Return to Functional Hand Use and Work Following Open Carpal Tunnel Surgery

This study assessed recovery from open carpal tunnel surgery. One hundred and twelve operations in 75 patients (38 unilateral, 37 bilateral) were reviewed prospectively. A validated questionnaire was completed pre- and postoperatively. Additional information was collected regarding symptom severity at regular intervals following surgery. The time to regain all evaluated activities of daily living was 13 (range 1–90, median 7) days. Return to driving took 9 days and return to work 17 days, even although exactly half of the patients underwent simultaneous bilateral operations. We did not find any significant differences in the time to resumption of activities of daily living or work between the patients who underwent unilateral or bilateral procedures, or between those who underwent surgery to the dominant or non-dominant hand. Overall improvement in symptoms and function was no worse in patients undergoing simultaneous bilateral procedures as compared with unilateral procedures.

Reducing the Pain Associated with Local Anaesthetic Infiltration for open Carpal Tunnel Decompression

This prospective, randomized study assessed the effectiveness of buffering lidocaine with sodium bicarbonate for reducing the pain associated with local anaesthetic infiltration for open carpal tunnel decompression. Twenty-one patients undergoing bilateral open carpal tunnel decompression received, in a randomized manner, lidocaine 1% with adrenaline (1:200,000) in one hand and the same local anaesthetic buffered with 8.4% NaHCO3 at a 5:1 ratio in the other hand. Pain, especially its burning element, was evaluated on a visual analogue scale and was significantly reduced with the buffered solution. The buffering was effective for all patients and no adverse effects were noted. This is a safe, easy and quick method for making open carpal tunnel surgery less uncomfortable to patients.