic Carpal Tunnel Release ◽  
Glass Tubes

We evaluated 108 endoscopically assisted carpal tunnel releases in 90 patients in a retrospective study to determine the efficiency and safety of a modified Okutsu endoscopic carpal tunnel release (ECTR) technique. The modification consisted of the use of glass tubes 5, 7, and 9 mm in diameter and a sharp tipped hook knife. The results were evaluated using a patient questionnaire, time off from work, grip strength, and two point discrimination. Symptoms were resolved in 71% of the patients, improved in 19.4%, and not improved in 9.3%. In this series, 59 patients were gainfully employed: 84.7% returned to work, half within 2 weeks of surgery. Severe complications included one laceration of the ulnar nerve, and one neuroma in continuity of the median nerve. ECTR using this modification of Okutsu's technique is effective in the relief of symptoms and returning patients to work quickly.

Experiences with Endoscopic Carpal Tunnel Release

Swiss Surgery ◽  
2002 ◽  
Vol 8 (4) ◽  
pp. 181-185
Author(s):  
Buchli ◽  
Scharplatz
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Endoscopic Carpal Tunnel Release ◽  
Endoskopische Karpaltunnelspaltung

Im Spital Thusis wurden zwischen 1994 und 2000 122 Patienten wegen eines Karpaltunnelsyndroms operiert. Wir wollten wissen, ob die endoskopische Karpaltunnelspaltung in einem Regionalspital mit genügend hoher Sicherheit angewandt wurde und ob die Ergebnisse mit der offenen Karpaltunnelspaltung vergleichbar sind. In einer retrospektiven Studie konnten wir 82 Patienten mittels Fragebogen über das Operationsergebnis befragen. 39 Patienten wurden offen operiert, 26 mittels der Zweipfortentechnik nach Chow und 17 mittels Einpfortentechnik nach Agee. Schwere irreversible Komplikationen wurden nicht beobachtet. Bezüglich der Operationsergebnisse zeigten sich keine signifikanten Unterschiede in den drei Gruppen. Von den 39 offenen Karpaltunnelspaltungen klagten neun Patienten über Restbeschwerden, wobei es zu einer Reoperation wegen einer Thenarastverletzung kam. Bei den 26 endoskopischen Karpaltunnelspaltungen in Zweipfortentechnik traten bei acht Patienten Restbeschwerden auf, wobei eine Reoperation wegen exzessiver Vernarbung durchgeführt werden musste. Bei den 17 Operationen nach Agee hatten fünf Patienten Restbeschwerden, es musste jedoch keiner reoperiert werden. Die Studie zeigt, dass mit den drei unterschiedlichen Operationsverfahren bezüglich Sicherheit und Therapieerfolg vergleichbare Resultate erreicht wurden. Vorteile wegen dem atraumatischeren Zugang der endoskopischen Techniken konnten wir jedoch nicht objektivieren.

WALANT Technique versus Sedation for Endoscopic Carpal Tunnel Release

Hand ◽  
2021 ◽  
pp. 155894472110031
Author(s):  
Ian Wellington ◽  
Antonio Cusano ◽  
Joel V. Ferreira ◽  
Anthony Parrino
Keyword(s):  
Local Anesthesia ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Postanesthesia Care Unit ◽  
Complication Rates ◽  
Endoscopic Carpal Tunnel Release ◽  
Average Operating ◽  
Wide Awake ◽  
No Tourniquet ◽  
Room Time

Background This study sought to investigate complication rates/perioperative metrics after endoscopic carpal tunnel release (eCTR) via wide-awake, local anesthesia, no tourniquet (WALANT) versus sedation or local anesthesia with a tourniquet. Methods Patients aged 18 years or older who underwent an eCTR between April 28, 2018, and December 31, 2019, by 1 of 2 fellowship-trained surgeons at our single institution were retrospectively reviewed. Patients were divided into 3 groups: monitored anesthesia care with tourniquet (MT), local anesthesia with tourniquet (LT), and WALANT. Results Inclusion criteria were met by 156 cases; 53 (34%) were performed under MT, 25 (16%) under LT, and 78 (50%) under WALANT. The MT group (46.1 ± 9.7) was statistically younger compared with LT (56.3 ± 14.1, P = .007) and WALANT groups (53.5 ± 15.8, P = .008), F(2, 153) = 6.465, P = .002. Wide-awake, local anesthesia, no tourniquet had decreased procedural times (10 minutes, SD: 2) compared with MT (11 minutes, SD: 2) and LT (11 minutes, SD: 2), F(2, 153) = 5.732, P = .004). Trends favored WALANT over MT and LT for average operating room time (20 minutes, SD: 3 vs 32 minutes, SD: 6 vs 23 minutes, SD: 3, respectively, F(2, 153) = 101.1, P < .001), postanesthesia care unit time (12 minutes, SD: 7 vs 1:12 minutes, SD: 26 vs 20 minutes, SD: 22, respectively, F(2, 153) =171.1, P < .001), and door-to-door time (1:37 minutes, SD: 21 vs 2:51 minutes, SD: 40 vs 1:46 minutes, SD: 33, respectively, F(2, 153) = 109.3, P < .001). There were no differences in complication rates. Conclusions Our data suggest favorable trends for patients undergoing eCTR via WALANT versus MT versus LT.

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