http://austinpublishinggroup.com/musculoskeletal-disorders/fulltext/ajmd-v4-id1043.php
Carpal tunnel syndrome (CTS) is a common neuropathy, affecting
the median nerve as it passes under the transverse carpal ligament. CTS is
described as a nerve compression at the wrist plane, CTS causes numbness and
tingling in the hand and fingers. Sir James Paget defined CTS first in1853, and
since then, in the 1950s a scientist named George Phalen popularized the diagnosis
and treatment of CTS. The aetiology of CTS is considered idiopathic in most
cases but it is still controversial. Conservative treatment consists of splinting or corticosteroid
injections and surgical release of the carpal tunnel are the treatment method
options. There has been continued debate over the optimal management of this
disease. Decision of the surgeon has consistently varied.
Carpal tunnel release (CTR) is known as an effective treatment
for idiopathic CTS. CTR is performed with a variety of techniques such as
endoscopic (ECTR) or open (OCTR). Literature has not got consensus on the
superiority of any one technique to another. Local anaesthesia (LA) and general anaesthesia (GA) are
anaesthetic options on the surgical treatment of CTS. LA is safe, fast, and
effective, but the injection could be painful. In one recent series, about 10%
of patients indicated that they would prefer another form of anaesthesia. When
applying the local anaesthetics under the skin patient could have pain and pain
could make the patient uncomfortable. Also from the surgeon side discomfort of
the patient could affect the surgical procedure and sometimes visualization of
the surgical area could be difficult due to oedema caused by local
anaesthetics. These problems in surgical procedure could affect the clinical
results of the surgery. Sedation or GA could make the procedure more comfortable.
The aim of the present study was to compare the effects of the
anaesthetic methods on the patient’s clinical results. To our knowledge this is
the first report that compares the clinical outcomes of the open CTR with GA or
LA. Computerized patient database was searched to identify all
patients with CTS who underwent open CTR between January 2009 and January 2013
at Fatih Sultan Mehmet Training and Research Hospital. The year 2013 was
selected to ensure a minimum one-year follow-up. At the result of the search
total of 148 patients (169 CTS hands) were found. Of the 148 patients (169 CTS hands) 21 patients were operated
bilaterally and excluded from study. Of the 127 patient operated monolaterally.
One patient died from another reason and 14 patients was not available and
excluded from the study. Fifty five patients operated with GA (group A) and 57
patients with LA (group B). The last available 50 monolateral patient operated
by the same surgeon for each group included to the study.
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