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

Not Applicable

Completed

• Conditions: Carpal Tunnel Syndrome
• Interventions: Procedure: Carpal tunnel release, WALANT technique; Procedure: Carpal tunnel release using a tourniquet

• Registration Number: NCT05747846
• Lead Sponsor: Hospital Italiano de Buenos Aires

Brief Summary

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.

Detailed 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.

Study Timeline

• Study Start: 2020-12-15
• Study First Submitted: 2023-01-25
• Study First Submitted QC: 2023-02-26
• Study First Posted: 2023-02-28
• Status Verified: 2023-08
• Primary Completion: 2023-08-07
• Study Completion: 2023-08-26
• Last Update Submitted: 2023-08-26
• Last Update Posted: 2023-08-29

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 82

Inclusion Criteria

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

Exclusion Criteria

• Lost follow-up

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
wide-awake local anesthesia no tourniquet	Carpal tunnel release, WALANT technique	Patients will be operated under local anesthesia without a tourniquet (WALANT technique)
Tourniquet	Carpal tunnel release using a tourniquet	Patients will be operated under local anesthesia with the use of a tourniquet

Primary Outcome Measures

Name	Time	Method
Pain during surgery	Immediately after surgery	Visual analog scale. A numerical scale from 0 to 10 (a higher score means the worst outcome), where 0 indicates no pain, and 10 indicates the worst pain possible.

Trial Locations

Locations (1)

Hospital Italiano; 🇦🇷 Buenos Aires, Argentina