Comparison of under general and local anesthesia in carpal tunnel release

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Journal of the Korean Society for Surgery of the Hand 2004;9(2):79-82.
Published online June 1, 2004.

Kwang-Hyun Lee, Hoon Yeo, Seong-Pil Lee, Joo-Hak Kim

전신 마취와 국소 마취 하에 시행한 수근관 감압술의 비교

이광현, 여훈, 이성필, 김주학, 정재홍

Abstract

Purpose
Although local anesthesia is commonly used for carpal tunnel release, many hand surgeons do under general anesthesia because of concerns regarding patient tolerance. We designed this retrospective study to assess the effect of different anesthesia techniques. Material and Methods: From Aug. 1999 to Sep. 2001, we performed open release under local anesthesia in 82 patients (92 wrists) (Group A). The local anesthetic (4∼6 ml of 1% lidocaine) was injected into the subcutaneous tissue and around the flexor retinaculum in the line of the incision and carpal tunnel. A pneumatic tourniquet was used around the upper arm in all cases and inflated for average 4 minutes and was well tolerated in all patients. Average 27 months postoperatively, we assessed pillar pain, tingling sensation, numbness, weakness, clumbsiness and edema. We used 0 to 10 scale with 0 as the worst score and 10 the best, and compared the result of 126 patients (137 wrists) who had underwent open release from May. 1991 to Sep. 2001 under general anesthesia or axillary block (Group B) with that of group A. Results: Overall satisfaction rate was 92.4% in group A. Average score for pillar pain was 9.7, tingling senstation 9.0, numbness 8.9, clumbsiness 9.1, weakness 9.3 and edema 9.2. In subjective symptoms, there was no statistical difference between two groups. Conclusion: If a surgeon had experimental skill, open release under local anesthesia could be performed safely and inexpensively in some outpatients.

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