The impact of WALANT anesthesia and office-based settings on patient satisfaction after carpal tunnel release: a patient reported outcome study

2021 ◽  
pp. 103134
Author(s):  
Lara Moscato ◽  
Adel Helmi ◽  
Pascal Kouyoumdjian ◽  
Donald Lalonde ◽  
Olivier Mares
Keyword(s):  
Patient Satisfaction ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Patient Reported Outcome ◽  
Outcome Study ◽  
Patient Reported ◽  
The Impact

Comparison of Patient-Reported Outcomes between Two Different Techniques of Carpal Tunnel Release: Classical Incision versus Minimal Incision

2020 ◽  
Author(s):  
Sajad Heidari ◽  
Alireza Taabbod ◽  
Mahmoud Farzan ◽  
Sadegh Saberi ◽  
Mitra Ashrafi
Keyword(s):  
Patient Satisfaction ◽  
Carpal Tunnel ◽  
Patient Reported Outcomes ◽  
Carpal Tunnel Release ◽  
Symptom Relief ◽  
Visual Analogue Score ◽  
Minimal Incision ◽  
Significant Difference ◽  
Patient Reported ◽  
One Year

Background: Carpal tunnel syndrome (CTS) is the most common compression neuropathy in the upper limb which needs surgery in many cases. Two common surgical incisions for carpal tunnel release (CTR) are classical incision and minimal incision. In this survey, the aim is to compare patient-reported outcomes of these two types of incisions. Methods: In this retrospective study, patients with CTS who underwent two different approaches for CTR (classical or minimal) during one year were included. The diagnosis was confirmed clinically and by electrodiagnostic studies. The patients were categorized into two groups regarding the type of surgery. At the 12-month visit, the patients were assessed for functional outcome, level of the pain, and satisfaction with Quick Disability of Arm, Hand and Shoulder score (QuickDASH), the visual analogue score (VAS) scale, and the scar appearance and symptom relief, respectively. Results: 39 patients were entered in this study, 3 of who had bilateral symptoms. The 42 operated hands were divided into two groups: classical incision group (n = 21) and minimal incision group (n = 21). No significant difference was discovered between the two groups considering age and sex. In addition, no significant difference was found in the variables evaluated between the two groups, except for the higher patient satisfaction with the scar appearance in minimal incision group after 12 months. Conclusion: After a one-year period, the minimal incision procedure had no priority to classical incision procedure, except for higher patient satisfaction considering the scar appearance.

scholarly journals Open carpal tunnel release and diabetes: a retrospective study using PROMs and national quality registries

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030179 ◽  
Author(s):  
Malin Zimmerman ◽  
Katarina Eeg-Olofsson ◽  
Ann-Marie Svensson ◽  
Mikael Åström ◽  
Marianne Arner ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Patient Reported Outcome ◽  
Residual Symptoms ◽  
Link Type ◽  
National Quality ◽  
Patient Reported ◽  
Patients With Diabetes ◽  
Open Carpal Tunnel Release

ObjectivesTo study patient-reported outcome after open carpal tunnel release (OCTR) for carpal tunnel syndrome (CTS) in patients with or without diabetes using national healthcare quality registries.DesignRetrospective cohort study.SettingData from the Swedish National Quality Registry for Hand Surgery (HAKIR;www.hakir.se) were linked to data from the Swedish National Diabetes Register (NDR;www.ndr.nu).ParticipantsWe identified 9049 patients (10 770 hands) operated for CTS during the inclusion period (2010–2016).Primary outcome measuresPatient-reported outcome measures were analysed before surgery and at 3 and 12 months postoperatively using the QuickDASH as well as the HAKIR questionnaire with eight questions on hand symptoms and disability.ResultsPatients with diabetes (n=1508; 14%) scored higher in the QuickDASH both preoperatively and postoperatively than patients without diabetes, but the total score change between preoperative and postoperative QuickDASH was equal between patients with and without diabetes. The results did not differ between patients with type 1 or type 2 diabetes. Patients with diabetic retinopathy scored higher in QuickDASH at 3 months postoperatively than patients with diabetes without retinopathy. In the regression analysis, diabetes was associated with more residual symptoms at 3 and 12 months postoperatively.ConclusionsPatients with diabetes experience more symptoms both before and after OCTR, but can expect the same relative improvement from surgery as patients without diabetes . Patients with retinopathy, as a proxy for neuropathy, may need longer time for symptoms to resolve after OCTR. Smoking, older age, higher HbA1c levels and receiving a diabetes diagnosis after surgery were associated with more residual symptoms following OCTR.

The Effect of Hand Dominance on Patient-Reported Outcomes of Carpal Tunnel Release in Patients with Bilateral Carpal Tunnel Syndrome

2017 ◽  
Vol 22 (03) ◽  
pp. 303-308
Author(s):  
Qian Ying TANG ◽  
Wei Hong LAI ◽  
Shian Chao TAY
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Complete Resolution ◽  
Carpal Tunnel Release ◽  
Patient Reported Outcome ◽  
Dominant Hand ◽  
Hand Dominance ◽  
Significant Difference ◽  
Patient Reported ◽  
Tunnel Syndrome

Background: There is a paucity of studies in published literature that examines the effect of hand dominance on the resolution of symptoms following a carpal tunnel release. The objective of this study is to examine the effect of hand dominance on the resolution of symptoms following surgical decompression in patients with severe and moderate carpal tunnel syndrome. Methods: Bilateral carpal tunnel release (total 90 open and 84 endoscopic) was performed on 87 patients (11 males, 76 females) presenting with bilateral severe or moderate carpal tunnel syndrome of equal severity. Patient-reported outcome of resolution of symptoms were recorded, with patients followed up until complete resolution of symptoms or last recorded consultation (mean follow-up duration 11.4 months, range 3.1 to 32.4 months). Results: In patients with bilateral severe carpal tunnel syndrome, a larger proportion of non-dominant hand (75.4%) achieved complete resolution compared to dominant hand (72.1%), and did so at a statistically shorter time (mean: 52.3 days) than the dominant hand (mean: 81.0 days). However, there was no statistically significant difference between proportion of patients and time taken before complete resolution of symptoms between dominant and non-dominant hand in patients with bilateral moderate carpal tunnel syndrome. Conclusions: Symptoms in the non-dominant hand resolved faster after carpal tunnel release in patients with severe carpal tunnel syndrome. We postulate that greater daily activity by the dominant hand compared to the non-dominant hand may be a contributing factor to its slower rate of symptoms resolution post-surgically in patients with bilateral severe carpal tunnel syndrome. This effect of hand dominance is not evident in post-surgical patients with moderate carpal tunnel syndrome.

The impact of tourniquet on patient satisfaction in carpal tunnel decompression

Open Medicine ◽  
2007 ◽  
Vol 2 (2) ◽  
pp. 222-226 ◽  
Author(s):  
Kamal Nagpal ◽  
Mohammed Gossiel ◽  
Hari Kumar
Keyword(s):  
Patient Satisfaction ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Clinical History ◽  
Apparent Difference ◽  
Significant Difference ◽  
Tunnel Syndrome ◽  
Without Tourniquet ◽  
Time Of Operation ◽  
The Impact

AbstractRelease of the transverse carpal ligament can be performed safely under local anesthesia and without the use of tourniquet. There are conflicting reports for the use of tourniquet in carpal tunnel syndrome. The aim of the study was to compare the patient satisfaction with and without tourniquet in patients with carpal tunnel decompression. This was a retrospective study performed in twenty-four patients who underwent bilateral carpal tunnel decompression. All the patients were diagnosed using a combination of clinical history, clinical tests and EMG recordings.One side was operated with use of tourniquet and other side without. Patient evaluation measure was used to assess the satisfaction score. A telephonic interview was conducted and patients were asked the questions regarding discomfort caused by tourniquet. The results demonstrated that there was a significant difference in discomfort at the tourniquet site at the time of operation (p<0.00017). Long term, there was no apparent difference in functional outcome of patients operated on with or without tourniquet. There was also no significant difference in subjective sensation, grip or use of hand in patients who underwent carpal tunnel release with or without tourniquet. We conclude that we should not use tourniquet in carpal tunnel decompression.

Optimizing electronic capture of patient-reported outcome measures in oncology clinical trials: lessons learned from a qualitative study

2020 ◽  
Vol 9 (17) ◽  
pp. 1195-1204
Author(s):  
Florence D Mowlem ◽  
Brad Sanderson ◽  
Jill V Platko ◽  
Bill Byrom
Keyword(s):  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Lessons Learned ◽  
Structured Interviews ◽  
Patient Reported ◽  
Oncology Clinical Trials ◽  
Anticancer Treatment ◽  
Fit For Purpose ◽  
The Impact ◽  
Electronic Implementation

Aim: To understand the impact of anticancer treatment on oncology patients’ ability to use electronic solutions for completing patient-reported outcomes (ePRO). Materials & methods: Semi-structured interviews were conducted with seven individuals who had experienced a cancer diagnosis and treatment. Results: Participants reported that the following would impact the ability to interact with an ePRO solution: peripheral neuropathy of the hands (4/7), fatigue and/or concentration and memory issues (6/7), where they are in a treatment cycle (5/7). Approaches to improve usability included: larger, well-spaced buttons to deal with finger numbness, the ability to pause a survey and complete at a later point and presenting the recall period with every question to reduce reliance on memory. Conclusion: Symptoms associated with cancers and anticancer treatments can impact the use of technologies. The recommendations for optimizing the electronic implementation of patient-reported outcome instruments in this population provides the potential to improve data quality in oncology trials and places patient needs at the forefront to ensure ‘fit-for-purpose’ solutions.

scholarly journals Development of a patient-reported outcome measure for neck pain in military aircrew: qualitative interviews to inform design and content

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e039488
Author(s):  
Anna Dowling ◽  
Ellen Slungaard ◽  
Nicola R Heneghan
Keyword(s):  
Neck Pain ◽  
Outcome Measure ◽  
Physical Symptoms ◽  
Patient Reported Outcome ◽  
Direct Access ◽  
Specific Patient ◽  
Concept Elicitation ◽  
Patient Reported Outcome Measure ◽  
Patient Reported ◽  
The Impact

IntroductionThe prevalence of flight-related neck pain is 70% in UK fast jet pilots; much higher than the general population. The Aircrew Conditioning Programme and direct access physiotherapy exist to minimise the impact on military capability, but a population specific patient-reported outcome measure (PROM) is required to investigate the effectiveness of these. We aimed to explore the experiences of flight-related neck pain to inform the content validity and development of a population specific PROM.MethodsQualitative semistructured interviews combining phenomenological and grounded theory methods, reported using Consolidated criteria for Reporting Qualitative research guidelines. A purposive sample of 10 fast jet pilots with neck pain was recruited. Concept elicitation interviews were audio recorded, transcribed verbatim along with field notes. Data analysis involved subject and methodological expertise used a concept elicitation approach.ResultsParticipants included 10 male fast jet pilots, age 34.7 years. Identified themes included: (1) physical symptoms associated with flying activities; (2) occupational effects revealed modifications of flying, or ‘suboptimal’ performance owing to neck pain; (3) psychological effects revealed feelings or worry and (4) social and activity effects showed impact on out of work time.ConclusionPopulation-specific occupational, psychological and social factors should be considered alongside physical symptoms when managing neck pain in military aircrew. Findings support the development of a PROM specifically designed for military aircrew with neck pain.

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