Libertação do Nervo Medianono Canal Cárpico com BloqueioLocorregional do Punho

Ana Esteves; Nuno Silva; Pedro Ribeiro; Sara Lima; João das Dores Carvalho

Authors

Ana Esteves Serviço de Ortopedia e Traumatologia do Centro Hospitalar Tâmega e Sousa, Porto, Portugal Author https://orcid.org/0000-0003-4418-4983
Nuno Silva Serviço de Ortopedia e Traumatologia do Centro Hospitalar Tâmega e Sousa, Porto, Portugal Author
Pedro Ribeiro Serviço de Ortopedia e Traumatologia do Centro Hospitalar Tâmega e Sousa, Porto, Portugal Author
Sara Lima Serviço de Ortopedia e Traumatologia da Unidade Hospitalar de Famalicão, Braga, Portugal Author
João das Dores Carvalho Serviço de Ortopedia e Traumatologia do Centro Hospitalar Tâmega e Sousa, Porto, Portugal Author

Keywords:

Anesthesia, Local, Carpal Tunnel Syndrome/surgery, Nerve Block

Abstract

Introduction: Carpal tunnel syndrome is the most common form of nerve compression, and its treatment is almost always surgical with the release of the median nerve. However, there is still no consensus on the type of anesthesia used for this procedure. This study aimed to evaluate whether wrist block represents a valid alternative to local anesthesia.
Methods: To that end, 40 patients indicated for surgical release of the carpal tunnel were selected and divided into two groups (Group 1 ‐ underwent carpal tunnel release with local anesthesia; Group 2 ‐ locoregional block). They were assessed for pain at the surgical incision site ‐ intraoperatively, in the postoperative period, and after one month of follow‐up ‐ as well as for functional evaluation and occurrence of complications. In terms of local pain, it was significantly greater (p<0.05) in patients from Group 1.
Results: Regarding functional assessment, Group 2 showed better results with respect to the Quick Dash score (p<0.05). Complications occurred only in Group 1 (p<0.05).
Conclusion: With this study, we were able to demonstrate that wrist anesthetic block is a valid alternative method to local anesthesia.

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References

Moreira SB, Chagas DC, Yamashita CT. Ultrasound‐Guided WALANT Technique in Carpal Tunnel Decompression Surgery. Rev Bras Ortop. 2021;58:538‐42. doi: 10.1055/s‐0041‐1735172.

Chang CY, Beduschi MG, Pacheco TA, de M Chang CC. Carpal tunnel syndrome: retrospective analysis of 60 consecutive cases of ambula‐ tory surgical treatment with local anesthesia. Hand. 2020;15:509‐13. doi: 10.1177/1558944718813721.

Kurtzman JS, Etcheson JI, Koehler SM. Wide‐awake Local Anesthe‐ sia with No Tourniquet: An Updated Review. Plast Reconstr Surg Glob Open. 2021;9:e3507. doi: 10.1097/GOX.0000000000003507.

Delaunay L, Chelly JE. Blocks at the wrist provide effective anesthe‐ sia for carpal tunnel release. Can J Anaesth. 2001;48:656‐60. doi: 10.1007/BF03016199.

Gebhard RE, Al‐Samsam T, Greger J, Khan A, Chelly JE. Distal nerve blo‐ cks at the wrist for outpatient carpal tunnel surgery offer intraopera‐ tive cardiovascular stability and reduce discharge time. Anesth Analg. 2002;95:351‐5. doi: 10.1097/00000539‐200208000‐00020.

Tsuda PS, Du AL, Gabriel RA, Curran BP. Outcomes following distal ner‐ ve blocks for open carpal tunnel release: a single‐institution retrospec‐ tive study. Cureus. 2023;15:e41258. doi: 10.7759/cureus.41258.

Droog W, Lin DY, van Wijk JJ, Ho‐Asjoe RC, Coert JH, Stolker RJ, et al. Is It the Surgery or the Block? Incidence, Risk Factors, and Outcome of Ner‐ ve Injury following Upper Extremity Surgery. Plast Reconstr Surg Glob Open. 2019;7:e2458. doi: 10.1097/GOX.0000000000002458.

Orhurhu V, Orman S, Peck J, Urits I, Orhurhu MS, Jones MR, et al. Car‐ pal Tunnel Release Surgery‐ A Systematic Review of Open and Endosco‐ pic Approaches. Anesth Pain Med. 2020;10:e112291. doi: 10.5812/ aapm.112291.